Clinical Manifestations of Temporomandibular Disorders and Their Relationship with Sleep Disturbances and Emotional Disorders in a Spanish Pediatric Population: A Cross-Sectional Study
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2025
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Tapia-Sierra FE, Ticona-Flores JM, Reichard-Monefeldt G, Elvira-Tapia N, Gallardo-López NE, Diéguez-Pérez M. Clinical Manifestations of Temporomandibular Disorders and Their Relationship with Sleep Disturbances and Emotional Disorders in a Spanish Pediatric Population: A Cross-Sectional Study. J Clin Med. 2025 May 21;14(10):3599. doi: 10.3390/jcm14103599
Abstract
The etiology of temporomandibular disorders (TMDs) has been linked to various factors, including functional and psychological factors, which makes it difficult to identify associations between a single etiological factor and the signs and symptoms of TMDs.
Objectives: This study aimed to describe the presence of TMD symptoms and their relationship with sleep disturbances and emotional disorders in children and adolescents.
Methods: This observational study included Spanish children aged between 8 and 13 years. The measurement instruments consisted of the BRUNI survey for sleep disorders and the Educational-Clinical Questionnaire: Anxiety and Depression (CECAD) survey. A clinical examination was subsequently performed following the DC/TMD guidelines for diagnosing TMDs. Frequencies, means, and standard deviations were applied, along with the prevalence ratio as a measure of association and the chi-square test. The significance level was set at 5%.
Results: A total of 128 participants participated in the study with a mean age of 10.89 (±2.15) years. The prevalence of TMDs was 54%, while the most common symptoms were muscle pain at 26%, joint pain at 14%, and a combination of both at 14%. Children who presented muscle pain had a mean anxiety score of 44.87 (±11.85), whereas those without symptoms had a mean score of 36 (±10.78, and 0.03 p-value). The BRUNI index revealed that 78.13% of patients with TMDs had difficulty initiating and maintaining sleep, with a prevalence ratio (PR) of 3.57 (p-value 0.041).
Conclusions: The present study reveals that temporomandibular disorders are common in children and adolescents, with 54% presenting at least one clinical sign or symptom. Emotional disturbances and sleep problems were also prevalent, affecting 41% and 56% of participants, respectively. Early interdisciplinary screening is essential to manage the co-occurrence of TMDs, emotional distress, and sleep problems in children.