PEDIATRICS Vol. 80 No. 4 October 1987, pp. 565-570
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Temporomandibular Joint Dysfunction and Facial Pain in Children: An Approach to Diagnosis and Treatment

Francine G. Pillemer EdD1, Bruce J. Masek PhD1, and Leonard B. Kaban MD, DMD1

1 From The Children's Hospital and Harvard Medical School, Boston, and University of California, San Francisco

A model for the diagnosis and treatment of temporomandibular joint dysfunction and facial pain in children is presented. Emphasis is placed on systematic assessment of physical, psychologic, and behavioral factors when conservative medical therapy is inadequate for symptom relief. The model represents a multidisciplinary approach to patient care which is described through case presentations. The results of research on the incidence of primary psychopathology in 53 children and 322 adults evaluated during a 3-year period for temporomandibular joint dysfunction and facial pain are also presented. It was found that children were more likely to be psychiatrically impaired (25%) than adults (7%). Children had a variety of psychiatric diagnoses including depression, conversion and adjustment disorders, overanxious behavior, and anorexia nervosa. The benefits of a multidisciplinary approach are discussed in terms of the efficacy of this coordinated treatment effort in ameliorating symptoms.

Key Words: temporomandibular joint dysfunction • myofascial pain

Submitted on October 9, 1986
Accepted on December 18, 1986