Temporomandibular disorders in children.

In 1982 the president of the American Dental Association convened a conference designed to address the etiology, diagnosis, and treatment of temporomandibular joint problems1. The term temporomandibular (TM) disorders was adopted at that meeting to describe all disorders related to function of the masticatory structures. The emphasis of the meeting was on the adult patient, not the child. To this date there has been no such meeting designed to address these problems in children. The purpose of this paper is to review the scientific literature concerning TM disorders in children. In many areas the pediatric dental literature is scanty and it is tempting to extrapolate information from adult studies. Although some conditions are similar, differences do exist. One of the most obvious differences is in the area of craniofacial growth and development; when treatment plans are developed for the growing child these differences must be considered. Another apparent difference relates to the child’s increased ability to tolerate change in the masticatory structures. Abrupt occlusal alterations (i.e., a high stainless steel crown) often seem to go almost unnoticed by a child where as an adult with smaller changes seems to encounter much more difficulty. Although this phenomenon is regularly seen clinically it has not been scientifically documented or explained. In order to understand TM disorders in children the following three questions must be addressed: