Comorbidities between temporomandibular disorders and somatization in young adults: exploring links with personality, emotional, and sleep disturbances.

OBJECTIVE: The comorbidities between temporomandibular disorders (TMDs) and somatization and their associations with personality traits, emotional disorders, and sleep disturbances were investigated. STUDY DESIGN: Adults aged 18 to 24 years completed an electronic survey encompassing TMD symptoms (5Ts), Patient Health Questionnaire-15, Big Five Personality Inventory-10, Depression Anxiety Stress Scales-21, and Pittsburgh Sleep Quality Index. Data were assessed using non-parametric tests/correlation analysis and logistic regression analysis (α = 0.05). RESULTS: The sample comprised 365 participants, of whom 22.2% and 19.5% were 5Ts-negative without and with somatization, respectively, and 18.1% and 40.3% were 5Ts-positive without and with somatization, respectively. Significant differences in neuroticism, distress, depression, anxiety, stress, and sleep quality were observed between 5Ts-negative participants with somatization and 5Ts-positive participants with somatization compared with 5Ts-negative participants without somatization and 5Ts-positive participants without somatization. Distress, anxiety, stress, and sleep were moderately correlated with somatic but not TMD symptoms (rs = 0.45-0.52). CONCLUSIONS: Irrespective of whether they had TMDs, participants with somatization exhibited heightened levels of neuroticism and emotional and sleep disturbances.

Temporomandibular disorder pain in older adolescents-young adults: Interrelationship with somatic burden, mental ill-being, and well-being.

OBJECTIVES: The associations of Temporomandibular disorder (TMD) pain with somatic symptoms, mental ill-being/distress, and well-being were explored, along with the mental correlates of TMD (TS) and somatic symptom (SS) burden in older adolescents-young adults. METHODS: TMD/somatic symptoms were appraised with the five quintessential symptoms (5Ts) of the DC/TMD/Somatic Symptom Scale-8, whereas mental distress/well-being was assessed with the Depression, Anxiety, Stress Scales-21/Scales of Psychological Well-being-18. Data were examined using Chi-square/non-parametric tests and multivariate analyses (α = .05). RESULTS: Among the 366 participants, 51.4%, 28.1%, 6.8%, and 13.7% had no TMD (NT), TMD pain (TP), TMD dysfunction (TD), and combined TMD (CT) respectively. Though mental distress varied substantially (CT, TP>NT, TD), no significant differences in well-being were discerned. SS burden, but not TS burden, was moderately correlated to distress. CONCLUSIONS: The prospect of TMD pain was increased by being female, depressed, and anxious but reduced by "positive relations with others" and "self-acceptance".

Psychological factors in Temporomandibular disorders and somatization: A multidimensional analysis of personality, coping, and distress among young adults.

PURPOSE: The association of Temporomandibular disorder (TMD) and somatic symptoms with the psychological variables of personality, coping, and distress were analyzed in young adults. Physical and psychological correlates were also explored along with the risk factors for TMDs/somatization. MATERIALS AND METHODS: Participants were enlisted from a local university and the presence of TMDs and somatic symptoms was determined with the Short-form Fonseca Anamnestic Index and Patient Health Questionnaire-15. The psychological variables of personality, coping, and distress was assessed with the Big-Five Personality Inventory-10, brief-COPE Inventory, and Depression, Anxiety, Stress Scales-21 accordingly. Statistical evaluations were performed with the Mann-Whitney U test, Spearman's correlation, and logistic regression analyses (α = 0.05). RESULTS: Among the 455 participants (mean age 22.7 ± 1.2 years), 18.2% and 5.7% had TMDs and medium-to-high somatization respectively. Participants with TMDs exhibited substantially higher somatization and psychological distress scores than those with no TMDs. Significant differences in TMD, conscientiousness, extraversion, and psychological distress scores were observed between participants with no-to-mild and medium-to-high somatization. The association between TMD and somatization scores, albeit significant, was weak. Neuroticism and dysfunctional coping style were moderately correlated to general distress, depression, anxiety, and stress (rs = 0.44-0.62). CONCLUSIONS: Findings suggest that anxiety is the main risk factor for the presence of TMDs and medium-to-high somatization in non-clinical young adults while conscientiousness is a protective factor for somatization.

