Critical Reviews in Oral Biology & Medicine, Vol 8, 291-305, Copyright © 1997 by International & American Associations for Dental Research
Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors
L. LeResche
Department of Oral Medicine, University of Washington, Seattle 98195-6370, USA.
Epidemiology is the study of the distribution, determinants, and natural
history of disease in populations. Epidemiology has several uses in
addition to its traditional role of documenting the public health
significance of a condition. Notably, epidemiologic methods and data can be
used to identify and verify causes of disease. This article reviews the
epidemiologic data on pain in the temporomandibular region, and on signs
and symptoms associated with specific subtypes of temporomandibular
disorders, with the aim of identifying possible etiologic factors for these
conditions that deserve further study. Despite methodologic and population
differences, several consistencies are apparent in the epidemiologic
literature. Pain in the temporomandibular region appears to be relatively
common, occurring in approximately 10% of the population over age 18; it is
primarily a condition of young and middle-aged adults, rather than of
children or the elderly, and is approximately twice as common in women as
in men. This prevalence pattern suggests that etiologic investigations
should be directed at biologic and psychosocial factors that are more
common in women than in men, and diminish in older age groups. Most signs
and symptoms associated with particular temporomandibular disorders (e.g.,
joint sounds, pain in the joint) also appear to be more prevalent in women
than in men, although age patterns for these signs and symptoms are not as
clear as for temporomandibular pain. The available data highlight the need
for further research on etiologic factors associated with temporomandibular
pain and with specific diagnostic subtypes of temporomandibular disorders.
