Temporomandibular disorders in children and adolescents

Temporomandibular disorders (TMDs) are conditions that affect the muscles of mastication, temporomandibular joints (TMJs), and associated structures. Historically these conditions were deemed to occur primarily in adults; however, many recent studies have reported a growing prevalence of signs and symptoms of TMDs in children and adolescents. The reported prevalence of these conditions in pediatric patients varies widely due to methodologic differences among studies; therefore, unified diagnostic criteria for children are needed. In this young population, TMDs can cause pain in the masticatory muscles and TMJs, restricted or asymmetric opening of the mouth, and TMJ noises. No single etiologic factor causes TMDs; rather, a combination of influences, including trauma, occlusion, systemic and genetic factors, and psychological factors, is usually to blame. A complete history and a thorough examination, which may include imaging, are needed to make a definitive diagnosis and achieve successful treatment of these conditions. A number of options exist for management of these conditions, but reversible options should prevail as the treatments of choice.