Association between Harmful Oral Habits and Signs and
Symptoms of TMD among Adolescents
Ms. Anitha1, Dr. V. Jayanth
Kumar2*
1Final Year BDS Student, Saveetha Dental
College, Chennai
2Reader, Dept of Oral Medicine and Radiology, Saveetha
Dental College, Chennai
*Corresponding Author E-mail: doctorjayanth@gmail.com
ABSTRACT:
Tempero Mandibular Disorders (TMD) has multifactorial
aetiologies with various initiating factors (trauma, parafunctional habits), predisposing factors (systematic,
genetic, structural, psychological) and perpetuating factors (metabolic
factors, muscle stress). Occurrence of sign and symptoms of TMD disorders in
all age groups with low prevalence among adolescents. The range of symptoms
occurring in adolescents are considered to be mild in nature. Non nutritional
oral habits like lip biting, nail biting being associated with TMD among
adolescents. Hence it is necessary to make the adolescents aware about the
harmful oral habits that could lead to TMD.
AIM: To find whether
harmful oral habits are associated with sign and symptoms of TMD among
adolescents
MATERIALS AND
METHODS: A cross sectional study is carried out among 100 adolescents as well as
questionnaire filled to find out whether harmful oral habits are associated
with signs and symptoms of TMD among adolescents.
RESULTS: The results revealed that 60 out of 80 participants
had atleast mild subclinical symptom of TMD. 75% of
patients had atleast one harmful/parafunctional
habit. The great majority among them were lip biting, nail biting.
KEYWORDS: Temperomandibular disorder,
adolescents, harmful habits.
INTRODUCTION:
Temporo mandibular disorder (TMD)
is a heterogenous group of psychophysiological
disorders commonly characterised by orofacial pain,
chewing dysfunction or both. Various Epidemiological studies had shown
occurrence of TMD in all age groups including children.TMD has multifactorial aetiologies with various initiating factors
like trauma, parafunctional habits and predisposing
factors like systematic, genetic, structural, psychological and perpetuating
factors like metabolic factors, muscle stress [1,2].
It initially manifests as quintessential triology of sign and symptoms in which patient usually
experience joint pain, clicking sound and difficulty in mouth opening [1].
Other commonly occurring sign and symptoms are soreness of muscles of
mastication, attrition of teeth ,mobility of teeth, headaches in the temple,
pain in forehead and eyes, pain in the back of the head , fullness in the ears,
tinnitus, pressure on the eyes, sensitivity to light, lack of concentration
[3].
MATERIALS AND METHODS:
A descriptive cross-sectional study was conducted in saveetha dental hospital, 100 adolescents were randomly
selected. Sign and symptoms of TMD and parafunctional
habits were analysed by using the questionnaire, which consisted of ten
questions with yes/no response along with patient history and detailed clinical
examination. According to guidelines of AAOP, three or more ‘Yes’ responses
indicate TMD [1].
QUESTIONNAIRE:
Age:
Sex:
1) Do you have any
of the following habits?
a) Nail
biting.
A)Yes. B)No
b) clenching of teeth.
A)Yes. B)No
c) Grinding of
teeth. A)Yes. B)No
d) Biting
lip.
A)Yes. B)No
e) Chewing
gum.
A)Yes.
B)No
2) Do you have pain,
difficulty or both opening your mouth, for instance to yawn?
a)
yes.
b) No
3) Does your jaw get
stuck, locked or out of place?
a)
yes
b) No
4)
Do you have pain, difficulty or both when chewing, speaking or using your
jaw?
a) yes.
b) No
5) Do you hear sounds
in your jaw joints?
a) yes.
b) No
6) Do your jaw get
stiff, tight or tired regularly?
a) yes.
b) No
7) Do you have pain
in or around your ear, temples or cheeks?
a) yes.
b) No
8) Do you get neck
pain, headache or toothache often?
a) yes.
b) No
9) Have you suffered
recent trauma to your head, neck or jaw?
a) yes.
b) No
10) Have you felt any recent
changes in your bite?
a) yes.
b) No
11) Have
you had recent treatment for an unexplained problem in your jaw joints?
a) yes.
b) No
RESULTS:
Study population comprised of 58 male and 42 females
age between 10-18. Twenty adolescents reported no sign or symptoms of TMD.
