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Temporomandibular Disorders in Association With Scuba Diving

Koob, Andreas Dr Med Dent*; Ohlmann, Brigitte Dr Med Dent*; Gabbert, Olaf Dent*; Klingmann, Christoph Dr Med; Rammelsberg, Peter Prof Dr Med Dent*; Schmitter, Marc Dr Med Dent*

Clinical Journal of Sport Medicine: September 2005 - Volume 15 - Issue 5 - p 359-363
doi: 10.1097/01.jsm.0000181435.03151.ab
Brief Report

Objective: To determine the prevalence of temporomandibular disorders (TMD) in scuba divers and to identify the risk factors for the development of pain in the stomatognathic system before and after diving by the use of a questionnaire.

Design: Retrospective cohort study based on questionnaires.

Participants: A total of 296 active divers, aged 18 to 65 years, participating in scuba diving meetings in Heidelberg, Germany.

Interventions: Each diver answered a questionnaire containing 29 questions, predominantly on symptoms of TMD.

Main Outcome Measures: The data collected from the divers were calculated by the use of logistic regression tests. Risk factors for the development of TMD were evaluated.

Results: Clenching seemed to be the greatest risk factor for pain while holding the mouthpiece and for pain in the masticatory muscle system after diving. Limited mouth opening and clenching were responsible for the development of pain in the temporomandibular joint after the dive. The prevalence of TMD-related symptoms was higher in women before, during, and after the dive.

Conclusions: Individuals exhibiting TMD-related symptoms seem to be at the greatest risk of developing pain in the masticatory muscle system and/or the temporomandibular joint during or after the dive.

From the *Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany; and †Department of Otorhinolaryngology, University of Heidelberg, Heidelberg, Germany.

Received for publication November 2004; accepted July 2005.

Reprints: Marc Schmitter, Dr Med Dent, University of Heidelberg, Germany, Poliklinik für Zahnärztliche Prothetik Im Neuenheimer Feld 400 69120 Heidelberg, Germany (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.