Prevalence of Temporomandibular Disorders: Samples Taken From Attendees of Medical Health-Care Centers in the Islamic Republic of Iran

Aims: To determine the prevalence of facial pain and temporomandibular disorders (TMD) in people located in urban and rural areas in a newly industrialized country (Iran). Methods: Two-hundred twenty-three subjects between 18 and 65 years of age (mean: 32.07; SD: 10.83) were randomly selected from an urban area and a rural area. One-hundred nineteen subjects from Mashhad (major city) and 104 subjects from Zoshk (village) were voluntarily recruited from medical health-care centers. Subjects who consulted the health-care center for dental, ear, nose, or throat issues were excluded. The monitoring of public health attendance of all citizens at designated health-care centers is compulsory by local law. All subjects were examined in accordance with the Research Diagnostic Criteria for TMD (RDC/TMD). Facial pain was assessed by using a questionnaire; the prevalence of myofascial pain, disc displacement, and degenerative disorders was determined by clinical examination. Nonparametric tests were used to assess group differences (ie, between village and city). Results: Subjects in urban areas suffered less from facial pain (20.2% versus 46.2%; P < .01 [Mann-Whitney U test]) than subjects in rural areas. The frequency of TMD, disc displacement, and degenerative disorders was greater in the rural area. Conclusion: The symptoms under investigation were signifi-cantly more widespread in rural than in urban areas. With regard to TMD per se, the place of residence appears to be unimportant. However, the rural population was significantly affected by facial pain.

degenerative disorders;disc displacement;facial pain;myofascial pain;prevalence

1. 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.

2. 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.

3. Katz J, Heft M. The epidemiology of self-reported TMJ sounds and pain in young adults in Israel. J Public Health Dent 2002;62:177–179.

4. Jagger RG, Wood C. Signs and symptoms of temporomandibular joint dysfunction in a Saudi Arabian population. J Oral Rehabil 1992;19:353–359.

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

6. Schmitter M, Balke Z, Hassel A, Ohlmann B, Rammelsberg P. The prevalence of myofascial pain and its association with occlusal factors in a threshold country non-patient population. Clin Oral Investig 2007;11:277–281.

7. Goddard G, Karibe H. TMD prevalence in rural and urban Native American populations. Cranio 2002;20:125–128.

8. Chung JW, Kim JH, Kim HD, Kho HS, Kim YK, Chung SC. Chronic orofacial pain among Korean elders: Prevalence, and impact using the graded chronic pain scale. Pain 2004;112:164–170.

9. Macfarlane TV, Blinkhorn AS, Davies RM, Kincey J, Worthington HV. Orofacial pain in the community: Prevalence and associated impact. J Dent Oral Epidemiol 2002;30: 52–60.

10. Ow RK, Loh T, Neo J, Khoo J. Symptoms of craniomandibular disorder among elderly people. J Oral Rehabil 1995;22:413–419.

11. Helkimo M. Studies on function and dysfunction of the masticatory system. IV. Age and sex distribution of symptoms of dysfunction of the masticatory system in Lapps in the north of Finland. Acta Odontol Scand 1974;32:255–267.

12. Warren MP, Fried JL. Temporomandibular disorders and hormones in women. Cells Tissues Organs 2001;169:187–192.

13. Noguerol B, Llodra JC, Sicilia A, Follana M. La salud Bucodental en Espana, 1994. Antecedntes y Perspectivas de Futuro. Madrid: Ediciones Avances, 1995.

14. White BA, Williams LA, Leben JR. Health care utilization and cost among health maintenance organization members with temporomandibular disorders. J Orofac Pain 2001;15: 158–169.