Research Article: Prevalence of diagnosed temporomandibular disorders: A cross-sectional study in Brazilian adolescents

Date Published: February 8, 2018

Publisher: Public Library of Science

Author(s): Fernanda Mara de Paiva Bertoli, Carolina Dea Bruzamolin, Eduardo Pizzatto, Estela Maris Losso, João Armando Brancher, Juliana Feltrin de Souza, Peter M. Milgrom.


The prevalence of signs and symptoms of temporomandibular disorders (TMD) increases during adolescence and adulthood. Few studies have examined TMD prevalence in Brazilian adolescents.

To investigate the prevalence of TMD in Brazilian adolescents.

A representative population-based sample of 934 adolescents (10–14-years-old) was examined. TMD screening was performed using a questionnaire by the American Academy of Orofacial Pain. TMD diagnoses used research diagnostic criteria for temporomandibular disorders (RDC/TMD—Axis-I). Examinations were performed by a single calibrated examiner (kappa > 0.80).

The prevalence of TMD symptoms was 34.9%; the most frequently reported symptoms were headache and neck ache (20.9%), followed by joint sounds (18.5%). Myofascial pain was the most prevalent type (10.3%), followed by disc displacement with reduction (8.0%) and arthralgia (3.5%). There was a significant association between sex and TMD symptoms; prevalence was significantly higher in girls (RP = 1.37; 95% CI = 1.14–1.65; p = 0.001). Myofascial pain of TMD and displacement with reduction were more prevalent in girls (RP = 1.76; p = 0.007 and RP = 2.06; p = 0.004, respectively).

TMD symptoms were present in 34.9% of adolescents, with myofascial pain being the most prevalent type (10.3%). TMD was significantly more common in girls. Routine pediatric dental care should include a TMD screening.

Partial Text

Temporomandibular disorders (TMD) are a set of joint and muscular dysfunctions of the cranio-orofacial area. They are primarily characterized by joint and/or muscular pain, noise in the temporomandibular joints (TMJ), and limited or irregular mandibular function. TMD can considerably affect quality of life [1]. The American Academy of Pediatric Dentistry recognizes that disorders of the TMJ, masticatory muscles, and associated structures occasionally occur during childhood and adolescence, but with less intensity than in adult populations. During adolescence, TMJ presents with mild or moderate signs and symptoms [2].

This study received approval from the Research Ethics Committee of Universidade Positivo (Process no. 879.404). This cross-sectional study included adolescents aged 10–14 years, attending public and private schools in the city of Curitiba, Paraná, Brazil. The city has approximately 1.893.997 inhabitants and has a Human Development Index of 0.823. The schools are geographically distributed in nine sanitary districts. The parent or legal guardian responsible of the participants received written and verbal information about the study, and signed consent was obtained from a parent for all participants. The study adhered to the tenets of the Declaration of Helsinki.

A total of 4,055 adolescents were invited to participate in the present study. Of those, 934 adolescents returned the signed consent form, met the inclusion criteria, agreed to participate, and were present when the evaluations were performed (a response rate of 23.1%) (S1 File). Of the participants, 55.4% (n = 518) were girls; 36.1% (n = 187) of them had experienced menarche. The mean age of the participants was 11 years, and most attended public school (87.7%, n = 820) (Table 1).

The diagnosis of TMD is a challenge in pediatric dentistry. The early signs of TMD should be discerned from other adaptive physiological changes during growth of the craniofacial complex. Thus, standard clinical criteria for TMJ must be applied to improve the validity of the results.




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