Temporomandibular joint dysfunction in children presenting as otalgia.

Thirty-one children between the ages of 6 and 16 years with otalgia but normal eardrums were investigated for temporomandibular joint dysfunction. Ear disease was excluded by microscopic examination, pure tone audiometry and impedance tympanometry. Dental disease was excluded by clinical and radiographic examination. Temporomandibular joint dysfunction was diagnosed by finding tenderness of the joint or masticatory muscles in at least two separate sites at one examination. Twenty-one patients were assessed as having joint dysfunction and in 18 of these the diagnosis was made when the child was seen in pain. Tympanometry on painful ears did not reveal any abnormality or trend in the values for compliance or middle ear pressure. Simple methods of treatment were effective in all cases. Temporomandibular joint dysfunction should be suspected in any child who complains of recurrent otalgia in the absence of dental and otological disease.