Temporomandibular Disorders, Work Productivity, and Activity Impairment: A Cohort Study Using a Claims and Survey Database in Japan

BACKGROUND: Temporomandibular disorders (TMDs) are prevalent musculoskeletal conditions worldwide. However, their societal and productivity burden remains poorly understood. OBJECTIVE: Using a claims and survey database, this 3-year cohort study investigated the association between TMD diagnosis and work productivity and activity impairment (WPAI) among Japanese workers. METHODS: We identified TMD diagnoses (exposure) using claims data and assessed the WPAI (outcome) using a validated questionnaire. A two-part model was used to examine the association between TMD diagnosis around the survey period and WPAI outcomes. The first part employed a logistic regression model to estimate the odds ratio (OR) and 95% confidence interval (CI) for impairments in WPAI outcomes. The second part utilized a generalized linear model with a gamma distribution and a log-link function to estimate the exponentiated coefficients (mean ratio) and 95% CI for the magnitude of impairment among those reporting impairment in WPAI outcomes. RESULTS: The analysis included 18 570 participants (mean age: 49.0 [standard deviation = 9.1] years; 65.7% male). After adjusting for all covariates, workers with TMD showed higher odds of impairment across all WPAI indicators than those without (OR: absenteeism, 1.31 [95% CI, 0.80-2.13]; presenteeism, 1.34 [0.97-1.85]; overall work impairment, 1.42 [1.03-1.96]; and activity impairment, 1.51 [1.10-2.08]). Among workers reporting any impairment in WPAI outcomes, TMD was not associated with WPAI severity. CONCLUSION: Workers with TMD diagnosis more often reported overall work and activity impairments. The observed association may inform future research on the impact of TMD on WPAI outcomes.