title: Are temporomandibular disorder symptoms and diagnoses associated with pubertal development in adolescents? An epidemiological study.
abstract: BACKGROUND
  In addition to low back pain, temporomandibular disorders (TMDs) are the most prevalent pain- and disability-related musculoskeletal conditions. However, the influence of pubertal development on TMD diagnoses remains unknown.
  
  
  OBJECTIVE
  To assess whether the prevalence of TMD diagnoses, in addition to self-reported symptoms (pain, restricted mandibular mobility, clicking), change according to pubertal stage.
  
  
  METHODS
  A random sample of 1,011 children and adolescents was chosen from the general population of 24,129 children and adolescents aged 10-17 years living in the urban area of Halle, Germany. Study participants were examined for TMD symptoms and diagnoses according to the Research Diagnostic Criteria for TMDs (RDC/TMD). Status of pubertal development was assessed using the Pubertal Development Scale (PDS). The χ(2) tests and multivariate logistic regression models were used, and odds ratios (ORs) and 95% confidence intervals calculated.
  
  
  RESULTS
  The observed increase in TMD symptoms during adolescence was mainly due to the higher frequency of self-reports of these symptoms by girls than boys (ORs for girls vs. boys: 1.42-1.53; p ≤ 0.05), whereas clinical TMD diagnoses (any RDC/TMD diagnosis, or RDC/TMD group IIa diagnosis) in adolescence increased mainly due to pubertal development itself (ORs for subjects beyond vs. before puberty: 1.58-2.00; p < 0.05; no significant sex-related effect was found).
  
  
  CONCLUSIONS
  Pubertal development increases the probability of self-reported TMD symptoms among girls, while the probability thereof decreases among boys. Independent of sex, pubertal growth increases the prevalence of RDC/TMD-related diagnoses-mainly disk displacement-in both sexes.
authors.affiliation: Dental School, University of Leipzig, Leipzig, Germany. christian.hirsch@medizin.uni-leipzig.de
authors.forename: Christian
authors.initials: C
authors.lastname: Hirsch
authors.forename: Julia
authors.initials: J
authors.lastname: Hoffmann
authors.forename: Jens C
authors.initials: JC
authors.lastname: Türp
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D011627:Puberty; D018570:Risk Assessment; D012307:Risk Factors; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000453:epidemiology*