Temporomandibular Joint and Muscle Disorder–type Pain in US Adults: The National Health Interview Survey

Aims: To compare prevalences of self-reported temporomandibular joint and muscle disorders (TMJMD)-type pain in the 2002 US National Health Interview Survey (NHIS) by age and gender for non-Hispanic whites (Caucasians) and non-Hispanic blacks (African Americans). Methods: Data from the 2002 NHIS included information on gender, age, race, ethnicity, education, and TMJMD-type pain. Rao-Scott survey chi-square and survey logistic regression analyses using sampling weights and accounting for the complex design were used to analyze variables relating to prevalences. Results: A total of 30,978 people, 17,498 females and 13,480 males, 20,389 non-Hispanic whites and 4,179 non-Hispanic blacks, were included. The overall prevalence of TMJMD-type pain was 4.6%, with 6.3% for women and 2.8%for men. However, based on age, a significant but modest racial/ethnic difference emerged after adjusting for socioeconomic status. For non-Hispanic white women up to age 50, the prevalence was ~7% to 8%, but it decreased after age 55. Non-Hispanic black women had much lower prevalence at younger ages (~4% at 25 to 34 years), which increased thereafter up to 55 to 64 years of age. A similar racial pattern seemed to emerge for non-Hispanic black men, with the lowest prevalence at ages 25 to 34 years, while non-Hispanic white men had higher prevalences. Overall, however, age seemed to play more of a role in women than men. Conclusion: This is the first report of findings from a nationally representative US sample for TMJMD-type pain by age and race/ethnicity. TMJMD-type pain differed significantly by race, age, and gender after adjusting for socioeconomic status.

age; gender; health disparity; prevalence; race/ethnicity; self-report; temporomandibular joint disorders

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

2. Dworkin SF, LeResche L (eds). Research Diagnostic Criteria for Temporomandibular Disorders: Review, criteria, examinations and specifications, critique. J Cranio-mandib Disord 1992;6:301–355.

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

4. Goulet J-P, Levigne GJ, Lund JP. Jaw pain prevalence among French-speaking Canadians in Quebec and related symptoms of temporomandibular disorders. J Dent Res 1995; 74:1738–1744.

5. List T, Dworkin SF. Comparing TMD diagnoses and clinical findings at Swedish and US TMD Centers using research diagnostic criteria for temporomandibular disorders. J Orofac Pain 1996;10:240–253.

6. Wanman A. Longitudinal course of symptoms of craniomandibular disorders in men and women. A 10-year follow-up study of an epidemiological sample. Acta Odontol Scand 1996;54:337–342.

7. Magnusson T, Egermark I, Carlsson GE. A longitudinal epidemiological study of signs and symptoms of temporomandibular disorders from 15 to 35 years of age. J Orofac Pain 2000;14:310–319.

8. Drangsholt M, LeResche L. Temporomandibular disorder pain. In: Crombie I, Croft PR, Linton SJ (eds). Epidemiology of Pain. Seattle: IASP Press, 1999:203–233.

9. LeResche L. Epidemiology of orofacial pain. In: Lund JP, Levigne GJ, Dubner R, Sessle BJ (eds). Orofacial Pain: From Basic Science to Clinical Management. Chicago: Quintessence, 2001:15–25.

10. Dworkin SF, Huggins KH, Wilson L, et al. A randomized clinical trial using Research Criteria for Temporomandibular Disorders-Axis II to target clinical cases for a tailored self-care treatment program. J Orofac Pain 2001; 16:48–63.

11. Dworkin SF, Turner JA, Mancl L, et al. A randomized clinical trial of a tailored comprehensive care treatment program for temporomandibular disorders. J Orofac Pain 2002;16:256–276.

12. Epker J, Gatchel RJ. Coping profile differences in the biopsychosocial functioning of patients with temporomandibular disorders. Psychosom Med 2000;62:69–75.

13. Dworkin SF. Psychological and psychosocial assessment. In: Laskin DM, Greene CS, Hylander WL (ed). TMDs: An Evidence-Based Approach to Diagnosis and Treatment. Chicago: Quintessence, 2006:203–217.

14. Lipton JA, Ship JA, Larach-Robinson D. Estimated prevalence and distribution of reported orofacial pain in the United States. J Am Dent Assoc 1993;124:115–124.

15. Nilsson IM, List T, Drangsholt M. The reliability and validity of self-reported temporomandibular disorder pain in adolescents. J Orofacial Pain 2006;20:138–144.

16. Pinelli C, de Castro Monteiro Loffredo L. Reproducibility and validity of self-perceived oral health conditions. Clin Oral Investig 2007;11:431–437.

17. Plesh, O, Crawford PB, Gansky SA. Chronic pain in a biracial population of young women. Pain 2002;99: 515–523.

18. Gansky SA, Plesh O. Widespread pain and fibromyalgia in a biracial cohort study of young women. J Rheumatol 2007;34:810–817.

19. The Centers for Disease Control and Prevention 2002 NHIS data document. http://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2002/srvydesc.pdf

20. von Korff M, Dworkin, SF, LeResche L. An epidemiological comparison of pain complaints. Pain 1988;32: 173–183.

21. Gansky SA, Plesh O. Chronic Pain in a biracial cohort study: Up to 5-years of follow-up [submitted]

22. Dworkin SF, LeResche L. Temporomandibular disorder pain: epidemiological data. APS Bulletin 1993(April/May): 12–13.

23. Johansson A, Unell L, Carlsson GE, Soderfeldt B, Halling

A. Risk factors associated with symptoms of temporomandibular disorders in a population of 50- and 60-year-old subjects. J Oral Rehab 2006;33:473–481.

24. Isong U, Gansky SA, Plesh O. Facial pain in US adults: The National Health Interview Survey. J Dent Res 2006; 85(Spec Iss B):2589.

25. Turp JC, Kowalsky CJ, O’Leary N, Stohler CS. Pain maps from facial pain patients indicate a broad pain geography. J Dent Res 1998;77:1465–1472.

26. Wolfe F, Katz RS, Michaud K. Jaw pain: Its prevalence and meaning in patients with rheumatoid arthritis, osteoarthritis, andfibromyalgia. J Rheumatol 2005;32: 2421–2428.

27. Geronimus AT, Hicken M, Keene D, Bound J. “Weathering” and age patterns of allostatic load scores among blacks and whites in the United States. Am J Public Health 2006;96:826–833.