Race and gender as TMD risk factors in children.

The aim of this study was to record the prevalence in preschool children of oral/facial pain symptoms of clinical interest in the diagnoses of temporomandibular disorders (TMD) and to analyze the association with the race and gender factors. Children, 525 4-6 year olds, mean age 5.1 +/- 0.65 (SD), 326 Caucasian and 199 African American, from a preschool and kindergarten program in a low income industrial area, who participated in a voluntary oral health examination, were examined. Comparisons were made using Chi-Square test. An alpha-level of 5% was chosen, and the effect of making multiple comparisons was compensated for by Bonferroni correction. No gender differences were found, but racial differences were observed regarding six of the 10 variables. Twenty-five percent of the children had recurrent (at least one to two times per week) headache. Thirteen percent had recurrent earache, African-American children more often than Caucasian children (p approximately 0.0038). Thirteen percent had recurrent temporomandibular joint (TMJ) pain, and 11% had recurrent neck pain. Pain or tiredness in the jaws during chewing was reported by 29% of the children, more often by African-American than by Caucasian (p < 0.00001). Pain at jaw opening occurred in 13% of the children, more often in the African-American than in the Caucasian children (p approximately 0.00004). Palpation pain was found in the posterior TMJ area in 28%, in the lateral TMJ area in 22%, in the masseter area in 19%, in the anterior temporalis area in 15% and was found more often in all of those regions in the African-American than in the Caucasian children (p approximately 0.00001), except for the temporalis area. In conclusion, this study showed that mild, but distinct, TMD-related oral/facial pain symptoms occur already by ages 4-6 with significant differences in distribution observed between the African-American and the Caucasian races. While gender seems to play a negligible role in this age group, this does not necessarily mean that race is a causative factor. The pain symptoms may be caused by other factors with different distribution in the two racial subgroups.