Psychological characteristics of young adults with temporomandibular disorders, somatization and combined conditions: A multidimensional evaluation.

BACKGROUND: Temporomandibular disorders and somatization have shown interrelation in many studies. The physical and psychological factors which contributed to the occurrence and relation of both conditions are yet to be determined. OBJECTIVES: The personality traits, coping styles and psychological distress of young adults with temporomandibular disorder (TMD) and somatic symptoms were characterized together with the determination of psychological risk factors for TMDs, somatization and combined conditions. METHODS: Participants were recruited from university-attending young adults. TMD and somatic symptoms were appraised with the short-form Fonseca Anamnestic Index and Patient Health Questionnaire-15. Psychological variables were assessed with the Big Five Personality Inventory-10, Brief-COPE Inventory and Depression, Anxiety, and Stress Scales-21. Data were evaluated using chi-squared/non-parametric tests and logistic regression analyses (α = .05). RESULTS: Among the 507 participants (mean age 22.2 ± 1.5 years), 46.4% reported no TMD/somatic symptoms (NS) while 7.5%, 34.5% and 11.6% had TMDs only (TS), somatization only (SS) and combined TMDs-somatization (CS), respectively. Significant differences in conscientiousness (NS > SS), agreeableness (NS, TS > CS; NS > SS), dysfunctional coping, general distress, depression, anxiety and stress (CS ≥ SS > NS) were discerned. Multivariate analyses indicated that the odds of TS were increased by anxiety (OR = 1.10; 95% CI = 1.01-1.21), while the odds of SS/CS were affected by anxiety (OR = 1.15; 95% CI = 1.06-1.25/OR = 1.34; 95% CI = 0.19-1.52) and problem-focused coping (OR = 0.71; 95% CI = 0.56-0.89/OR = 0.55; 95% CI = 0.39-0.78). CONCLUSION: Though individuals with TMDs and somatization have dissimilar psychological profiles, anxiety constantly increased their likelihood. Problem-focused coping strategies may help alleviate psychosocial and physical stressors associated with TMDs and somatization.

Oral behaviors in young adults: a multidimensional evaluation of the influence of personality, coping, and distress.

OBJECTIVES: This study explored the relationship of oral parafunction to the psychological variables of personality, coping, and distress. Correlates of sleeping/waking-state oral activities with the different psychological factors were also examined, along with psychological predictors for high parafunction. MATERIALS AND METHODS: Young adults from a large private university were enrolled. The frequency of oral behaviors was appraised with the oral behavior checklist (OBC), and participants were stratified into low and high parafunction (LP/HP) groups following the DC/TMD. Personality traits, coping styles, and psychological distress were assessed with the Big Five Personality Inventory-10 (BFI-10), brief-COPE Inventory (BCI), and Depression, Anxiety, Stress Scales-21 (DASS-21) correspondingly. Statistical evaluations were performed using the chi-square/Mann-Whitney U tests, Spearman's correlation, and logistic regression analyses (α = 0.05). RESULTS: Among the 507 participants (mean age 22.2 ± 1.5 years), 84.6% and 15.4% had low and high parafunction respectively. While personality profiles did not vary substantially, the HP group exhibited significantly greater emotion-focused/dysfunctional coping, general distress, depression, anxiety, and stress scores than the LP group. Associations between OBC and the various psychological variables were weak when significant or insignificant. Neuroticism and dysfunctional coping were moderately correlated to general distress, depression, anxiety, and stress (rs = 0.44-0.60/0.45-0.51). Multivariate analyses indicated that high parafunction was predicted by dysfunctional coping style (OR = 2.55) and anxiety (OR = 1.33). CONCLUSIONS: Dysfunctional coping was the main risk factor for high parafunction, increasing its odds by about 2.5 times. CLINICAL RELEVANCE: Oral parafunction appears to be a dysfunctional coping response to psychological distress.

