Characterizing pain and psychosocial profiles in adolescents with temporomandibular disorders: A cross-sectional case-control study.

BACKGROUND

Temporomandibular disorders (TMDs) often emerge during adolescence and are associated with substantial pain burden and psychosocial distress, yet few researchers have comprehensively characterized these profiles in youth.

METHODS

Adolescents (aged 10-19 years) were screened for TMDs using the validated 3 screening questions for TMDs questionnaire and categorized into TMD or non-TMD control groups. All participants (50/group) completed validated questionnaires assessing pain characteristics (Graded Chronic Pain Scale), symptom burden and headache (Symptom Questionnaire), and psychosocial functioning (Revised Child Anxiety and Depression Scale and Perceived Stress Scale). Groups were compared using t tests and χ2 tests; hierarchical cluster analysis was used to identify subgroups within the TMDs sample.

RESULTS

Adolescents with self-reported TMD symptomatology reported significantly greater pain intensity (P < .001), pain-related interference (P < .001), symptom burden (P < .001), headache frequency (P < .001), anxiety (P = .002), and depression (P < .001) than control participants. Through cluster analysis the following 3 subgroups were identified: headache cluster (high profiles), intermediate cluster (high symptom burden and pain-related interference), and no headache cluster (low profiles). Among those with TMDs, co-occurring headache (56%) was associated with significantly worse outcomes across all domains (all, P ≤ .017). No significant interaction was observed between TMDs and headache on the basis of a multiple analysis of variance (P = .054).

CONCLUSIONS

Adolescents with self-reported TMD symptomatology experienced elevated pain and psychological symptoms, with distinct symptom-based subtypes. Headache co-occurrence worsened symptoms severity.

PRACTICAL IMPLICATIONS: Incorporating psychosocial screening and headache assessment into routine care for adolescents with TMDs may improve early identification of those at greater risk of developing pain-related disability and facilitate timely, targeted intervention.