Rubin- Friedman P, Emodi-Perlman A, Winocur E.
OBJECTIVES: To evaluate the relationship between oral parafunctions and signs & symptoms (S & S) of temporomandibular disorders (TMD) among children with primary and mixed dentition, and to compare this group with groups of adolescents who participated in previous studies.
METHODS: A total of 244 children (61 boys, 184 girls) age 5-12, were selected from a private religious elementary school in Israel. The parents responded to a questionnaire regarding their children's oral habits and symptoms of TMD. A clinical examination was conducted regarding signs of TMD (using the Wong-Baker Faces Pain Rating Scale).
RESULTS: A low prevalence of signs (20%) and symptoms (5%) of TMD was found. Parafunctional habits were performed on 77% of the children. No statistically significant difference was found between the genders in regard to the prevalence of the S & S of TMD. However, statistically significant differences were found between parafunctions and S & S of TMD and between the signs and symptoms themselves.
Pain during chewing and muscles tenderness were associated with multiple parafunctional habits. In addition, they were significantly associated with age (p=0.03). Similar to previous studies, Jaw play was determined to be the most detrimental habit in TMD.
A notable percent of the subjects (23%) suffered from stressful life events during the last year. Statistically significant associations were found between stressful life events and parafunctions or S & S of TMD.
CONCLUSIONS: Parafunctions and S & S are common during childhood, usually mild. Parafunctional habits during childhood are a risk factor for development of TMD.
Stressful life events are significantly associated with many parafunctions and signs and may be risk factors for TMD. These issues need to be further studied.