Association between primary Sjögren’s disease and temporomandibular disorder in Taiwan: a 15-year nationwide cohort, with an exploratory analysis of hydroxychloroquine

The relationship between primary Sjögren’s disease (pSjD) and temporomandibular disorder (TMD) has received little attention in previous studies. Therefore, we investigated this association using data from a large, population-based cohort. This retrospective cohort study analyzed data from Taiwan’s Longitudinal Generation Tracking Database for the period 2000–2015. Patients with pSjD (n = 36,195) were compared with matched controls (n = 144,780). Cox regression analysis estimated the risk of TMD, adjusting for comorbidities and medication exposure. pSjD was significantly associated with an increased risk of TMD (adjusted hazard ratio [aHR] = 1.921, 95% confidence interval = 1.39–2.58, p < 0.001). In secondary analyses, differences in observed incidence were noted across HCQ exposure groups. However, these findings should be interpreted cautiously due to potential confounding by indication and database limitations. This nationwide cohort study demonstrates a significant association between pSjD and subsequent TMD development. Findings related to HCQ exposure require further investigation in prospective studies.