Pediatric TMD: Associations with malocclusion, parafunctions, and symptoms: A cross-sectional study

The aim of this study was to determine the prevalence of temporomandibular joint (TMJ) disorders and to investigate the role of malocclusion and harmful oral habits in their etiology among children. The rising prevalence of TMJ disorders in the pediatric population constitutes a significant clinical problem affecting their quality of life. A total of 242 patients aged 7 to 16 years who visited our clinic between March and September 2024 were included in this cross-sectional study. Patients were divided into 2 groups based on the presence or absence of TMJ disorders using the Fonseca questionnaire. Harmful oral habits were assessed with the Oral Behavior Checklist, and the impact on oral health with the Oral Health Impact Profile-14 questionnaires. Dental occlusion was determined according to Angle's classification. Additionally, clinical findings such as joint sounds, tenderness, and mouth opening were recorded. Appropriate statistical tests were used for data analysis. TMJ disorders were detected in 63.2% of the patients. Statistical analyses revealed that the risk of TMJ disorder was 2.32 times higher in individuals with high scores for harmful oral habits (P < .001). The presence of Class II and Class III malocclusion increased this risk by 1.69 times (P = .005). In terms of gender, the incidence of TMJ disorders was 1.47 times higher in girls than in boys (P = .027). As the severity of the disorder increased, patients' quality of life scores rose from 8.4 to 31.2 (P < .001). TMJ disorders were detected in 79.6% of patients who clenched their teeth at night. This study confirms that TMJ disorders are more prevalent than expected in the pediatric population. The findings indicate that harmful oral habits and malocclusion, particularly in Class II and Class III cases, are significant and modifiable risk factors for TMJ disorders. These results emphasize that careful assessment for these risk factors during routine pediatric dental examinations is a critical step for developing effective early diagnosis and intervention strategies.