Are occlusal characteristics, headache, parafunctional habits and clicking sounds associated with the signs and symptoms of temporomandibular disorder in adolescents?

[Purpose] To assess the association between the oclusal characteristics, headache, parafunctional habits and clicking sounds and signs/symptoms of TMD in adolescents. [Subjects] Adolescents between 14 and 18 years of age. [Methods] The participants were evaluated using the Helkimo Index and a clinical examination to track clicking sounds, parafunctional habits and other signs/symptoms of temporomandibular disorder (TMD). Subjects were classified according to the presence or absence of headache, type of occlusion, facial pattern and type of bite. In statistical analyse we used the chi-square test and Fisher's exact test, with a level of significance of 5%. [Results] The sample was made up of 81 adolescents with a mean age of 15.64 years; 51.9% were male. The prevalence of signals/symptoms of TMD was 74.1%, predominantly affecting females. Signals/symptoms of TMD were significantly associated with clicking sounds, headache and nail biting. No associations were found between signals/symptoms of TMD and angle classification, type of bite and facial pattern. [Conclusion] Headache is one of the most closely associated symptoms of TMD. Clicking sounds were found in the majority of cases. Therefore, the sum of two or more factors may be necessary for the onset and perpetuation of TMD.