Personality, psychosocial and oral behavioural risk factors for temporomandibular disorder symptoms in Asian young adults.

BACKGROUND: The relation between personality, psychosocial factors, somatisation, andoral behaviours as risk factors to temporomandibular disorder symptoms have notbeen well established. OBJECTIVES: This study examined the association of temporomandibular disorder (TMD) symptoms with personality traits, psychological distress, somatisation and oral behaviours. The psychosocial and oral behavioural risk factors for TMD symptoms were also established in Asian young adults. METHODS: Participants were recruited from a large private University. Based on the quintessential five TMD symptoms (5Ts) of the DC/TMD, the participants were stratified into those with no (NT), painful (PT), dysfunctional (DT) and mixed (MT) TMD symptoms. Personality traits, psychological distress, somatisation and oral behaviours were evaluated with the Big Five Inventory-10 (BFI-10), Depression, Anxiety, Stress Scales-21 (DASS-21), Patient Health Questionnaire-15 (PHQ-15) and Oral Behaviours Checklist (OBC) accordingly. Data were examined using Kruskal-Wallis/Mann-Whitney U and Chi-squared tests, as well as multivariate logistic regression analysis (α = .05). RESULTS: Of the 420 young adults (mean age 22.7 ± 1.1 years) evaluated, 41.4% had no TMD symptoms, while 17.4%, 20.0% and 21.2% reported PT, DT and MT, respectively. Though personality traits did not vary notably, participants with MT and PT had significantly higher levels of negative affectivity, anxiety and stress than the NT group. Moreover, those with MT and PT presented significantly greater somatisation and more oral behaviours than the DT and NT groups. Multivariate regression analyses indicated that anxiety, somatisation, sleep-related and waking-state nonfunctional oral activities were associated with painful and/or dysfunctional TMD symptoms. CONCLUSIONS: Except for sleep-related oral activity, psychosocial and oral behavioural risk factors differed for painful, dysfunctional and mixed TMD symptoms in Asian young adults.

Psychological distress and coping orientations in young adults: their associations with temporomandibular disorder symptoms.

OBJECTIVES: The relationships between Temporomandibular disorder (TMD) symptoms, psychological distress and coping, together with the psychological risk factors for TMDs were investigated in young adults. MATERIAL AND METHODS: The quintessential five TMD symptoms (5Ts) of the DC/TMD were used to screen for TMDs. Participants were categorized into 5Ts-negative/positive groups and 5Ts-positive individuals were divided into those with pain-related (PT), intra-articular (IT) and combined (CT) TMD symptoms. Psychological distress and coping were examined using the Depression, Anxiety, Stress Scales-21 and brief-COPE inventory. Statistical evaluations were performed using non-parametric and regression analyses (α = 0.05). RESULTS: Of the 455 participants (mean age 22.5 ± 1.2 years) appraised, 41.1% were 5Ts-negative and 58.9% were 5Ts-positive (17.6% PT, 19.8% IT and 21.5% CT). Significant differences in negative affectivity, anxiety and stress were observed. However, the variances in coping styles/strategies were largely insignificant. For both 5Ts groups, dysfunctional coping was moderately correlated to negative affectivity/emotions (rs = 0.40-0.52). CONCLUSIONS: Asian young adults with CT and PT had significantly higher levels of negative affectivity, anxiety and stress than their counterparts with IT and/or NT. Negative affectivity/emotions were associated with the use of dysfunctional coping strategies and anxiety was the main psychological risk factor for TMD symptoms.

As psychological distress is associated with the frequent use of dysfunctional coping strategies, clinicians are urged to assess negative emotions and coping behaviours when supporting individuals with TMDs.

Correlates between temporomandibular disorder severity, emotional distress, and eudaimonic well-being among young adults.

