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03-24-2007, 08:09 PM
If dentists ask two simple questions during annual examination, they can single out adolescents who suffer from temoromandibular dysfunction and pain, so-called TMD pain. The condition, characterized by pain in the face and jaw, can lead to long-term suffering in severe cases.

"If we find the patients in time, their risk of developing chronic pain as adults declines," says dentist Ing-Marie Nilsson, who recently defended her doctoral dissertation at the Faculty of Dentistry at Malmö University College in Sweden.

Her dissertation, Reliability, validity, incidence and impact of termoromandibular pain disorders in adolescents, shows that more than four percent of all children between the ages of 12 and 19 examined by the National Dental Service in Ostergötland County suffer from TMD pain.

In the study, which started in 2000, some 1,200 teens reported that they have pain. The figures are based on the responses given by the adolescents to two questions: "Do you have pain in the temple, face, jaw, or jaw joint at least once a week?" and "Do you experience pain at least once a week when you open your mouth or chew?" If the adolescents answered yes to one or both questions, they were registered as patients with TMD pain.

Ing-Marie Nilsson is not surprised by the outcome of the study, since earlier studies have presented similar results.

"But we are unique in having examined so many patients," she says. She feels the problem is underestimated.

"For those suffering from it, it is definitely a problem, and more people should be able to get help than actually do."

Her dissertation shows that in 2000 only half of those who wanted help for their pain were actually offered help.

One of the four studies that make up the dissertation shows that girls are afflicted more often than boys and that the problem increases with age. In other ways as well, TMD evinces a picture like that of other painful conditions, such as headache. It is unusual in children and usually debuts at puberty.

"This is a difficult age, especially for girls."

One study shows that 60 percent of those treated with an acrylic splint experience at least a 50-percent reduction in pain. But Ing-Marie Nilsson believes that in many cases it would be enough simply to provide adequate information or behavior-oriented treatment, where the patient learns various relaxation techniques.

The earlier these patients are discovered, the lower the risk of their developing chronic pain as adults.

Ing-Marie Nilsson's dissertation shows that the majority will be fine without major treatment measures, but for a small group, the pain becomes both recurrent and protracted.

This smaller group needs help if they are to avoid a long period of disability.

"It is important to teach them ways to deal with the pain early in life," says Ing-Marie Nilsson.

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