Prevalence and Risk Indicators of Temporomandibular Disorder Signs and Symptoms in a Pediatric Population with Spastic Cerebral Palsy

Abstract

Objective: To determine risk indicators for signs and symptoms of temporomandibular disorders (TMD) in children with cerebral palsy (n=60) and control subjects (n=60). Study design: The subjects were assessed by means of questionnaire and clinical exam: 1) signs and symptoms of TMD; 2) malocclusions [Dental Aesthetic Index (DAI)]; 3) harmful habits; and 4) bio-psychosocial characteristics. Statistical analysis involved the chi-square, Fisher's exact tests (p≤0.05) and multivariate logistic regression (forward stepwise procedure). Variables that achieved a p-value ≤ 0.20 were used as potential predictors of signs and symptoms of TMD and applied as co-variables in the multivariate analysis. Results: The prevalence of at least one sign and/or symptom of TMD in the present sample was 1.7% (n=1) among the individuals in the control group and 13.3% (n=8) among the individuals with cerebral palsy. The presence of cerebral palsy (Odds Ratio:9.08; p=0.041), male gender (OR: 6.21; p=0.027), severity of the malocclusion (OR: 4.75; p=0.031), mouth breathing (OR: 5.40; p=0.022) and mixed dentition (OR: 4.73; p=0.035) were identified as risk indicators for signs and symptoms of TMD. Conclusions: It was concluded that children with cerebral palsy had a significantly greater chance of developing signs and symptoms of TMD.