Clinical Signs of Temporomandibular Disorders and Various Pain Conditions Among Children 6 to 8 Years of Age: The PANIC Study

Aims: To examine the prevalence and significance of clinically determined signs of temporomandibular disorders (TMD) and pain in different parts of the body as well as the frequency, intensity, and other features of pain in children. Methods: The subjects were a population-based sample of children 6 to 8 years of age. Complete data on clinical signs of TMD were available for 483 children. Data on pain during the past 3 months, assessed by a questionnaire administered by parents, were available for 424 children. Differences between the prevalence of at least one sign of TMD and the location or frequency of pain were evaluated using the chi-square test, as well as the associations between the prevalence, frequency, and location of pain and gender, the use of medication, and visits to a physician. The relationship of various pain conditions with the risk of having clinical signs of TMD was analyzed using logistic regression. Results: Of the 483 children, 171 (35%) had at least one clinical sign of TMD. Of the 424 children, 226 (53%) had experienced pain during the past 3 months. Pain was most prevalent in the lower limbs (35%) and head (32%). Of the 226 children with pain, 119 (53%) had experienced frequent pain (>= once a week). No gender differences were found. The risk of having at least one clinical sign of TMD was 3.0 (95% confidence intervals [CI]: 1.1-8.5, P .05) times higher in children with back pain, 2.7 (95% CI: 1.2-6.0, P .05) times higher in children with neck-shoulder pain, and 1.6 (95% CI: 1.1-2.5, P .05) times higher in children with headache compared to children without these pain symptoms. The risk of having at least one clinical sign of TMD was 12.2 (95% CI: 1.4-101.8, P .01) times higher among children with palpation tenderness in trapezius muscles than among those without it. Conclusion: Clinical signs of TMD and pain symptoms are common in children. The relationship of back pain, neck-shoulder muscle palpation tenderness, and headache with clinical signs of TMD suggests that more attention should be paid to stomatognathic function in children with such pain problems. Keywords: children, headache, pain, temporomandibular disorders, widespread pain