307 - Pediatric TMD: Prevalence and Risk Correlates in BigMouth

Abstract:

Purpose: Temporomandibular disorders (TMD) are important sources of orofacial pain in children, yet population-based data in dental settings are limited. This study estimated age- and sex-specific prevalence of TMD signs and symptoms and examined medical and psychological comorbidities associated with painful TMD in a large multi-institutional pediatric cohort.

Methods: We conducted a cross-sectional analysis of electronic health record data from the BigMouth dental data repository (January 2014–May 2025). Children aged 3–17 years with documented TMD screening were included. Outcomes were provider-documented painful TMD and intracapsular interference (jaw popping/clicking). Explanatory variables included age group, sex, headaches, arthritis, sleep apnea, and psychological comorbidities. Prevalence of TMD signs and symptoms was compared using chi-square tests, and multivariable logistic regression estimated adjusted odds of painful TMD.

Results: Among 13,265 children (mean age 12.9±3.5 years; 53.1% female), adolescents had higher prevalence of painful TMD and intracapsular interference than younger children. Females reported more painful TMD than males. Painful TMD clustered with headaches, arthritis, sleep apnea, and psychological comorbidities. Children with higher psychological comorbidity burden had greater odds of painful TMD (P < .001; OR=2.37; 95% CI 1.76–3.19).

Conclusions: TMD symptoms increased during adolescence and were more common in girls, with strong associations to medical and psychological comorbidities. These findings support routine TMD screening in pediatric dental settings and highlight the need for early identification, interdisciplinary management, and targeted intervention for at-risk children.

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