Environmental noise pollution and its association with temporomandibular joint disorders, malocclusion, and bruxism: A Comparative cross-sectional study of adults in high-traffic and low- traffic areas
- 1Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
- 2Department of Oral Diagnosis, Oral Biology and Periodontology, College of Dentistry, King Khalid University, Abha, Saudi Arabia
- 3Department of Allied Dental Health Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
Abstract
Background: Chronic environmental noise exposure is a recognized public health concern linked to stress-mediated physiological responses, yet its specific impact on temporomandibular disorders (TMD), bruxism, and malocclusion remains poorly investigated. Objectives: To compare the prevalence of TMD, malocclusion, and bruxism between adults residing in high-traffic versus Low- traffic areas in New Delhi, India, and to identify independent predictors of TMD risk. Methods: This comparative cross-sectional study enrolled 300 adults (150 per group) from high traffic and low traffic residential areas of New Delhi, India. Individual-level noise exposure (LAeq,24h) was objectively measured. TMD was diagnosed using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD Axis I criteria). Bruxism, malocclusion, perceived stress scale −1= (PSS-10), and Pittsburgh sleep quality (PSQI) were assessed using validated instruments. Multivariable logistic regression and mediation analysis were performed. Results: High-traffic residents had significantly higher TMD prevalence (61.3% vs. 25.3%), bruxism (42.7% vs. 14.0%), and malocclusion (52.0% vs. 26.0%; all p < 0.001). A significant dose-response relationship was confirmed (χ² for trend p < 0.001). High noise exposure was the strongest independent predictor of TMD (aOR = 3.10; 95% CI: 2.00–4.80). Bruxism and perceived stress accounted for 41.4% of this association in exploratory mediation analysis, a pattern compatible with mediation, though the cross sectional design precludes establishing temporal precedence. Conclusions: Environmental noise exposure was independently and dose-dependently associated with TMD andbruxism. malocclusion was also prevalent in high traffic areas; however, this cross sectional association more likely reflects pre-existing skeletal or occlusal characteristics than a causal effect of noise, and should be interpreted with caution. These findings support noise abatement policies and targeted oral health screening in high traffic urban environments.
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BibTeX
@article{alshehri2026environmental,
title = {{Environmental noise pollution and its association with temporomandibular joint disorders, malocclusion, and bruxism: A Comparative cross-sectional study of adults in high-traffic and low- traffic areas}},
author = {Abdullah Hasan A. Alshehri and Abdulkhaliq Ali F. Alshadidi and Lujain Ibrahim N. Aldosari and Sultan Mohammed Kaleem and Vishwanath Gurumurthy and Rajesh Vyas and Sunil Kumar Vaddamanu},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0360667},
url = {https://doi.org/10.1371/journal.pone.0360667},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Environmental noise pollution and its association with temporomandibular joint disorders, malocclusion, and bruxism: A Comparative cross-sectional study of adults in high-traffic and low- traffic areas
AU - Abdullah Hasan A. Alshehri
AU - Abdulkhaliq Ali F. Alshadidi
AU - Lujain Ibrahim N. Aldosari
AU - Sultan Mohammed Kaleem
AU - Vishwanath Gurumurthy
AU - Rajesh Vyas
AU - Sunil Kumar Vaddamanu
PY - 2026
DA - 2026/10/09
JO - PLOS One
DO - 10.1371/journal.pone.0360667
UR - https://doi.org/10.1371/journal.pone.0360667
AB - Background: Chronic environmental noise exposure is a recognized public health concern linked to stress-mediated physiological responses, yet its specific impact on temporomandibular disorders (TMD), bruxism, and malocclusion remains poorly investigated. Objectives: To compare the prevalence of TMD, malocclusion, and bruxism between adults residing in high-traffic versus Low- traffic areas in New Delhi, India, and to identify independent predictors of TMD risk. Methods: This comparative cross-sectional study enrolled 300 adults (150 per group) from high traffic and low traffic residential areas of New Delhi, India. Individual-level noise exposure (LAeq,24h) was objectively measured. TMD was diagnosed using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD Axis I criteria). Bruxism, malocclusion, perceived stress scale −1= (PSS-10), and Pittsburgh sleep quality (PSQI) were assessed using validated instruments. Multivariable logistic regression and mediation analysis were performed. Results: High-traffic residents had significantly higher TMD prevalence (61.3% vs. 25.3%), bruxism (42.7% vs. 14.0%), and malocclusion (52.0% vs. 26.0%; all p < 0.001). A significant dose-response relationship was confirmed (χ² for trend p < 0.001). High noise exposure was the strongest independent predictor of TMD (aOR = 3.10; 95% CI: 2.00–4.80). Bruxism and perceived stress accounted for 41.4% of this association in exploratory mediation analysis, a pattern compatible with mediation, though the cross sectional design precludes establishing temporal precedence. Conclusions: Environmental noise exposure was independently and dose-dependently associated with TMD andbruxism. malocclusion was also prevalent in high traffic areas; however, this cross sectional association more likely reflects pre-existing skeletal or occlusal characteristics than a causal effect of noise, and should be interpreted with caution. These findings support noise abatement policies and targeted oral health screening in high traffic urban environments.
SN - 1932-6203
ER -