Abstract
OBJECTIVES: This study evaluated the oral health condition of transgender (trans) men and women before starting gender-affirming hormone therapy (GAHT), focusing on the prevalence of periodontal disease and temporomandibular disorder (TMD) as well as the influence of alcohol consumption and anxiety. MATERIALS AND METHODS: The study was a cross-sectional, descriptive exploratory study conducted with transgender individuals over the age of 18 from the Gender Incongruence Clinic (AING) at Ribeirão Preto Medical School (FMRP-USP). The study was approved by the Research Ethics Committee of the School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP) (CAAE No. 02198018.5.0000.5419) and the Research Ethics Committee on Human Beings of the Ribeirão Preto Medical School (HCRP/FMRP) (CAAE No. 59992522.1.3001.5440). All volunteers provided informed consent before participation. Inclusion criteria consisted of individuals over 18 years of age, patients of the AING, who were hormone-free or had not used hormones for at least 6 months (for trans women), and those with no prior hormone use (for trans men). Exclusion criteria included individuals with cognitive limitations that could hinder comprehension of the research instruments, those who had used analgesics, non-steroidal anti-inflammatory drugs (NSAIDs) or opioids within 24 h before the assessments, and individuals with reports of head and neck trauma, a history of plastic surgeries or orofacial harmonisation procedures or those undergoing orthodontic treatment or extensive oral rehabilitation. Each participant completed a sociodemographic questionnaire and was assessed for periodontal health using the Periodontal Screening Recording (PSR), TMD using DC/TMD criteria and anxiety levels with the GAD-7 scale. Data analysis included descriptive statistics, chi-squared, T-test (p < 0.05) and multivariate logistic regression. RESULTS: A total of 54 trans individuals over the age of 18 from the Gender Incongruence Clinic (AING) at Ribeirão Preto Medical School (FMRP-USP) were invited, with 45 participants completing the study (24 trans men, 21 trans women). High levels of gingivitis and plaque accumulation were found in all participants, with no significant gender differences (p > 0.05). TMD was present in 83.33% of trans men and 47.62% of trans women, with a significantly higher incidence among trans men (p = 0.046). Alcohol consumption (p = 0.049) and anxiety (p = 0.043) were significantly associated with TMD, especially among trans men 1.624 [Confidence Interval (95% CI): 1.006-2.621]. CONCLUSIONS: The study revealed alarming levels of gingivitis across all participants, highlighting the need for periodontal intervention. Over half of the participants exhibited TMD, with trans men showing a higher occurrence. TMD was significantly associated with alcohol consumption and anxiety. CLINICAL RELEVANCE: The findings emphasise the need for integrated dental and mental health care in transgender populations, particularly for the prevention and management of TMD and periodontal disease.