Tooth Wear, Temporomandibular Disorders, Cervical Proprioception and Posture in Men Receiving Opioid Maintenance Treatment With Polysubstance Use History: A Case – Control Study

OBJECTIVE: Substance use disorder (SUD) may contribute to tooth wear and temporomandibular disorders (TMDs), particularly in individuals undergoing opioid maintenance treatment (OMT). The primary aim of this study was to compare TMD-related clinical characteristics, including pain sensitivity, TMD presence, and tooth wear, between men in OMT and healthy controls. MATERIALS AND METHODS: This study included 37 males in OMT with a polysubstance use history and 37 controls. All participants underwent evaluation of pressure-pain thresholds (PPT), pain tolerance, and neck position sense. Presence of TMDs and tooth wear was evaluated by a maxillofacial surgeon. Severity of TMDs, posture, depression, and sleep quality were quantified using the Fonseca Anamnestic Index (FAI), New York Posture Rating Scale (NYPR), the Beck Depression Inventory (BDI), and the Pittsburgh Sleep Quality Index (PSQI), respectively. RESULTS: Cervical proprioception differed significantly between groups (p < 0.001). Upper trapezius PPT and pain tolerance were lower in the OMT Group (p < 0.05). Tooth wear, TMD severity, sleep disturbance, and depression scores were higher, whereas posture scores were lower in the OMT group (p < 0.001). CONCLUSION: These findings support a comprehensive multidisciplinary assessment of oral, musculoskeletal, and psychosocial factors in individuals in OMT with a polysubstance use history.