OBJECTIVES: This study examined the correlates between severity of temporomandibular disorders (TMDs), emotional distress, and eudaimonic well-being. SUBJECTS AND METHODS: TMD severity, negative emotions, and eudaimonia were assessed with the Fonseca Anamnestic Index (FAI), Depression, Anxiety, Stress Scales-21 (DASS-21), and Psychological Well-being Scale-18 (PWBS-18) in a cohort of community young adults. Statistical evaluations were done with non-parametric tests/correlation and multivariate regression analyses (α = 0.05). RESULTS: Amongst the 873 participants (mean age 19.8 ± 1.66 years), 40.7%, 49.0%, and 10.3% had no (NT), mild (MT), and moderate-to-severe (ST) TMD, respectively. Significant differences in total-DASS, depression, anxiety, and stress were ST ≥ MT > NT. Significant variances in total-PWSB and self-acceptance were NT > MT > ST while that for environmental mastery, positive relations, and purpose in life were NT > MT, ST. An inverse relationship was discerned between total-DASS and total-PWBS (correlation coefficient = -0.54). The prospect of ST was increased by anxiety but reduced by positive relations and self-acceptance. CONCLUSIONS: Young adults with mild and moderate-to-severe TMD experienced substantially higher emotional distress and lower eudaimonia than those with no TMD. As emotional distress and eudaimonic well-being are interrelated, positive psychological interventions may be beneficial for managing TMD-related psychosocial disabilities.

Negative affectivity and emotions in youths with temporomandibular disorders across cultures.

OBJECTIVE: The relationships between temporomandibular disorders (TMDs) and negative affectivity/emotions across cultures and the emotional predictors for TMDs in Southeast Asian youths were investigated. METHODS: The presence of TMDs and negative affectivity/emotions were determined with the Fonseca Anamnestic Index (FAI) and Depression, Anxiety, Stress Scales-21 (DASS-21). Statistical evaluations were done with non-parametric and logistic regression analyses (α. RESULTS: The total sample comprised 400 Singaporean and 501 Indonesian youths (mean age 19.30 ± 1.48 years; 65.0% women) of whom 47.0% and 59.3% had mild-to-severe TMDs, respectively. For both cultures, participants with TMDs had significantly greater negative affectivity, depression, anxiety, and stress than those with no TMDs. Indonesian youths also presented higher levels of emotional distress than their Singaporean counterparts. Correlations between FAI and anxiety/stress scores were moderately strong. CONCLUSION: Cultural variations can influence the expression of TMDs and emotional distress. Being female and anxious increased the risk of TMDs.

Temporomandibular disorder symptoms in young adults: Three-dimensional impact on oral health-related quality of life.

BACKGROUND: The impact of temporomandibular disorders on functional, pain, and psychosocial aspect of patients' quality of life needed to be assessed. OBJECTIVES: This study examined the three-dimensional impact of pain-related and/or intra-articular Temporomandibular disorder (TMD) symptoms and ascertained the inter-relationships between the functional, pain, and psychosocial aspects of oral health-related quality of life (OHRQoL). METHODS: Young adults were enlisted from a local university and TMD symptoms were assessed with the Diagnostic Criteria for TMDs Symptom Questionnaire (DC/TMD-SQ). Participants were stratified into those with no (NT), pain-related (PT), intra-articular (IT), and mixed (MT) TMD symptoms. OHRQoL was examined using the Oral Health Impact Profile-14 (OHIP-14), and dimensional effects (oral function [OF], orofacial pain [OP], and psychosocial impact [PI]) were established subsequently. Data were evaluated with Kruskal-Wallis, Dunn, and Wilcoxon signed-rank tests (α = .05). RESULTS: The mean age of the participants (n = 1205) was 7 ± 1.3 years (71.8% women). While 42.2% reported no TMD symptoms, 22.3%, 16.9%, and 18.5% had PT, IT, and MT accordingly. The MT, PT, and IT groups presented higher total OHIP-14 and dimension scores than the NT group (p < .01). Scores were also significantly different between the MT and IT groups except for OF. For all TMD groups, the ranking of dimensional impact was OP > PI > OF, and associations between the OP and PI dimensions were the strongest (correlation coefficient [rs ] = .57-.76). CONCLUSIONS: Young adults with PT and/or IT symptoms have poorer OHRQoL, especially in the OP and PI dimensions, which were moderate to strongly correlated. The use of the three dental Patient-reported Outcome (dPRO) dimensions could provide construct equivalency among OHRQoL measures.

