Painful yawning and temporomandibular disorder: a cross-sectional study among Italian patients

Objective: Orofacial pain is a common symptom associated with various conditions, including temporomandibular disorders (TMD). Painful yawning, a form of orofacial pain, may be related to TMD, though no studies have conclusively established this connection. This study aimed to examine the relationship between painful yawning and TMD and to investigate factors influencing the occurrence of painful yawning in both TMD and non-TMD populations. Methods: A cross-sectional study was conducted at the Clinica di Chirurgia Maxillofacciale e Odontostomatologica di Trieste, Italy, between January 2018 and June 2021. Data were collected using a self-administered questionnaire. Bivariate analysis was used to compare means between various variables and the presence of painful yawning. Binary logistic regression was performed to confirm associations between independent variables and painful yawning and to quantify the strength of these relationships in terms of odds ratios and confidence intervals. Results: A total of 1,725 patients participated, with a mean age of 50 years, and 61.4% were females. 16% of the population had TMD. Painful yawning was significantly more common among the TMD group (49%) compared to the non-TMD group (14.2%). Bivariate analysis revealed significant associations between painful yawning and age, sex, TMD status, and yawning frequency (p < 0.05). A strong association was observed between painful yawning and TMD (Cramér’s V = 0.32), with moderate associations with sex (Cramér’s V = 0.144) and yawning frequency (Cramér’s V = 0.176). Binary logistic regression confirmed its relationship with female sex, TMD presence, and frequent yawning. TMD increased the likelihood of painful yawning by six times, while frequent yawning increased the risk by five times, and female sex doubled the risk. Conclusion: The study demonstrates a significant association between TMD and painful yawning, suggesting that painful yawning could serve as a potential indicator for early TMD detection, which warrants further validation. Additionally, factors such as sex and yawning frequency were found to increase the likelihood of painful yawning, irrespective of TMD status.