Emotional Stress and Craniomandibular Dysfunction in Children

ABSTRACT

This study investigated the relationship between craniomandibular dysfunction (CMD) and emotionally stressful states measured by the urinary catecholamines in 314 children aged six to eight years. The children were examined clinically and interviewed by the same investigator. During the clinical examination the following variables were recorded: maximal mouth opening with and without pain, deviation of the mandible in opening wide, muscle and temporomandibular joint (TMJ) tenderness or pain and sounds from the TMJ. The variables recorded during the interview were headaches, difficulties in opening wide, pain upon opening wide, and clicking. A questionnaire was distributed to the parents to collect information regarding socioeconomic factors. A 24-hour urine sample was collected for each subject and analyzed by the high performance liquid chromatography (HPLC) technique to assay the catecholamine content. The logistic multiple regression analysis was carried out to test whether craniomandibular dysfunction was affected by the studied variables. A 95% probability level was used. The results showed that epinephrine had a significant effect on TMJ tenderness, while norepinephrine and dopamine did not have a significant association with any of the signs and symptoms of CMD. The data suggest that emotionally stressful states increase the probability of developing TMJ tenderness in children of this age.

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Notes on contributors

Apostole P. Vanderas

Dr. Apostole P. Vanderas received his D.D.S. and J.D. degrees at the University of Athens, Greece and an M.P.H. and M.D.S.from the University of Pittsburgh. He is currently Assistant Professor in the Department of Pediatric Dentistry, School of Dental Medicine, University of Athens, Greece.

Maria Menenakou

Dr. Maria Menenakou is in private practice as a pediatric dentist in Athens, Greece. She received her D.D.S. degree from the University of Athens, Greece and her specialty in Pediatric Dentistiy from Eastman Dental Center in the United States.

Liza Papagiannoulis

Dr. Lisa Papagiannoulis is Professor and Head of the Department of Pediatric Dentistry, School of Medicine, University of Athens, Greece. She received her D.D.S. degree from the University of Athens, Greece and her M.S. degree from the University of California at Los Angeles in the United States.