An 8-year Follow-up Study of Temporomandibular Disorder and Psychosomatic Symptoms from Adolescence to Young Adulthood

Aims: To assess the prevalence of subjective symptoms of pain and/or temporomandibular disorder (TMD) dysfunction and their association with psychosomatic (PS) symptoms in a longitudinal follow-up study of Finnish young adults over an 8-year period. Methods: One hundred twenty-eight Finnish young adults (60 men and 68 women) were assessed longitudinally at the ages of 15, 18, and 23 years using routine stomatognathic methods and a standardized questionnaire. Results: The prevalence of reported TMD symptoms ranged from 6% to 12% for pain symptoms, from 12% to 28% for dysfunctional symptoms, and from 4% to 7% for a combination of these 2 types of symptoms. The preva-lence of PS symptoms, which were constantly present in many of the patients who reported them, ranged from 7% to 11%. A sig-nificant correlation (P ＜ .05) was found between TMD pain and PS symptoms at the ages of 15 and 18 years. PS symptoms were not significantly correlated to TMD dysfunction symptoms or to experiencing no symptoms at any age. The majority of subjects in all age groups with both TMD and PS symptoms were female, in a ratio of approximately 2 to 1. Conclusion: The prevalence of TMD and PS symptoms was low in adolescence and young adult-hood, and there was a significant association, although relatively weak, between PS symptoms and reports of either TMD pain or a combination of TMD pain and dysfunction symptoms.

longitudinal studies; prospective studies; psychosomatic symptoms; temporomandibular disorders

1. Suvinen TI. Psychophysiological Aspects of Temporoman-dibular Pain and Dysfunction [PhD thesis]. Melbourne, Australia: University of Melbourne, 1992.

2. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders. Review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992;6:301–355.

3. Okeson JP (ed). Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. Chicago: Quintessence, 1996.

4. McNeill C. Management of temporomandibular disorders: Concepts and controversies. J Prosthet Dent 1997; 77:10–22.

5. Nilner M. Prevalence of functional disturbances and dis-eases of the stomatognathic system in 15–18 year olds. Swed Dent J 1981;5:189–197.

6. Carlsson GE. Epidemiological studies of signs and symptoms of temporomandibular joint-pain-dysfunction. A literature review. Aust Prosthodont Soc Bull 1984;14:7–12.

7. Magnusson T, Egermark-Eriksson I, Carlsson GE. Five-year longitudinal study of signs and symptoms of mandibular dysfunction in adolescents. J Cranioman-dibular Pract 1986;4:338–344.

8. Wänman A, Agerberg G. Mandibular dysfunction in adolescents. I. Prevalence of symptoms. Acta Odontol Scand 1986;44:47–54.

9. Heikinheimo K, Salmi K, Myllärniemi S, Kirveskari P. Symptoms of craniomandibular disorder in a sample of Finnish adolescents at the ages of 12 and 15 years. Eur J Orthod 1989;11:325–331.

10. Dworkin SF, Huggins KH, LeResche L, et al. Epidemiology of signs and symptoms in temporomandibular disorders: Clinical signs in cases and controls. J Am Dent Assoc 1990;120:273–281.

11. Könönen M, Nyström M. A longitudinal study of craniomandibular disorders in Finnish adolescents. J Orofac Pain 1993;7:329–336.

12. de Kanter RJ, Truin GJ, Burgersdijk RC, et al. Prevalence in the Dutch adult population and meta-analysis of signs and symptoms of temporomandibular disorder. J Dent Res 1993;72:1509–1518.

13. Carlsson GE, LeResche L. Epidemiology of temporo-mandibular disorders. In: Sessle BJ, Bryant PS, Dionne RA (eds). Progress in Pain Research and Management. Vol 4: Temporomandibular disorders and related pain condi-tions. Seattle, WA: IASP Press, 1995:211–226.

14. Dworkin SF, Suvinen TI. Orofacial pain/temporo-mandibular disorders. Review of the scientific literature on biobehavioral aspects of temporomandibular disorders. Behavioral, cognitive and emotional factors related to etiology, assessment, diagnosis and management. In: Proceedings of the World Workshop on Oral Medicine III, 2–5 Aug 1998, Chicago, IL.

15. Suvinen T, Reade PC. Temporomandibular disorders: A critical review of the nature of pain and its assessment. J Orofac Pain 1995;9:317–339.

16. Dahlsröm L. Psychometrics in temporomandibular disorders. An overview. Acta Odontol Scand 1993;51:339–352.

17. Nyström M. Development of the deciduous dentition in a series of Finnish children. Proc Finn Dent Soc 1982;78 (4 suppl):1–48.

18. Alaluusua S, Kleemola-Kujala E, Grönroos L, Evälahti M. Salivary caries-related tests as predictors of future caries increment in teenagers. A three-year longitudinal study. Oral Microbiol Immunol 1990;5:77–81.

19. Nilner M, Lassing S-Å. Prevalence of functional disturbances and diseases of the stomatognathic system in 7–14 year olds. Swed Dent J 1981;5:173–187.

20. Rimpelä M, Rimpelä A, Pasanen M. Perceived symptoms among 12-18 year-old Finns [in Finnish with English summary]. J Soc Med 1982;19:219–233.

21. Könönen M, Nyström M, Kleemola-Kujala E, et al. Signs and symptoms of craniomandibular disorders in a series of Finnish children. Acta Odontol Scand 1987;45:109–114.

22. Könönen M, Waltimo A, Nyström M. Does clicking in adolescence lead to painful temporomandibular joint locking? Lancet 1996;347:1080–1081.

23. Kleinknecht R, Mahoney E, Alexander L. Psychosocial and demographic correlates of temporomandibular disorders and related symptoms: An assessment of community and clinical findings. Pain 1987;29:313–324.

24. De Leeuw JRJ, Steenks MH, Ros WJ, Lobbezoo-Scholte AM, Bosman F, Winnubst JA. Multidimensional evaluation of craniomandibular dysfunction. I: Symptoms and correlates. J Oral Rehabil 1994;21:501–514.

25. Suvinen T, Reade PC, Sunden B, Gerschman JA, Koukounas E. Temporomandibular disorders: Part I. A comparison of symptom profiles in Australian and Finnish patients. J Orofac Pain 1997;11:58–66.

26. Suvinen T, Reade PC, Sunden B, Gerschman JA, Koukounas E. Temporomandibular disorders: Part II. A comparison of psychologic profiles in Australian and Finnish patients. J Orofac Pain 1997;11:147–157.

27. Reade PC. An approach to the management of temporo-mandibular joint pain-dysfunction syndrome. J Prosthet Dent 1984;51:91–96.

28. Dworkin SF. Psychosocial issues. In: Lavigne G, Sessle BJ, Dubner R (eds). Orofacial Pain: From Basic Science to Clinical Management. Chicago: Quintessence, 2001: 115–188.

29. Dworkin SF, Von Korff M, LeResche L. Epidemiologic studies of chronic pain: A dynamic ecologic perspective. Ann Behav Med 1992;14:3–11.

30. Rugh JD. Psychological components of pain. Dent Clin North Am 1987;31:579–594.

31. Turner JA, Clancy S. Strategies for coping with chronic low back pain: Relationship to pain and disability. Pain 1986;24:355–364.