Self-reported symptoms of temporomandibular disorders: Relationship to psychological wellbeing, psychological distress, and oral health-related quality of life.

PURPOSE: To investigate the relationship of self-reported temporomandibular disorder (TMD) symptoms with psychologic well-being (PWB), psychologic distress (PD), and oral health-related quality of life (OHRQoL). MATERIALS AND METHODS: The study sample was recruited from a local university using a convenience sampling technique. The Diagnostic Criteria for TMD Symptom Questionnaire (DC/TMD-SQ); Scales of Psychological Well-being-18 (SPWB-18); Depression, Anxiety, and Stress Scales-21 (DASS-21); and Oral Health Impact Profile-14 (OHIP-14) were administered electronically to establish TMD symptoms and to assess PWB, PD, and OHRQoL, respectively. Data were analyzed by number/type of TMD symptoms using Kruskal-Wallis/Mann-Whitney U tests and Spearman correlation (α = .05). RESULTS: A total of 602 participants with a mean age of 19.30 ± 1.18 years (84.3% women) were evaluated. Of these, 59.2% reported TMD symptoms, with 10.7% having multiple (≥ 3) features. Pain-related (PT), intra-articular (IT), and combined (CT) TMD symptoms were present in 23.8%, 15.4%, and 20.2% of the cohort, respectively. For both number and type of symptoms, significant differences in SPWB-18 (total, environmental mastery, and self-acceptance), DASS-21 (total/all domains), and OHIP-14 (total/all domains) scores were observed (P < .05). A moderately strong negative correlation was noted between PWB and PD (rs = -0.55). CONCLUSION: Participants with no TMD (NT) symptoms had significantly higher PWB than those with two or more TMD symptoms. They also had significantly lower levels of PD and better OHRQoL. Conversely, individuals with PT/CT reported significantly lower PWB compared to those with no symptoms. Moreover, they also had significantly higher levels of PD and poorer OHRQoL than the IT/NT groups.

Psychometric properties of the Indonesian Fonseca anamnestic index and the presence/severity of temporomandibular disorders among Indonesian young adults.

OBJECTIVE: The psychometric properties of the Indonesian FAI (FAI-I) and presence/severity of temporomandibular disorders (TMDs) among Indonesian young adults were explored. METHODS: The FAI-I was developed following the INfORM guidelines and used to determine the presence/severity of TMDs. Internal consistency/test-retest reliability were examined with Cronbach's alpha/intra-class correlation (ICC) coefficients. Construct/criteria validity were established by correlating (Spearman) the FAI-I to the five major TMD symptoms (5 Ts) and OHIP-14 (p < 0.05). RESULTS: Five hundred-one participants (mean age 19.73 ± 1.27 years; 75.2% women) were recruited from a local University. Of these, 40.7% had no TMD, while 49.9%, 8.8%, and 0.6% had mild, moderate, and severe TMD. While Cronbach's α = 0.57 and ICC = 0.72, correlation coefficients to total 5 Ts and OHIP-14 were 0.53 and 0.47, respectively. CONCLUSION: The FAI-I had low internal consistency, good test-retest reliability, and good validity. Moderate-to-severe TMD was experienced by 9.4% of the young adults examined.

Psychological distress and well-being: their association with temporomandibular disorder symptoms.

OBJECTIVE: This study investigated the associations between temporomandibular disorder (TMD) symptoms, psychological distress, and well-being. METHODS: A total of 372 university students were recruited and stratified into no TMD, TMD pain, TMJ sounds, and combined TMD groups. Psychological distress and well-being were assessed with the Depression, Anxiety, and Stress Scale-21 (DASS-21) and Scales of Psychological Well-being-18 (SPWB-18), respectively. Data were appraised with Kruskal-Wallis/Mann-Whitney U tests and logistic regression analysis (α = 0.05). RESULTS: Significant differences in anxiety, stress, and autonomy scores were observed among the four groups, and psychological distress was mostly negatively correlated to psychological well-being. Multivariate analyses revealed that anxiety was associated with TMD pain, TMJ sounds, and combined TMD, while autonomy was related to TMJ sounds. CONCLUSION: Participants with TMD symptoms generally experienced more psychological distress and lower autonomy. Anxiety appeared to increase the likelihood of TMD pain and/or TMJ sounds.

