Occurrence of Clinical Signs of Temporomandibular Disorders in Adult Finns

Aims: To study the age- and gender-related prevalence of signs of temporomandibular disorders (TMD) in the Finnish adult popula-tion. Methods: A clinical health examination was performed as a part of a Health 2000 Health Examination Survey in 2000 and 2001. A nationally representative sample included 8,028 Finns at least 30 years of age, of whom 79% participated also in an oral health investigation, including examination of the stomatognathic system in order to assess the presence of certain TMD signs: maxi-mum interincisal distance < 40 mm, pain in temporomandibular joints or masticatory muscles, and sounds in temporomandibular joints (crepitation, clicking). Results: Thirty-eight percent of the subjects had at least 1 sign of TMD. All the signs studied were more common in women than men. Overall, signs of TMD were also associated with age; the older the subject, the higher the prevalence of the TMD signs. However, when stratified by gender, the association with age was not as clear, and gender differences were observed in the prevalence of the single TMD signs at differ-ent ages. Conclusion: Signs of TMD may be more common among the elderly than is usually reported.

age; gender; prevalence; temporomandibular disorders

1. Mc Neill C, Mohl ND, Rugh JD, Tanaka TT. Temporomandibular disorders: Diagnosis, management, education and research. J Am Dent Assoc 1990;120: 253–263.

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

3. De Kanter RJAM, Truin GJ, Burgersdijk RCW, et al. Prevalence in the Dutch adult population and a meta-analysis of signs and symptoms of temporomandibular disorder. J Dent Res 1993;72:1509–1518.

4. Jagger RG, Woolley SM, Savio L. Signs and symptoms of temporomandibular disorders in Ecuadorian Indians. J Oral Rehabil 2004;31:293–297.

5. Locker D, Slade G. Prevalence of symptoms associated with temporomandibular disorders in a Canadian population. Community Dent Oral Epidemiol 1988;16:310–313.

6. Tervonen T, Knuuttila M. Prevalence of signs and symptoms of mandibular dysfunction among adults aged 25, 35, 50 and 65 years in Ostrobotnia, Finland. J Oral Rehabil 1988;15:455-463.

7. Agerberg G, Inkapööl I. Craniomandibular disorders in an urban Swedish population. J Craniomandib Disord 1990;4:154–164.

8. Wänman A. The relationship between muscle tenderness and craniomandibular disorders: A study of 35-year-olds from the general population. J Orofac Pain 1995;9: 235–243.

9. Egermark I, Carlsson GE, Magnusson T. A 20-year longitudinal study of subjective symptoms of temporomandibular disorders from childhood to adulthood. Acta Odontol Scand 2001;59:40–48.

10. Gesch D, Bernhardt O, Alte D, et al. Prevalence of signs and symptoms of temporomandibular disorders in an urban and rural German population: Results of a population-based Study of Health in Pomerania. Quintessence Int 2004;35:143–150.

11. Rantala MA, Ahlberg J, Suvinen TI, Savolainen A, Kononen M. Symptoms, signs, and clinical diagnoses according to the Research Diagnostic Criteria for Temporomandibular Disorders Among Finnish Multiprofessional Media Personnel. J Orofac Pain 2003;17:311–316.

12. Salonen L, Hellden L, Carlsson G. Prevalence of signs and symptoms of dysfunction in the masticatory system: An epidemiologic study in an adult Swedish population. J Craniomandib Disord 1990;4:241–250.

13. Sohlberg WK, Woo MW, Houston JB. Prevalence of mandibular dysfunction in young adults. J Am Dent Assoc 1979;98:25–34.

14. Glass EG, McGlynn FD, Glaros AG, Melton K, Roman K. Prevalence of temporomandibular disorder symptoms in a major metropolitan area. Cranio 1993;11:217–220.

15. Matsuka Y, Yatani H, Kuboki T, Yamashita A. Temporomandibular disorders in the adult population of Okayama City, Japan. Cranio 1996;14:158–162.

16. Swanljung O, Rantanen T. Functional disorders of the masticatory system in Southwest Finland. Community Dent Oral Epidemiol 1979;7:177–182.

17. Duckro PN, Tait RC, Margolis RB, Deshields TL. Prevalence of temporomandibular symptoms in a large United States metropolitan area. Cranio 1990;8:131–138.

