Children and adolescents with temporomandibular disorders (TMD) may experience emotional, somatic, and aggressive behavior more frequently than their healthy counterparts as reported by their parents, according to a study published in the Journal of Headache and Pain.

For this cross-sectional study, a total of 386 children and adolescents between the age of 10 and 18 who reside in Jeddah, Saudi Arabia, were randomly selected. One day before clinical evaluation, parents were asked to complete the Child Behavior Checklist to assess their child’s psychosocial status (eg, emotional, behavioral, and somatic functioning and social competence). Using the Research Diagnostic Criteria for temporomandibular disorders Axis I and II, Arabic version of the Child Behavior Checklist scale, participants were categorized as not having TMD (n=279), experiencing TMD-associated pain (n=85), or having TMD with no associated pain (n=22).

Girls with TMD-related pain were found to have higher scores for anxiety/depression (Coefficient, 7; 95% CI, 3.8-10.2) and somatic complaints (Coefficient, 6; 95% CI, 3.0-9.0) compared with boys in the adjusted analysis. Boys with TMD-associated pain had higher scores for somatic complaints (Coefficient, 8; 95% CI, 2.8-13.2) and aggression (Coefficient, 5; 95% CI, 0.13- 9.9). Children between the age of 10 and 13 with TMD-associated pain had higher scores for affective issues in the adjusted analysis (Coefficient, 5; 95% CI, 1.0-9.0), anxiety problems (Coefficient, 5.5; 95% CI, 1.1-9.8), somatic problems (Coefficient, 5; 95% CI, 1.1-8.9), and conduct problems (Coefficient, 3; 95% CI, 0.3-5.7).

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The high dropout rate of boys, the sole inclusion of residents from Jeddah, and the reliance on parent reports represent the main limitations of the study.

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“[T]he present study revealed that the parents rated that their children with TMD-pain suffer from emotional, somatic and aggressive behavior to a higher degree than healthy control subjects, […] emphasiz[ing] the importance of using self-reported measures among youth suffering from pain conditions,” noted the study authors. 

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Al-Khotani A, Gjelset M, Naimi-Akbar A, et al. Using the child behavior checklist to determine associations between psychosocial aspects and TMD-related pain in children and adolescents. J Headache Pain. 2018;19(1):88.