Thirty four adolescents responded yes to atleast one
statement of AAOP questionnaire and a total of 80 adolescents responded yes to
three or more questions. Total number of twenty five participants had no
harmful oral habits while 40% and 35% participants had presence of two, three
or more habits respectively. Statistically significant association was found
between nail biting, biting lip / objects, grinding of teeth with sign and
symptoms of TMD (p ≤ 0.05).Top three symptoms of TMD reported by study
population were headache, neck pain, toothache (48%), pain in mouth opening
(35%) and jaw sounds (37%). [Table-1] describes the detailed description of
sign and symptoms of TMD reported by the study population. There is a
statistically significant association was found between patients with TMD and
sign and symptoms like headache, pain in mouth opening, sounds from joint etc
TABLE-1
|
Questions |
Gender |
Yes |
No |
Statistical Significance |
|
Do you have pain,
difficulty or both opening your mouth, for instance to yawn? |
Male |
19(32.8%)
|
39(67.2%) |
P>0.05 |
|
Female
|
16(38.1%)
|
26(61.9%)
|
||
|
Does your jaw get stuck,
locked or out of place? |
Male |
8(13.8%)
|
50(86.2%)
|
P>0.05 |
|
Female |
4(9.5%)
|
38(90.5%)
|
||
|
Do
you have pain, difficulty or both when chewing, speaking or using your jaw? |
Male |
12(20.7%)
|
46(79.3%)
|
P>0.05 |
|
Female |
11(26.2%)
|
31(73.8%)
|
||
|
Do you hear sounds in your
jaw joints? |
Male |
23(39.7%)
|
35(60.3%)
|
P>0.05 |
|
Female |
14(33.3%)
|
28(66.7%)
|
||
|
Do your jaw get stiff,
tight or tired regularly? |
Male |
8(13.8%)
|
50(86.2%) |
P>0.05 |
|
Female |
5(11.9%)
|
37(88.1%) |
||
|
Do your jaw get stiff,
tight or tired regularly? |
Male |
16(27.6%)
|
42(72.4%)
|
P>0.05 |
|
Female |
12(28.6%)
|
30(71.4%)
|
||
|
Do
you get neck pain, headache or toothache often? |
Male |
28(48.3%)
|
30(51.7%)
|
P>0.05 |
|
Female |
20(47.6%)
|
22(52.4%)
|
||
|
Have you felt any recent
changes in your bite? |
Male |
1(1.7%)
|
57(98.3%)
|
P>0.05 |
|
Female |
5(11.9%)
|
37(88.1%)
|
||
|
Have you suffered recent
trauma to your head, neck or jaw? |
Male |
3(5.2%)
|
55(94.8%)
|
P>0.05 |
|
Female |
1(2.4%)
|
41(97.6%)
|
||
|
Have you had recent
treatment for an unexplained problem in your jaw joints? |
Male |
0.
|
58(100%)
|
P>0.05 |
|
Female |
0.
|
42(100%)
|
DISCUSSION:
This study was aimed to find association between parafunctional habits and sign and symptoms of TMD among
adolescent residing in Chennai. In present study there was statistically
significant association between harmful oral habits like nail biting object/lip
biting; grinding of teeth and sign and symptoms of TMD which was accordance to
study done by Lauriti et al.,[5]. Lobbezoo
et al., and Respetro C et al. was conducted a study
on “bruxism, clenching/grinding of teeth, nail
biting, object biting, forward thrust of mandible as parafunctions”
[4,6]. In present study statistically significant association was found between
Nail biting and TMD]. These parafunctional habits
should be considered as risk factor for TMD as they act as triggering point for
appearance of TMD due to its effect on stomatognathic
system. Headache, neck pain, toothache (48%), sounds in the joint (37%) and
pain in mouth opening (35%) were top three sign and symptoms of TMD, similarly
Motta et al., was conducted among Brazilian adolescents [1]. Three sign and
symptoms are considered as classic triad of TMD disorder occurring in a
sequential pattern. Questionnaire can be used for screening and diagnosis of
individuals with TMD disorders. These questionnaires can help in identification
of individuals having sign and symptoms of TMD.
CONCLUSION:
This study says that there was an association between parafunctional habits and sign and symptoms of TMD. Non
nutritional oral habits like lip biting, nail biting being associated with TMD
among adolescents. Hence it is necessary to make the adolescents aware about
the harmful oral habits that could lead to TMD.
REFERENCE:
1)
Motta LJ, Guedes CC, De Santis
TO, Fernandes KP, Mesquita-Ferrari
RA, Bussadori SK. Association between parafunctional habits and signs and symptoms of temporomandibular dysfunction among adolescents. Oral
Health Prev Dent. 2013; 11(1):3-7
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Tecco S, Crincoli V, Di Bisceglie B, Saccucci M, Macrí M, Polimeni A, Festa F. Signs and symptoms of temporomandibular
joint disorders in Caucasian children and adolescents. Cranio.
2011;29(1):71-79.
3)
Micheloni A, Fernandes G, Goncalves D, Camparis C. Temporomandibular disorders among Brazilian adolescents:
reliability and validity of a screening questionnaire. J Appl
Oral Sci. 2014;22(4):314–22.
4)
Lobbezoo F, van der Zaag J, van Selms MK, et al.
Principles for the management of bruxism. J Oral Rehabil. 2008;35:509–23.
5)
Lauruti L, Motta L, Silva P, et al. Are Occlusal Characteristics, Headache, Parafunctional
Habits and Clicking Sounds Associated with the Signs and Symptoms of Temporomandibular Disorder in Adolescents? J PhysTher Sci. 2013;25(10):1331–34.
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Restrepo C, Gomez S, Manrique
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Received on 24.05.2017
Modified on 17.06.2017
Accepted on 03.07.2017
© RJPT All right reserved
Research J. Pharm. and Tech.
2017; 10(8): 2668-2670.
DOI: 10.5958/0974-360X.2017.00474.7