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OHRQoL: Children and Cranio Facial Pain Dr. Sven Widmalm

OHRQoL: Children and Cranio Facial Pain Dr. Sven Widmalm.

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OHRQoL: Children and Cranio Facial Pain Dr. Sven Widmalm

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  1. OHRQoL: Children and Cranio Facial PainDr. Sven Widmalm

  2. Together with Drs Richard Christiansen & Sondra Gunn I took part 10 years ago in studies of 540 4-6 year old pre-school children in Willow Run. I will give a few examples from that research. They may be of interest in relation to our present survey questions and statements. Willow Run

  3. We found that • signs and symptoms of TMD, headache, and neck pain are common already in 5 year old children. • there were differences related to gender, race (Caucacian vs. African-American), and oral para-functions (thumb/finger sucking, nail biting, bruxism).

  4. We strongly suspected that socio economic factors, that we could not include, had effect. • The Willow Run study was cross-sectional and we understood that prospective longitudinal studies in cooperation with relevant experts are needed.

  5. Some “prevalence results” from Willow Run • Recurrent pain (at least a couple of times every week) • TMJ pain 8 % • Neck pain 5 % • Headache 17 % • Earache 3 % • 25 % had pain or tiredness in the jaws during chewing. • 10 % had pain at jaw opening. • 13 % had problems in opening the mouth. • Reduced opening in 2 %.

  6. Palpation pain • Lateral TMJ area 16 % • Posterior TMJ area in 25 % • Temporalis and masseter areas in 10 %

  7. Two Willow Run variables that are also part of the present survey

  8. 34 % of the African-American, and 15% of the Caucasian children admitted to having ear noises (p<0.01).

  9. “Does it hurt when you open your mouth wide?” • Strong indication of TMJ problem. • Can also indicate muscle-ligament damage. • A slap on the face can be the cause. • Some parents think it is OK to slap the face.

  10. “Do you hear a noise (clicking) when you open your mouth wide and close it?” • Clicking during opening and closing is a cardinal sign of disk displacement with reduction which may or may not be painful. • Crepitation is a cardinal sign of TMJ arthritis but seldom painful. • Juvenile Rheumatoid Arthritis (JRA) typically starts in the 2-4 year old group. The TMJs are affected eventually in more than 70% of all RA patients.

  11. “Is it difficult for you to bite hard?” • Can be related to • intra- or extra articular TMJ dysfunction/pathology. • muscle soreness in heavy bruxism. • damaged muscle or joint ligaments. • mandibular fractures after trauma.

  12. Fractures are sometimes difficult to diagnose.

  13. Few people know that a slap on the face can be a causative factor in TMD

  14. “Does your face hurt when you chew on tough food?” • Such pain is a cardinal symptom in TMD patients and can be related to • TMJ pathology • Muscle ligament damage • A standard advice to TMD patients is to avoid chewing on tough food.

  15. These structures are easily damaged by trauma to the face.

  16. Old and New Myths • Myth #1. TMD does not occur in children or young teenagers. • Myth # 2. You cannot trust answers from children. • Myth # 3. Even if TMD and related S&S are found in children, there are no methods for prevention.

  17. Craniofacial pain and related pain, headache, neck pain, and TMJ pain, are costing the society a lot of money and have significant negative impact on Quality of Life.

  18. I strongly believe that educational intervention can significantly reduce suffering from craniofacial pain by • identifying risk groups and risk factors • paying more attention to and helping children in risk groups • educate children, parents, teachers, and ourselves about how to recognize risk factors and reduce their influence. • Part of that can be done in this study. Many factors may deserve additional separate studies.

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