18. Lundeen TF, Scruggs RR, McKinney MW, Daniel SJ, Lewitt SR. TMD symptomology among denture patients. J Craniomandib Disord 1990;4:40–46.

19. Suominen-Taipale AL, Alanen P, Helenius H, Nordblad A, Uutela A. Edentulism among Finnish adults of working age, 1978–1997. Community Dent Oral Epidemiol 1999;27:353–365.

20. Aromaa A, Koskinen S (eds). Health and Functional Capacity in Finland. Baseline Results of the Health 2000 Health Examination Survey. Publications of the National Public Health Institute B12/2004. Helsinki: Hakapaino, 2004.

21. Vehkalahti M, Knuuttila M, Hausen H. Kliinisten mittausten laadun varmistaminen (Quality assurance of the clinical examinations). In: Suominen-Taipale L, Nordblad A, Vehkalahti M, Aromaa A (eds). Suomalaisten aikuisten suunterveys, Terveys 2000 –tutkimus (Oral Health of The Finnish Adults, Health 2000 Health Examination Survey). Publications of the National Public Health Institute B16/2004. Helsinki: Hakapaino, 2004:24–32.

22. SUDAAN User’s Manual, Release 8.0. Research Triangle Park, NC: Research Triangle Institute, 2001.

23. Butz-Jörgensen E, Luan W-M, Holm-Pedersen P, Fejerskov O. Mandibular dysfunction related to dental, occlusal and prosthetic conditions in a selected elderly population. Gerodontics 1985;1:28–33.

24. Österberg T, Carlsson GE. Symptoms and signs of mandibular dysfunction in 70-year-old men and women in Gothenburg, Sweden. Community Dent Oral Epidemiol 1979;7:315–321.

25. Leveille SG. Musculoskeletal aging. Curr Opin Rheumatol 2004;16:114–118.

26. Liljeström MR, Le Bell Y, Anttila P, et al. Headache children with temporomandibular disorders have several types of pain and other symptoms. Cephalalgia 2005;25: 1054–1060.

27. LeResche L. Epidemiology of temporomandibular disorders: Implications for the investigation of etiologic factors. Crit Rev Oral Med 1997;8:291–305.

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

29. Kuttila M, Kuttila S, Niemi PM, Alanen P, Le Bell Y. Fluctuation of treatment need for temporomandibular disorders and age, gender, stress and diagnostic subgroup. Acta Odontol Scand 1997;55:350–355.

30. Alanen P, Kuttila M, Le Bell Y. Fluctuation of temporo-mandibular disorders in accordance with two classifications: The Helkimo dysfunction index and treatment need grouping. Acta Odontol Scand 1997;55:14–17.

31. Kircos LT, Ortendahl DA, Mark AS, Arakawa M. Magnetic resonance imaging of TMJ disc in asymptomatic volunteers. J Oral Maxillofac Surg 1987;45:852–854.

32. Kozeniauskas JJ, Ralph WJ. Bilateral arthrographic evaluation of unilateral temporomandibular joint pain and dysfunction. J Prosthet Dent 1988;60:98–105.

33. Kraus H. Diagnosis and treatment of muscle pain. In: Gelb H (ed). New Concepts in Craniomandibular and Chronic Pain Management. London: Mosby-Wolfe, 1994:77–84.

34. Burakoff R. Epidemiology. In: Kaplan AS, Assael LA (eds). Temporomandibular Disorders. Diagnosis and Treatment. Philadelphia: WB Saunders, 1991:95–103.

35. Heistaro S (ed). Menetelmäraportti. Terveys 2000 – tutkimuksen toteutus, aineisto ja menetelmät Publications of the National Public Health Institute B6/2005. Helsinki: Hakapaino, 2005. Available at: www.ktl.fi/attachments/suomi/julkaisut/julkaisusarja_b/20 05b6.pdf

36. Suominen-Taipale L, Nordblad A, Vehkalahti M, Aromaa A (eds). Suomalaisten aikuisten suunterveys, Terveys 2000 – tutkimus). Publications of the National Public Health Institute [Author: is a number available, as in ref 35?]. Helsinki: Hakapaino, 2004:24–32. Available at: www.ktl.fi/attachments/suomi/julkaisut/julkaisusarja_b/20 04b16.pdf