Severity and form of temporomandibular disorder symptoms: Functional, physical, and psychosocial impacts.

OBJECTIVE: The associations between the presence of differing severity/form of temporomandibular disorder (TMD) symptoms and oral health-related quality of life (OHRQoL) were explored. METHODS: The severity and form of TMDs in young adults were categorized based on the Fonseca Anamnestic Index (FAI) and Diagnostic Criteria for TMDs (DC/TMD), and OHRQoL was assessed with the Oral Health Impact Profile-14 (OHIP-14). Data were analyzed using non-parametric statistics (α = 0.05). RESULTS: The study cohort consisted of 501 young adults (mean age 19.7 ± 1.3 years; 75.2% women). Participants with severe/moderate TMDs had significantly higher OHIP severity scores than those with mild/no TMDs. Moreover, participants with combined/pain-related symptoms exhibited significantly higher severity scores compared to those without symptoms. The physical pain and psychological discomfort domains were typically more impaired regardless of severity/form of TMD symptoms. CONCLUSION: More severe and painful symptoms were related to greater impairments in OHRQoL, especially in the physical and psychological domains.

Psychological well-being and distress: Their associations with temporomandibular disorder symptoms and interrelationships.

OBJECTIVES: This cross-sectional study established the relationships between temporomandibular disorder (TMD) symptoms, psychological well-being (PWB), and psychological distress (PD). Additionally, the psychological predictors for various TMD features were determined. STUDY DESIGN: TMD symptoms were ascertained with the Diagnostic Criteria for TMDs Symptom Questionnaire in young adults and PWB and PD were assessed with Ryff's Scales of Psychological Well-Being-18 (SPWB-18) and Depression, Anxiety, and Stress Scales-21, respectively. Statistical analyses were conducted using Kruskal Wallis/Mann-Whitney U tests, Spearman's correlation, and multivariate logistic regression (α = .05). RESULTS: Of the 734 participants (mean age = 19.35 ± 1.24 years) appraised, 40.7% had no TMD manifestations and 59.3% reported various TMD symptoms (25.2% pain-related, 14.6% intra-articular, and 19.5% combined). Among the 4 symptom groups, significant differences in PWB were perceived for total SPWB and the Environmental Mastery/Self-Acceptance subscales. Significant differences in total Depression, Anxiety, and Stress Scales-21, depression, anxiety, and stress were also noted between the pain-related TMD symptoms/combined TMD symptoms and no TMD symptoms groups. For all groups, the strongest correlation was observed between total SPWB and depression (rs = -0.52 to 0.65). CONCLUSIONS: Environmental mastery decreased the likelihood of pain-related and intra-articular TMD symptoms. Conversely, overall PD and anxiety predicted the presence of pain-related and intra-articular/combined TMD symptoms correspondingly.

Geographical variation of parental-reported sleep bruxism among children: comparison between the Netherlands, Armenia and Indonesia.

OBJECTIVE: The aim of this study was to investigate whether geographical variation exists in the prevalence rates and associated factors of parental-reported sleep bruxism (SB) among 7- to 12-year-old children living in three culturally different countries. METHODS: An identical questionnaire was completed by parents or guardians of children in the Netherlands (Europe), Armenia (West Asia) and Indonesia (Southeast Asia). Pearson's chi-square tests were used to investigate geographical variation in occurrence; logistic regression analyses were performed to study associations. RESULTS: In total, data of 2,562 questionnaires were analysed. The overall prevalence of parental-reported SB was significantly higher in Armenia (36.5%) than in the Netherlands and Indonesia (19.5% and 24.2%, respectively; P < 0.001). However, differences between countries seemed to have disappeared in children around the age of 12. Geographical variation in associated factors is reflected in the fact that, depending on the country, a variety of variables were positively related with parental-reported SB (i.e. younger age, and/or having male gender, and/or experiencing pressure or tension from the home situation, and/or being more easily scared and/or having difficulties in falling asleep). CONCLUSIONS: Considerable geographical variation can exist in the epidemiology of parental-reported SB in children. Cultural rules and standards could explain these findings.

