A self administered questionnaire that

A self-administered questionnaire that includes the Fonseca’s anamnestic index (FAI) has been proposed as a low-cost, easily applied alternative TMD assessment tool for the non-patient paricalcitol (Da Fonseca et al., 1994). The use of FAI for detecting TMD signs and symptoms offers the advantage of being easily used by either general practitioners or epidemiologists. Thus, the FAI would serve as a preliminary TMD screening tool. After the affected population is identified, a more thorough investigation can be conducted, which would include a complete clinical examination and use of diagnostic instruments to confirm the diagnosis. In a literature review regarding the reliability of using a questionnaire for assessing the severity of TMDs, Campos and colleagues (2009) recommended the use of FAI because of its simplicity, speed, and cost effectiveness. The questionnaire also provides a severity index with less influence from the examiner and less variability in the measures (Nomura et al., 2007; de Oliveira et al., 2006). Fonseca’s questionnaire follows the characteristics of a multidimensional evaluation. It is composed of 10 questions that screen for the presence of pain in the TMJ, head, and back; pain while chewing; parafunctional habits; movement limitations; joint clicking; perception of malocclusion; and sensation of emotional stress (Da Fonseca et al., 1994).
Psychological factors are known to play a role in the etiology and persistence of TMDs. In particular, a high incidence of exposure to stressful life events and elevated levels of anxiety and stress-related symptoms have been reported in TMD patients (Pesqueira et al., 2010; Pallegama et al., 2005). Anxiety and depression are the most frequent clinical disorders in the general population and are highly present among university students. The repercussions of academic stress on the health of university students have been reported in the literature (Bonjardim et al., 2009). The university setting provides an ideal context for studying the mental health of young adults. University students are often undergoing role transitions, such as moving away from the family home for the first time, residing with other students, and experiencing reduced adult supervision. These changes may increase the risk of depression (Bonjardim et al., 2009; Pesqueira et al., 2010).

Methods

Results
Of 600 questionnaires distributed, 400 completed questionnaires were received (response rate: 66.6%).Of these 400 respondents, 120 (20%) were excluded from the study based on the aforementioned criteria, leaving a total of 280 (46.66%) participants for the analysis. Eligible respondents included 141 (50.5%) from the College of Dentistry, 56 (20%) from the College of Medicine, 31 (11.25%) from the College of Pharmacy, 30 (9.25%) from the College of Engineering, and 25 (9%) from the College of Applied Medical Sciences. The mean age of participants was 21.90±1.79years.
The medical, dental, and TMJ histories of all the 400 participants are presented in Table 2. With respect to past medical history, 30.5% of participants reported a history of psychological stress. Over three-fourths (77%) of participants reported a history of dental fillings. Whereas 67 participants (16.8%) reported a history of TMD, only 2 of them (0.5%) had received treatment for it.
The number and percentage of participants with different levels of TMJ dysfunction based on the FAI are presented in Table 3 and Fig. 1. Almost half of participants (53.2%) were classified as having no dysfunction, whereas only 1.1% was classified as having severe dysfunction. There was no significant difference in the mean age of participants among the Fonseca’s severity categories.
The frequencies of the participants in Fonseca’s severity categories with respect to past medical and dental histories are listed in Table 4. Most participants Depressed state reported a history of psychological stress (42.2%), teeth extraction (45.67%), and dentures (66.66%) were classified by the FAI as having light dysfunction. Participants with a history of crowns and bridges were classified equally as having no dysfunction (29.72%) or light dysfunction (43.24%) for each category. The majority of participants in the moderate dysfunction category had a history of dental fillings (10.90%), teeth extraction (13.58%), and root canal treatment (8.41%). Most participants in the severe dysfunction category had a history of dental fillings (1.42%) or teeth extraction (2.46%).