Ethnic background as a factor in temporomandibular disorder complaints.

AIMS: To examine the associations between the ethnic backgrounds of temporomandibular disorder (TMD) patients in the Netherlands and the level of TMD pain complaints and psychological/behavioral factors and whether these associations are influenced by socioeconomic factors. METHODS: A sample of 504 consecutive patients from a TMD clinic completed the Research Diagnostic Criteria for TMD (RDC/TMD) Axis II questionnaire (pain intensity, pain-related disability, somatization, depression, ethnic background, and socioeconomic status), an oral parafunctions questionnaire, and questions related to stress. Ethnic background was classified, following the method of Statistics Netherlands (CBS), using the country of birth from subject and both parents. This resulted in a classification into three subgroups: Native Dutch (ND; 69.6%), Non-Native Western (NNW; 14.8%), and Non-Native Non-Western (NNNW; 15.6%). Statistics used were chi-square, one- and two-way ANOVA, and Kruskall-Wallis tests; for post-hoc interpretation, standardized residual values, Bonferroni, and Mann-Whitney U tests were used. RESULTS: No differences in age or gender were found between the three ethnic groups, nor were there any differences in characteristic pain intensity or oral parafunctions. However, TMD patients from the NNNW subgroup had significantly higher scores on psychological factors, namely pain-related disability, disability days, somatization, depression, and stress. These patients had a lower incidence of employment, a lower level of education, and a lower income level than patients from the ND and NNW ethnic backgrounds. Analysis of variance showed no interaction effects between ethnic background and socioeconomic factors in relation to the psychological variables mentioned. CONCLUSION: Ethnic background of TMD patients in the Netherlands is associated with psychological factors, regardless of socioeconomic status, but not with TMD pain complaints or oral parafunctions.

Severity, distribution, and correlates of occlusal tooth wear in a sample of Mexican-American and European-American adults.

PURPOSE: The objective of this study was to determine the severity, distribution, and correlates of tooth wear in a sample of Mexican-American and European-American adults drawn from a community-based longitudinal aging study on oral health. MATERIALS AND METHODS: The maxillary teeth of 71 subjects enrolled in a longitudinal aging study were assessed using a previously introduced five-point (0 to 4) ordinal scoring system in which each tooth is given a score describing the severity of wear. The tooth wear scores were compared with data concerning demographic factors, functional/parafunctional habits, soft drink consumption, and bite force measurements to determine specific correlates of tooth wear. RESULTS: The mean wear score for all teeth was 1.50 on the five-point scale. There was a significant difference between the mean wear score of anterior teeth (1.85) and posterior teeth (1.17). Bivariate analyses detected a moderate degree of correlation between maxillary tooth wear and age and bite force. Maxillary tooth wear was significantly greater in males and in subjects with reported teeth clenching/grinding. Multivariate analyses revealed that age, gender, bite force, self-reported teeth clenching/grinding, and number of daily meals/snacks had significant correlations with maxillary tooth wear. CONCLUSION: The overall severity of maxillary tooth wear in this sample of Mexican-American and European-American adults was low, with anterior teeth having a greater degree of wear than posterior teeth. Age, gender, bite force, teeth clenching/grinding, and number of daily meals/snacks are potential factors that may have contributed to tooth wear in the study sample.

Ethnicity and bruxism.

Distributions of students of four ethnic groups were statistically significantly different. 106 African-American students reported the lowest incidence of self-reported bruxism (9.4%), 452 Asian students the highest incidence (24.6%); 312 Euro-American and 225 Hispanic students' incidence was intermediate.

Anthropology, tooth wear, and occlusion ab origine.

The purpose of this essay is to emphasize that anthropology, the study of man in his environments, is a potent tool for scientific discovery and inspiration in dental science. It attempts to capture flashes of creative anthropological insight which have illuminated studies of tooth wear and occlusion in the past. While it documents contributions, understandings, and misunderstandings from Australian and New Zealand dentists, it is not a hagiography. The real saint of this essay is the Australian aborigine. For when men and women are understood in their environments, much is learned from them which challenges preconceptions of our dental science culture. The essay concludes that new, contemporary Australian culture needs to be studied by anthropological approaches if we are to understand how dental erosion is exacerbating tooth wear and damaging the occlusions of contemporary Australians. Much remains to be discovered about contemporary lifestyles, habits, and diets that lead to dental erosion, the principal cause of contemporary tooth wear in this part of the world.