Temporomandibular joint anterior disc displacement with reduction in a young population: Prevalence and risk indicators.

BACKGROUND: Temporomandibular joint (TMJ) anterior disc displacements with reduction (ADDR) are commonly found in the young population and often found to be associated with biomechanical and anatomical factors. Until now, most knowledge on ADDR among children and adolescents comes from studies performed on Caucasian subjects. AIMS: To assess the clinically determined prevalence rates of ADDR among the young Indonesian population and to evaluate its risk indicators. DESIGN: In this cross-sectional study, 1562 pupils and students of 7-21 years old completed a questionnaire and underwent a clinical examination. RESULTS: The prevalence rates of ADDR were 7.0% among children (7-12 years), 14.4% among adolescents (13-18 years), and 12.3% among young adults (19-21 years). Logistic regression analyses revealed that increasing age and lip biting were associated with ADDR in children, whereas pen biting was associated with ADDR in the adolescent population. None of the included factors were found to be associated with ADDR in the young adult population. CONCLUSIONS: The present findings indicate that prevalence of ADDR increases with age, with a peak during the years of adolescence. Biomechanical factors seem to play a significant role in ADDR development.

Temporomandibular Disorders among Dutch Adolescents: Prevalence and Biological, Psychological, and Social Risk Indicators.

Aims: To assess the prevalence rates of pain-related temporomandibular disorders (TMDs) and temporomandibular joint (TMJ) sounds in a large group of Dutch adolescents, aged between 12 and 18 years and to determine if the same biological, psychological, and social risk indicators are related to both TMD pain and TMJ sounds. Methods: In this cross-sectional questionnaire survey, 4,235 questionnaires were analyzed, with an about equal gender distribution. Results: The overall prevalence of pain-related TMDs was 21.6% (26.1% for girls and 17.6% for boys) and that of TMJ sounds was 15.5% (19.3% for girls and 11.7% for boys). Logistic regression analyses revealed that the following variables appeared to be the strongest predictors of TMD pain: female gender, increasing age, sleep bruxism, biting on lips and/or cheeks, stress, and feeling sad. Regarding self-reported TMJ sounds, the multiple regression model revealed that female gender, increasing age, awake bruxism, and biting on lips and/or cheeks were the strongest predictors. Conclusions: TMDs are a common finding among Dutch adolescents. Except for the psychological factors that appeared to be associated with TMD pain only, pain-related TMDs and TMJ sounds shared similar biological risk indicators.

Prevalence and risk indicators of pain-related temporomandibular disorders among Indonesian children and adolescents.

OBJECTIVES: To assess the prevalence of pain-related temporomandibular disorders (TMDs) among Indonesian children and adolescents, and to investigate which risk indicators are associated with it. METHODS: In this cross-sectional study, 1,800 questionnaires were distributed among pupils of schools in the greater Jakarta area. This was done for 2 samples: children with ages ranging from 7 to 12 years (parental report) and adolescents aged 13-18 years (self-report). RESULTS: The prevalence rates for pain-related TMDs in Indonesian children and adolescents were 23.4% (95% CI = 20-27) and 36.9% (95% CI = 33-41), respectively. Regression models revealed that psychological factors and the presence of bodily pain were strongly associated with pain-related TMDs in both children and adolescents, next to oral habits (in children), and sleep and awake bruxism (in adolescents). On the other hand, the socioeconomic status of parents was not associated with pain-related TMDs in either sample. CONCLUSIONS: Pain-related TMDs are common among the young Indonesian population. These findings corroborate those from earlier studies of young populations, namely that bruxism and oral habits, bodily pain complaints, and psychological factors are risk indicators for pain-related TMDs.