title: Signs and symptoms of first-onset TMD and sociodemographic predictors of its development: the OPPERA prospective cohort study.
abstract: Although cross-sectional studies of temporomandibular disorder (TMD) often report elevated prevalence in young women, they do not address the risk of its development. Here we evaluate sociodemographic predictors of TMD incidence in a community-based prospective cohort study of U.S. adults. Symptoms and pain-related disability in TMD cases are also described. People aged 18 to 44 years with no history of TMD were enrolled at 4 study sites when they completed questionnaires about sociodemographic characteristics. During the median 2.8-year follow-up period, 2,737 participants completed quarterly screening questionnaires. Those reporting symptoms were examined clinically and 260 had first-onset TMD. Additional questionnaires asked about severity and impact of their symptoms. Univariate and multivariable Cox regression models quantified associations between sociodemographic characteristics and TMD incidence. First-onset TMD developed in 3.9% of participants per annum, typically producing mild to moderate levels of pain and disability in cases. TMD incidence was positively associated with age, whereas females had only slightly greater incidence than males. Compared to whites, Asians had lower TMD incidence whereas African Americans had greater incidence, although the latter was attenuated somewhat after adjusting for satisfaction with socioeconomic circumstances.
  
  
  CONCLUSIONS
  In this study of 18- to 44-year-olds, TMD developed at a higher rate than reported previously for similar age groups. TMD incidence was positively associated with age but weakly associated with gender, thereby differing from demographic patterns of prevalence found in some cross-sectional studies. Experiences related to aging merit investigation as etiologic influences on development of TMD.
authors.affiliation: Regional Center for Neurosensory Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; (†)Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; (‡)Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: gary_slade@dentistry.unc.edu.
authors.forename: Gary D
authors.initials: GD
authors.lastname: Slade
authors.forename: Eric
authors.initials: E
authors.lastname: Bair
authors.forename: Joel D
authors.initials: JD
authors.lastname: Greenspan
authors.forename: Ronald
authors.initials: R
authors.lastname: Dubner
authors.forename: Roger B
authors.initials: RB
authors.lastname: Fillingim
authors.forename: Luda
authors.initials: L
authors.lastname: Diatchenko
authors.forename: William
authors.initials: W
authors.lastname: Maixner
authors.forename: Charles
authors.initials: C
authors.lastname: Knott
authors.forename: Richard
authors.initials: R
authors.lastname: Ohrbach
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology
keywords: Temporomandibular disorder; demography; population characteristics; prospective cohort studies; socioeconomic factors