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 h ave 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 betwee n parafunctions and oral/facial TMD-related pain in preschool children , Bruxism, nail biting, and thumb sucking were found to be significant ly associated with important oral/facial pain symptoms of clinical int erest 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 ex 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 significa nce level, Only 28% of the children had no history of any parafunction , More girls (82%) than boys (63%) in the Caucasian subgroup had at le ast one parafunction (p similar to 0.00017), No such difference was fo und in the African-American subgroup where the corresponding figures w ere 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-o ne percent had a history of nail biting, Bruxism was noted in 20% of t he children, but occurred mostly in combination with other parafunctio ns and was seldom (in 3.4%) the only parafunction, Of the 10 pain vari ables, bruxism was significantly associated with eight, thumb sucking with three, and nail biting with two, Analysis with logistic regressio n confirmed the results, Association does not, however, tell if a para function is the cause or the consequence of pain, or ii a third factor is causing both pain and increased prevalence of oral parafunctions, Further prospective longitudinal studies including higher age groups a re needed to clarify those relations and to determine if there are lon g-term effects of childhood parafunctions.