Oral parafunctions as temporomandibular disorder risk factors in children.

Oral parafunctions are generally considered to be important factors in the etiology of temporomandibular disorders (TMDs) and many reports have been published about their prevalence in adults and schoolchildren. However, few have included significant numbers of children below the age of 7. The aim of this study was to examine the association between parafunctions and oral/facial TMD-related pain in preschool children. Bruxism, nail biting, and thumb sucking were found to be significantly associated with important oral/facial pain symptoms of clinical interest in the diagnoses of TMD indicating that those parafunctions are risk factors. The study included 525 4- to 6-year-old African-American and Caucasian children, mean age 5.1 +/- 0.65 (SD). An alpha level of 5% was chosen for comparison with a Pearson Chi-Square test. Bonferroni correction was made and a p-value of < 0.005 was accepted as significance level. Only 28% of the children had no history of any parafunction. More girls (82%) than boys (63%) in the Caucasian subgroup had at least one parafunction (p approximately 0.00017). No such difference was found in the African-American subgroup where the corresponding figures were 71% for girls and 73% for boys. Thumb sucking was reported by 57% of the children, more often by Caucasian girls (69%) than by Caucasian boys (43%) (p < 0.00001). Thirty percent still had the habit. Forty-one percent had a history of nail biting. Bruxism was noted in 20% of the children, but occurred mostly in combination with other parafunctions and was seldom (in 3.4%) the only parafunction. Of the 10 pain variables, bruxism was significantly associated with eight, thumb sucking with three, and nail biting with two. Analysis with logistic regression confirmed the results. Association does not, however, tell if a parafunction is the cause or the consequence of pain, or if a third factor is causing both pain and increased prevalence of oral parafunctions. Further prospective longitudinal studies including higher age groups are needed to clarify those relations and to determine if there are long-term effects of childhood parafunctions.

Prevalence of signs and symptoms of craniomandibular disorders and orofacial parafunction in 4-6-year-old African-American and Caucasian children.

Children, 4-6 years old, 153 Caucasian and 50 African-American, from a pre-school and kindergarten programme in a low income industrial area, who participated in a voluntary oral health examination, were questioned and examined for signs and symptoms of craniomandibular disorders (CMD) and of oral parafunctions. Most of the CMD signs and symptoms were mild. Eight per cent had recurrent (at least 1-2 times per week) TMJ pain, and 5% had recurrent neck pain, African-American children more often than Caucasian children (P < 0.05). Seventeen per cent had recurrent headache. Three per cent had recurrent earache. Pain or tiredness in the jaws during chewing was reported by 25% of the children, more often by African-American than by Caucasian children (P < 0.001) and more often by girls than by boys (P < 0.05). Pain at jaw opening occurred in 10% of the children, more often in the African-American than in the Caucasian group (P < 0.001). Thirteen per cent of the children had problems in opening the mouth. Deviation during opening was observed in 17% and reduced opening in 2%. Reduced lateral movements, locking or luxation were not observed in any child. Palpation pain was found in the lateral TMJ area in 16%, in the posterior TMJ area in 25%, in the temporalis and masseter areas in 10%, and pain for all regions was found more often in the African-American than in the Caucasian children (P < 0.01). Thirty-four per cent of the African-American, and 15% of the Caucasian children admitted to having ear noises (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Nature and frequency of dental wear facets in an Australian aboriginal population.

The nature and frequency of dental wear facets were studied in a sample of 18-year-old Aborigines, 28 males and 31 females, living at Yuendumu in the Northern Territory of Australia. Facet frequencies were scored indirectly using dental models for all permanent teeth, except third molars, and evidence of non-masticatory tooth grinding in eccentric jaw positions was also recorded. The interplay between attrition and abrasion in an individual over time was assessed by examining facet appearance on serial dental models obtained at approximately yearly intervals from 7 to 25 years of age. Facetting was found to be a very common feature of the Aboriginal dentitions, with frequencies ranging from around 65% for pre-molars to about 90% for molars. Evidence of extreme mandibular movement was noted in 93% of males and 100% of females. The longitudinal observations indicated that wear facet definition varied over time, apparently due to episodes of tooth grinding superimposed on continually-acting abrasive influences. These results show that facetting on teeth associated with extreme mandibular positions and, by inference, the related behaviour of tooth grinding or bruxism are very common features in dentitions of Australian Aboriginals living an essentially non-industrial way of life.