Temporomandibular disorders (TMDs) may be associated with higher rates of nicotine, alcohol, and smartphone addiction among university students, according to a study recently published in BMC Oral Health.
Additionally, participants with TMDs appeared to experience more depression and anxiety, the authors wrote.
“Increased TMDs severity is associated with higher depression and higher levels of addiction to nicotine, alcohol, and smartphone,” wrote the authors, led by Besime Ahu Kaynak of Toros University in Turkey (BMC Oral Health, January 17, 2026).
In 2024, 909 university students ages 18 to 25 were enrolled in this study to examine the prevalence of addictions among students with TMDs. TMD presence was determined using the Diagnostic Criteria for TMDs and the standards of the International Association for Dental, Oral and Craniofacial Research (IADR). Then participants were classified into TMD and control groups. Overall, 70.5% of participants reported symptoms related to TMDs, they wrote.
The severity of TMDs was assessed with the Fonseca Anamnestic Index (FAI). Nicotine dependence, alcohol use, smartphone addiction, and levels of depression and anxiety were evaluated using the Fagerström Test for Nicotine Dependence (FTND), alcohol dependence with the Addiction Profile Index Risk Scanning Scale (APIRSS), smartphone addiction with the Smartphone Addiction Index-Short Form (SPAI-SF), and depression and anxiety levels using the Patient Health Questionnaire-4 (PHQ-4), respectively.
Nicotine (p = 0.009), alcohol (p = 0.004), and smartphone (p < 0.001) addictions were significantly more common among students with TMDs compared with controls. Also, scores for PHQ-4, SPAI-SF, APIRSS, and FTND were higher in the TMD group (p < 0.001 for all measures; p = 0.003 for FTND). Among participants with nicotine addiction, those with TMDs demonstrated higher FTND scores than those without TMDs (p < 0.007), they wrote.
Furthermore, FAI scores showed positive correlations with SPAI-SF (r = 0.283), FTND (correlation coefficient [r] = 0.147), APIRSS (r = 0.123), and PHQ-4 (r = 0.48), while PHQ-4 scores were correlated with SPAI-SF (r = 0.328), APIRSS (r = 0.125), and FTND (r = 0.120) (all p < 0.001). The prevalence of nicotine addiction was higher in individuals with TMDs (32%) than in controls (23.9%), as were alcohol addiction (22.3% versus 14.6%) and screen addiction (44.7% versus 26.1%).
This study, however, had limitations. The study included only university students, so the findings may not be generalizable to other age groups, the authors added.
“The findings emphasize the need for a multidimensional treatment approach in TMDs that consider coexisting addictions,” Kaynak and colleagues concluded.
