Prevalence and association of temporomandibular disorders with malocclusion and anxiety in children and adolescents: a cross-sectional observational study.

The aims of this study were to evaluate the prevalence of temporomandibular disorders (TMDs) in children between 6 and 12 years of age in the city of Qom, Iran, and explore the associations between TMDs and both malocclusion and anxiety. This study was conducted in 193 children who were assessed via interview, clinical examination, and the parent version of the Spence Children's Anxiety Scale. Clinical examinations consisted of assessment of asymmetry, joint sounds, jaw movements (functional shift, temporomandibular joint pain on opening, limitations on mouth opening, and mandibular deviation from midline on mouth opening), and masticatory muscles (sensitivity of masseter and temporalis muscles on palpation and dysfunction of pterygoid muscles). The presence of malocclusion and parafunctional habits were also evaluated. The data were analyzed using chi-square and independent t tests. The associations between anxiety and the quantitative variables of the study were analyzed with the Pearson correlation coefficient. The total prevalence of TMDs in this sample was 17.1%. Most children with TMDs had a moderate anxiety level, and the anxiety score had a significant correlation with the presence of TMDs (P = 0.000). There was a significant relationship between Class II malocclusion and TMDs as well as between Class III malocclusion and TMDs. The most common oral habit was placing a pencil or other objects between the teeth. No significant relationships were observed between the prevalence of TMDs and the sex and age groups. This study showed significant relationships between TMDs and anxiety, malocclusion, and parafunctional habits.