If a massage client smells like Marlboros, the therapist might want to check for jaw dysfunction. In new research, investigators found cigarette smokers with temporomandibular disorder (TMD) reported higher pain severity than nonsmokers with TMD.

The investigators set out evaluate the impact of smoking on pain severity, psychosocial impairment, depression, anxiety and sleep disturbances in a large sample of patients with temporomandibular disorders.

A retrospective database review was performed on data from 3,251 patients with TMD. Pain-severity ratings and psychometric data regarding impairment, sleep disturbance, depression, and anxiety were obtained.

Of the entire population, 26.9 percent admitted they were smokers. Even after controlling for relevant covariates, smokers reported significantly higher pain severity, impairment, anxiety, depression, and sleep disturbances than nonsmokers.

“The association of smoking status with sleep disturbance, psychological functioning, and pain severity in patients with temporomandibular disorders” was published in the Journal of Orofacial Pain.