Prevalence of the Signs and Symptoms of Temporomandibular Disorders Among Spanish Adults and Seniors According to Five National Surveys Performed Between 1993 and 2015

Aims: To determine the prevalence of the signs and symptoms of temporomandibular disorders (TMD) and associated variables over the past two decades in samples of Spanish adults and seniors. Methods: Data from Spanish national oral health surveys from the last two decades (1993, 2000, 2005, 2010, and 2015) were analyzed from a total of 2,602 adults (35-44 years of age) and 2,529 seniors (65-74 years of age). All surveys were carried out using similar methods (according to World Health Organization standards) for determining prosthetic, dental, and periodontal statuses. For TMD (assessed only among the adults and seniors), inspection/palpation of the temporomandibular joint and masticatory muscles was used to evaluate three different domains: joint sounds; pain-related conditions (joints/muscles); and range of jaw motion. Risk factors were identified using bivariate analysis and were confirmed after a multivariate logistic regression analysis for predicting the presence of TMD pain/dysfunction. Results: Despite the clear improvement in oral health status observed over the entire study period (1993-2015), the prevalence of temporomandibular pain and dysfunction increased over time in both adults and seniors (the odds ratio [OR] 95% confidence interval [CI] for the entire study period increased, to 2.39 to 4.29). The odds of women and those living in rural areas developing TMD were higher than for men (OR = 1.85; 95% CI 1.52 to 2.25; P .001) and for those living in urban areas (OR = 1.55; 95% CI 1.24 to 1.94; P .001), respectively; however, the prevalence of joint sounds (with no pain or functional restrictions) appeared to be stable throughout the study period at around 14%. Conclusion: The prevalence of painful or dysfunctional TMD has significantly increased in the last 22 years in Spain. Besides the time factor, other major predictors of TMD were gender and place of residence. Palabras clave: epidemiology, functional limitation, pain, risk factors, secular changes, temporomandibular disorders