Comparison of TMD between Israeli children, adolescents and young adults

Introduction: The reported prevalence of temporomandibular disorders (TMD) present during childhood and adolescence ranges between 7%-68%. However, research on TMD during childhood is limited. Studies show that most TMD signs and symptoms in young children are mild. Moreover, pain in children is mainly observed on palpation and not as a reported symptom. Therefore, there is a need for more research in order to further characterize this specific age group. Objective: to compare TMD Axis I and II parameters between Israeli children and youth using the Hebrew version of the Research Diagnostic Criteria (RDC) for TMD. Methods: The study consisted of 483 consecutive Israeli patients, between the ages 6-24 (male/female ratio1:2.7), arriving at an Orofacial Pain Clinic during the years 2001-2010. The patients were divided into three age groups: children (age 6-13, 53 patients), adolescents (age 14-17, 152 patients) and adults (age 18-24, 278 patients). A complete clinical examination was carried out according to the RDC/TMD protocol. Results: There were no statistically significant differences in the prevalence of Axis I diagnoses between the age groups. However, the patients' depression and somatization including pain items levels increased in direct relation to their age (p=0.002, p=0.005). No correlation was found between age and somatization excluding pain items and anxiety. The jaw disability check list was statistically significantly lower in the “children” group as compared to the adolescent and adult groups (p=0.024). The average pain duration of the children and adolescent groups was statistically significant lower as compared to the adult group. Characteristic pain intensity (CPI) and disability score increased with age. (p=0.025, p= 0.002). No statistical differences were found between groups as to missing days of work/school. Conclusions: The current study highlights the relative importance of Axis II components in determining the course of the disease, regardless of Axis I diagnoses.