Comparison of TMD in Young Population among Diagnostic Subgroups

Temporomandibular Disorders (TMD) patients can be divided into diagnostic subgroups that include problems with temporomandibular joint (TMJ) and/or problems with muscles of mastication. There are many studies comparing TMD patients among diagnostic subgroups in adults, however, few studies have been done in children. Objectives: The purpose of this study was to compare pain intensity and difficulty of daily living activity in young TMD patients among 3 diagnostic subgroups. Methods: One hundred four TMD patients (78 females, 26 males; 15.6 ± 3.7 years) at the University of California San Francisco Center for Orofacial Pain and the Nippon Dental University Hospital pediatric dental clinic were selected. All of the patients received a comprehensive examination including the RDC/TMD and assessed by using standardized examination and subjective symptom forms. Patients were diagnosed and divided into 3 diagnostic subgroups; TMJ problem group (JT; disc derangement disorders, inflammatory disorders, osteoarthoritis etc), masticatory muscle pain group (MM; myofascial pain in masticatory muscles) and TMJ problem and muscle pain combined group (JM). A subjective symptom form was filled out by the patient. The form consisted of 5 pain ratings (0-10 scale) in orofacial region and 7 daily living activity ratings (0-10 scale). The symptoms were compared among 3 groups by utilizing ANOVA and Kruskal-Wallis statistics. Results: Gender ratio, ages, chronicity of symptom, jaw/face tightness, tooth pain, talking, yawning, prolonged opening, eating soft foods and sleeping were not significantly different among 3 groups. However, patients in MM group and JM group scored significantly higher on jaw/face pain, headaches, neck pain and eating hard foods than patients in JT group (P=0.0001, 0.003, 0.001, 0.0001, respectively). Conclusions: These results suggest that even in a young population, TMD patients with myofascial pain suffered from pain in orofacial region and difficulty of eating hard foods more than TMD patients with TMJ problem only.