Karen Harnott – Total TMJ Operations Director
Temporomandibular joint disorder (TMD) may be more common in adults, but it also manifests in children. In these crucial, developmental years, impaired jaw function can cause a host of problems for children as they enter adolescence and adulthood, impacting their quality of life.
Child prevalence of TMD is broad, ranging from 6-68%.[i] Unlike simpler ailments – broken bones, headaches, cuts – awareness of TMD will be naturally lower among children due to its more complex aetiology. However, children may present with symptoms that could be jaw-related. Paediatric TMD patients have identified emotional stress (52% of cases) and clenching and grinding (27.3%) among the most common symptoms of TMD, whilst mastication difficulties and earaches may also be recorded.i It should also be noted that, like in adults, TMD is more prevalent in female patients, with 61.5% of child TMD cases being girls.i
For dental professionals, being able to identify the causes for TMD in paediatric patients is vital, educating the parents on how best to manage the problem.
Beating bruxism and eliminating emotional stress
Bruxism aggravates the temporomandibular joint (TMJ) and 20-30% of children have reported teeth grinding or clenching, increasing the risk of TMD.[ii] Whilst many children grow out of bruxism once the deciduous teeth are lost[iii], tackling the issue minimises TMD symptoms and reduces the risk of tooth wear. Factors of bruxism include a misaligned bite, hyperactivity, and stress and anxiety; whilst occlusal issues cannot be effectively sorted until a child reaches adolescence, addressing stress and anxiety will also improve a child’s quality of life, as well as managing TMD.[iv]
High levels of stress can cause constant dental clamping, impacting the circulation in the local muscles and leading to stimulation of the pain receptors.i Relieving stress and anxiety for a child can be as difficult as identifying it, as children may not be forthcoming with their feelings or may struggle to verbalise their worries.
Sources of stress in children
Stress and anxiety could stem from events at school, such as struggling in class, not wanting to disappoint academically, and bullying.[v] Domestically, uncertainties over separating parents, moving homes, changing schools or an illness in the family can all weigh heavily on a child.
Dental practitioners should explain the link between such stressful events and bruxism to the child’s accompanying adult, providing an open space for the parent or guardian to discuss any issues that could be increasing the child’s tooth grinding. Stress-relief advice should also be given for the parents to pass onto the child; this could include having a stress ball, teaching relaxation techniques and promoting positive thinking.v
To check for subconscious bruxism, encouraging parents or siblings to listen out for any clicking or grinding noises whilst asleep is also valuable.ii If so, paediatric dentists can create a custom mouthguard for the child to wear at night – parents must ensure compliancy with this.
Proactive preparation
Whilst identifying risk factors can help reduce the prevalence of TMD in children, proactive measures can strengthen the jaw and promote mobility. Whilst sweets or chewing gum are ill-advised for those with TMD, chewy foods are excellent for working the masticatory muscles, supporting their growth and function in paediatric patients and keeping the TMJ healthy.[vi] However, chewy foods can also be detrimental to oral health, be they dried fruits or fresh bread – particles can stick to the teeth or become lodged in the interdental spaces. As such, moderation is always encouraged with chewy foods.
A first-class solution to help children with TMD is the Paediatric OraStretch® Press Rehab System from Total TMJ. A handheld unit designed to stretch the jaw and treat trismus, dysfunction and hypomobility, the device provides a safe and effective way of increasing flexibility and function to the TMJ for all. For patients aged 10 and under, the paediatric is ideal, with its mouthpiece measuring 31mm across. Diligent use of the OraStretch® Press that follows the recommend exercises leads to notable improvements in jaw mobility, ensuring that TMD does not impact a child’s life for long.
Jaw problems and stress are not just in the realms of adulthood. Raising awareness among patients on the impact that TMD can have on a child means that management steps can be taken to minimise its prevalence, fostering a world where the next generation are conscious and proactive in looking after their oral cavity.
For more details about Total TMJ and the products available, please email info@totaltmj.co.uk
[i] Minghelli, B., Porfírio, M., Gonçalves, R., Soeiro, A., Cardoso, I., Cascalheiro, S., Barreto, V. and Almeida, L. (2014). Prevalence of temporomandibular disorder in children and adolescents from public schools in Southern Portugal. North American Journal of Medical Sciences, 6(3), p.126. doi:https://doi.org/10.4103/1947-2714.128474.
[ii] www.colgate.com. (n.d.). Bruxism in Children: What to Look for and How to Treat It. [online] Available at: https://www.colgate.com/en-us/oral-health/bruxism/bruxism-in-children-signs-symptoms-treatment#.
[iii] kidshealth.org. (n.d.). Bruxism (Teeth Grinding or Clenching) (for Parents) – Nemours Kidshealth. [online] Available at: https://kidshealth.org/en/parents/bruxism.html.
[iv] NHS (2017). Teeth grinding (bruxism). [online] nhs.uk. Available at: https://www.nhs.uk/conditions/teeth-grinding/.
[v] Unicef (2023). What is stress? [online] www.unicef.org. Available at: https://www.unicef.org/parenting/mental-health/what-is-stress.
[vi] Simione, M., Loret, C., Le Révérend, B., Richburg, B., Del Valle, M., Adler, M., Moser, M. and Green, J.R. (2018). Differing structural properties of foods affect the development of mandibular control and muscle coordination in infants and young children. Physiology & Behavior, [online] 186, pp.62–72. doi:https://doi.org/10.1016/j.physbeh.2018.01.009.
