1. Poster Presentation Board Number: 231
Symptoms and pain intensity among adolescents with temporomandibular disorders (TMD). A study in the public dental service in a Norwegian county
Vegard Østensjø University of Bergen
Østensjø V1,2, Moen K1,2, Storesund T2,3, Rosén A1,2
1 Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen 2 Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen 3 Oral Health Centre of Expertise for Western Norway, Stavanger, Norway
Aims of investigation
To estimate the prevalence of TMD and examine symptoms among a group of adolescents diagnosed with TMD with a focus on pain.
Materials and method
Patients were recruited from 4 clinics located in Rogaland County, Norway. 563 patients, aged 13 to 19, came for their annual dental examination and were consecutively selected with an even age and gender distribution.
A general health history was recorded together with socio-economic and demographic information. TMD pain (TMD-P) was recorded by asking two validated questions: Q1 “Do you have pain in the temple, face, temporomandibular joint or jaws once a week or more?” and Q2 “Do you have pain when you open your mouth wide or chew once a week or more?” (Nilsson et al 2006).
All participants that scored yes were subjected to a clinical examination and a more specific questionnaire.
The clinical examination and questionnaire were based on the Research Diagnostic Criteria for TMD but modified for this purpose. The examination consisted of palpation of the TMJ and muscles of mastication. As well as measurement of the range of movement of the mandible and registration of joint sounds. A pain score in mild, moderate or severe pain were registered for these variables. No radiological examination was performed.
The examiners were dentists, specially trained for this study.
Results
Figure 6: the pain score on a visual analogue scale (VAS) was recorded and is shown according to gender. Females recorded significantly higher scores. (p=0.028).
Figure 3: Shows the distribution between Q1, Q2 or both for the participants with a positive response
Figure 1: shows a flowchart of participants, answering TMD-P questions, with the case group in the left column and the control group in the right. The clinical examination divided the TMD positive patients into a subdiagnosis of myalgia, disc derangement or a combination.
Figure 7: The VAS score for the TMD diagnoses myalgia, disc derangement and a combination of the two is presented.
Figure 4: Frequency of mild, moderat or severe tenderness to palpation over the Temporomandibular joint (TMJ) and muscles of mastication is presented. The percentage with moderate or severe tenderness is shown in red in parenthesis.
Conclusions
TMD prevalence was 7.3%, with a female:male ratio of 2.7:1.
Muscle pain was the most frequent symptom.
Pain intensity among adolescent females was more severe than for males.
Disc derangement disorders seemed to be more painful than muscle disorders.
Pain in movement and headache was frequent.
Figure 2: The age and gender distribution in the case group is presented. Females are highly overrepresented from the age of 15 and up.
Acknowledgements
This study would not have been possible to conduct without Tannhelse Rogaland FKF and Haugesund, Bryne, Madla and Nærbø Dental clinics. All the participating dentists and other personel that voulenteered are acknowledged. Thank you to the masters students Sinduja Nagen and Solveig Ystgaard for their help with plotting and analyzing the data.
Figure 5: shows the frequency (never, daily, weekly or seldom) of certain symptoms of TMD.