title: Temporomandibular disorders and oral parafunction in children living with their parents and children living in institutional protective care: a comparative study.
abstract: OBJECTIVE
  This study aimed: (i) to identify and compare the prevalence of temporomandibular disorders (TMDs) and oral parafunctions among children living in child-protection institutions (CLCPI) with children living with their parents (CLWP); (ii) to determine whether or not there is an association between oral parafunctions and TMDs; and (iii) to examine the possible impact of stress on TMDs.
  
  
  METHODS
  The study was conducted on a total of 385 children who were divided into two groups: the CLCPI group (n = 184); and the CLWP group (control, n = 201). All children 8-18 years of age and living in protective-care facilities in Kocaeli, Turkey, were included in this study in the CLCPI group. The CLWP control group comprised children of the same age as those in the CLCPI group, but those in the CLWP group were living with their families and were randomly selected from one primary school, one elementary school and one high school in Kocaeli, Turkey. Each child in the study completed a questionnaire and underwent a clinical examination.
  
  
  RESULTS
  The overall prevalence of TMDs and oral parafunctions were higher in the CLCPI group than in the CLWP group (P < 0.05). The vast majority of participants reported at least one parafunction (CLCPI, n = 97.3%; CLWP, n = 93%). Problems related to family or friends were higher in the CLCPI group, whereas problems related to school lessons were higher in the CLWP group (P < 0.05). In both groups, positive associations were found between signs and symptoms of TMDs, oral parafunctions and stressful life events.
  
  
  CONCLUSIONS
  The prevalence of signs and symptoms of TMDs and oral parafunctions differed significantly between CLCPI and CLWP groups, with children of the CLCPI group found to be significantly more prone to TMDs and oral parafunctions than children of the CLWP group.
authors.affiliation: Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey.
authors.forename: Ülkü
authors.initials: Ü
authors.lastname: Şermet Elbay
authors.affiliation: Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey.
authors.forename: Husniye
authors.initials: H
authors.lastname: Demirturk Kocasarac
authors.affiliation: Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Elbay
authors.affiliation: Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Kaya
authors.affiliation: Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey.
authors.forename: Ceren
authors.initials: C
authors.lastname: Uğurluel
authors.affiliation: Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Baydemir
mesh_terms: D000293:Adolescent; D002012:Bruxism / Q000453:epidemiology; D002648:Child; D000068216:Child Protective Services; D002674:Child, Institutionalized / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005386:Fingersucking; D006801:Humans; D008297:Male; D009259:Nail Biting; D010290:Parents; D015995:Prevalence; D013315:Stress, Psychological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000453:epidemiology*; D014421:Turkey / Q000453:epidemiology
keywords: Temporomandibular disorder; institutionalised children; oral parafunctions; orophanages