Relation between stress and symptoms of craniomandibular disorders in adolescents

The psychophysiologic theory proposes that stress can precipitate craniomandibular disorders (CMD) and that stress correlates more strongly to disorders of the masticatory muscles than to temporomandibular joint disorders. Empirical reports show only low correlations between emotional stress and CMD signs and symptoms, and that some of them might be spurious. In the present study this correlation was assessed in 417 adolescents from 11 to 16 years old. Data from the clinical examination were used to construct two indices: 1) The number of muscles sites tender to palpation, and 2) signs from the joint and restricted movement. Results show that global stress was only significantly correlated with the muscle index (r = .20), but not with the other index. Only the multiple regression analyses regarding muscle disorders had a significant beta weight of global stress that remained significant when controlling for the intervening variables age, gender and psychosomatic symptoms. The pattern of the stress-specific and unspecific CMD signs was consistent with the postulated stress model. Since there are positive results with regard to the stress model in patient samples and in this unselected sample of adolescents, further research is indicated, including the concept of somatization more explicitly.