Vierola Anu, Suominen Anna Liisa, Ikavalko Tiina, Lintu Niina, Lindi Virpi, Lakka Hanna-Maaria, Kellokoski Jari, Narhi Matti, Lakka Timo A
University of Eastern Finland, Finland.
J Orofac Pain. 2012 Winter;26(1):17-25.
To examine the prevalence and significance of clinically determined signs of temporomandibular disorders (TMD) and pain in different parts of the body as well as the frequency, intensity, and other features of pain in children.
The subjects were a population-based sample of children 6 to 8 years of age. Complete data on clinical signs of TMD were available for 483 children. Data on pain during the past 3 months, assessed by a questionnaire administered by parents, were available for 424 children. Differences between the prevalence of at least one sign of TMD and the location or frequency of pain were evaluated using the chi-square test, as well as the associations between the prevalence, frequency, and location of pain and gender, the use of medication, and visits to a physician. The relationship of various pain conditions with the risk of having clinical signs of TMD was analyzed using logistic regression.
Of the 483 children, 171 (35%) had at least one clinical sign of TMD. Of the 424 children, 226 (53%) had experienced pain during the past 3 months. Pain was most prevalent in the lower limbs (35%) and head (32%). Of the 226 children with pain, 119 (53%) had experienced frequent pain (≥ once a week). No gender differences were found. The risk of having at least one clinical sign of TMD was 3.0 (95% confidence intervals [CI]: 1.1-8.5, P < .05) times higher in children with back pain, 2.7 (95% CI: 1.2-6.0, P < .05) times higher in children with neck-shoulder pain, and 1.6 (95% CI: 1.1-2.5, P < .05) times higher in children with headache compared to children without these pain symptoms. The risk of having at least one clinical sign of TMD was 12.2 (95% CI: 1.4-101.8, P < .01) times higher among children with palpation tenderness in trapezius muscles than among those without it.
Clinical signs of TMD and pain symptoms are common in children. The relationship of back pain, neck-shoulder muscle palpation tenderness, and headache with clinical signs of TMD suggests that more attention should be paid to stomatognathic function in children with such pain problems.
研究临床诊断的颞下颌关节紊乱病（TMD）体征及身体不同部位疼痛的患病率和意义，以及儿童疼痛的频率、强度和其他特征。
研究对象为基于人群的6至8岁儿童样本。483名儿童有完整的TMD临床体征数据。424名儿童有过去3个月内疼痛情况的数据，由家长通过问卷进行评估。使用卡方检验评估至少一种TMD体征的患病率与疼痛部位或频率之间的差异，以及疼痛的患病率、频率和部位与性别、用药情况及就医次数之间的关联。使用逻辑回归分析各种疼痛情况与出现TMD临床体征风险之间的关系。
483名儿童中，171名（35%）至少有一项TMD临床体征。424名儿童中，226名（53%）在过去3个月内经历过疼痛。疼痛在下肢（35%）和头部（3l%）最为常见。在226名有疼痛的儿童中，119名（53%）经历过频繁疼痛（每周至少一次）。未发现性别差异。与无这些疼痛症状的儿童相比，有背痛的儿童出现至少一项TMD临床体征的风险高3.0倍（95%置信区间[CI]：1.1 - 8.5，P < 0.05），有颈肩痛的儿童高2.7倍（95% CI：1.2 - 6.0，P < 0.05），有头痛的儿童高1.6倍（95% CI：1.1 - 2.5，P < 0.05）。与无斜方肌触压痛的儿童相比，有斜方肌触压痛的儿童出现至少一项TMD临床体征的风险高12.2倍（95% CI：1.4 - 101.8，P < 0.01）。
TMD临床体征和疼痛症状在儿童中很常见。背痛、颈肩肌触压痛和头痛与TMD临床体征之间的关系表明，对于有此类疼痛问题的儿童，应更多关注其口颌系统功能。
