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Prevalence of symptoms and signs indicative of temporomandibular disorders in children and adolescents: A cross-sectional epidemiological investigation covering two decades
Jönköping University, School of Health Science, HHJ. Oral health.
Jönköping University, School of Health Science, HHJ. Oral health.
Jönköping University, School of Health Science, HHJ. Oral health.
2009 (English)In: European Archives of Paediatric Dentistry, ISSN 1818-6300, Vol. 10, no Suppl. 1, p. 16-25Article in journal (Refereed) Published
Abstract [en]

AIM: These were to 1) estimate the prevalence of subjective symptoms and clinical signs of temporomandibular disorders (TMD) in children and adolescents in the city of Jönköping, Sweden, 2) follow possible variations in TMD signs and symptoms over a 20-year period, and 3) study possible associations between TMD symptoms and signs and factors of interest. DESIGN: About 100 individuals in the age groups of 3, 5, 10 and 15 years participated in crosssectional stratified epidemiological investigations in 1983, 1993 and 2003. METHODS: All participants were asked to fill in a questionnaire including questions on general and oral health, dental care habits and some sociodemographic issues. More specific questions recorded the presence or absence of subjective symptoms: tiredness in the jaws on awakening or during chewing; clicking sounds or crepitations from the temporomandibular joints (TMJs); locking/ catching of the mandible; luxation of the mandible; reduced jaw movement capacity; pain during jaw movements; other pain conditions in the jaws or in the TMJ regions. Subjects were examined clinically at each time period for; jaw mobility (maximum jaw opening including vertical overbite, maximum laterotrusion to the right and to the left, maximum protrusion); TMJ function (normal function, deflection on jaw opening of > 2 mm, TMJ clicking or crepitations, TMJ locking, TMJ luxation); pain on jaw movement (no pain on movements, pain on one movement, pain on more than one movement); muscle pain (no muscle pain, pain on palpation in 1-3 sites, pain on palpation in > 3 sites); TMJ pain (no joint pain, pain on lateral palpation of one or both joints, pain on posterior palpation of one or both joints). No functional examination of the masticatory system was performed in children aged 3 and 5 years. RESULTS: TMD-related symptoms were very rare in 3- and 5-year-olds. In the age groups of 10- and 15-yearolds, 5-9% of the participants reported more severe symptoms, up to 50% showed one or more TMD signs, while it was estimated that 1-2% were in need of TMD treatment. Several symptoms and signs increased with age. No gender differences, with the exception of recurrent headache, were noted. Oral parafunctions were reported by 11-47%. Apart from a few variables, no statistically significant changes in the prevalence of TMD symptoms and signs were observed over the 20-year period. Clenching/grinding of teeth and general health factors were found to be associated with TMD symptoms and signs. CONCLUSIONS: The prevalence of more severe TMD symptoms and signs in children and adolescents was generally low in all three examinations and did not change significantly during the 20-year period. Increasing age, general health factors and oral parafunctions were associated with TMD symptoms and signs in 10- and 15-year-olds.

Place, publisher, year, edition, pages
2009. Vol. 10, no Suppl. 1, p. 16-25
Keywords [en]
TMD, treatment need, cross-sectional, parafunctions, headache
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-11294PubMedID: 19863894OAI: oai:DiVA.org:hj-11294DiVA, id: diva2:285887
Available from: 2010-01-13 Created: 2010-01-13 Last updated: 2012-11-26Bibliographically approved
In thesis
1. On temporomandibular disorders: Time trends, associated factors, treatment need and treatment outcome
Open this publication in new window or tab >>On temporomandibular disorders: Time trends, associated factors, treatment need and treatment outcome
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

During the last few decades, and especially during the 1990s, an increase in musculoskeletal pain conditions and stress-related ill-health has been observed in Sweden. At the same time, an improvement in the oral health of the population has been noted. The overall aim of this thesis was to acquire knowledge relating to possible time trends for the presence of temporomandibular disorders (TMD) in the population. A further objective was to study factors that possibly influence the presence of these disorders and the outcome of their treatment.

Studies I–III are based on a series of repeated cross-sectional population-based investigations. Three independent samples of 130 individuals in the age groups of 3, 5, 10, 15, 20, 30, 40, 50, 60 and 70 years were randomly selected from the inhabitants of the city of Jonkoping, Sweden in 1983, 1993 and 2003. The total participation rate was 21%, 22% and 29% respectively. The participants were examined using a questionnaire, interview and a clinical examination of the stomatognathic system regarding the presence of symptoms and signs indicative of TMD. Study IV is a retrospective survey of a clinical sample of patients referred to and treated at the Department of Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jonkoping, in 1995–2002. The overall frequencies of symptoms and the rates for some clinical signs and consequently of an estimated treatment need in adults increased during the study period. In 2003, the prevalence of frequent headache in 20-year-olds, mainly females, had markedly increased. The reports of bruxism among adults increased from 1983 to 2003. Awareness of bruxism and self-perceived health impairment were associated with TMD symptoms and signs. A favourable treatment outcome was observed for the majority of patients with common TMD sub-diagnoses and no strong predictors of treatment outcome were found.

In conclusion, the results suggest some time trends towards an increased prevalence in the overall symptoms and some signs indicative of TMD in the Swedish adult population during the time period 1983–2003. A profound understanding of the social determinants of health is recommended when planning public health resources.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2012. p. 120
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 38
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-19842 (URN)978-91-85835-37-9 (ISBN)
Public defence
2012-12-14, Forum Humanum, HHJ (School of Health Sciences), 13:00
Opponent
Supervisors
Available from: 2012-11-26 Created: 2012-11-16 Last updated: 2015-08-26Bibliographically approved

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Anastassaki Köhler, AlkistiMagnusson, TomasHugoson, Anders

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