title: Differences in pain perception in children reporting joint and orofacial muscle pain.
abstract: OBJECTIVE
  To determine changes in orofacial pain perception in community-based children by assessing the pressure pain threshold (PPT) with an algometer and pain intensity by manual palpation (MP).
  
  
  METHODS
  A total of 100 children from the community aged 7 to 12 years were assessed. Thirty-eight children reported pain in the orofacial region. Of these children,10 reported joint pain (GJ), 12 reported joint and muscle pain (GJMM), 5 reported muscle pain (GMM), 11 reported pain during mastication (GMAST), and 62 reported no pain. An ANOVA (p < 0.05) was used to determine the differences in pain intensity and PPT among groups.
  
  
  RESULTS
  Significantly higher pain intensity upon MP was observed for the temporalis muscle in the GJMM, GMAST and GJ groups compared to the remaining groups. The PPT values were significantly lower in the masseter temporalis muscles, TMJ and thenar region in the GJMM group compared to the other groups.
  
  
  CONCLUSIONS
  MP more accurately differentiated symptomatic subjects from symptom-free TMD subjects, and PPT values were more sensitive to the discrimination of pain in the orofacial sites assessed. In addition, the changes in perception at a larger number of sites among children reporting mixed pain may suggest the presence of a possible mechanism of central sensitization.
authors.affiliation: Department of Neurosciences and Behavioral Sciences, Ribeirão Preto School of Medicine Ribeirao Preto, University of São Paulo--USP. chavestc@fmrp.usp.br
authors.forename: T C
authors.initials: TC
authors.lastname: Chaves
authors.forename: H Martins
authors.initials: HM
authors.lastname: Nagamine
authors.forename: L Mêlo
authors.initials: LM
authors.lastname: de Sousa
authors.forename: A Siriani
authors.initials: AS
authors.lastname: de Oliveira
authors.forename: S C Hallak
authors.initials: SC
authors.lastname: Regalo
authors.forename: D Bevilaqua
authors.initials: DB
authors.lastname: Grossi
mesh_terms: D018771:Arthralgia / Q000503:physiopathology*; D059333:Central Nervous System Sensitization / Q000502:physiology; D002648:Child; D004192:Discrimination, Psychological / Q000502:physiology; D005157:Facial Pain / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008406:Masseter Muscle / Q000503:physiopathology; D008409:Mastication / Q000502:physiology; D058748:Pain Perception / Q000145:classification* / Q000502:physiology; D017288:Pain Threshold / Q000502:physiology; D010173:Palpation / Q000379:methods; D011795:Surveys and Questionnaires; D013703:Temporal Muscle / Q000503:physiopathology; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000503:physiopathology; D013710:Tendons / Q000503:physiopathology