Göran Agerberg

Functional disorders of the masticatory system. I. Distribution of symptoms according to age and sex as judged from investigation by questionnaire.

A random sample of every 35th individual, aged 15–74 years, and residing in the Swedish city of Umei was investigated by questionnaire regarding the frequency of functional disorders of the masticatory apparatus and certain associated factors. of the 1, 215 persons invited, 1, 106 (91 %) cooperated. Facial pain and headache was reported by 24 %. Pain on gaping was localised mainly to the temporomandibular area and wasnoted in 12 %, equally often in miles as in females. the range of movement of the mandible was reported as impaired by 7 %, and somewhat more often by females than by males. Clicking and crepitation of the temporomandibular joints was reported by 39%, somewhat more often by females. Women also had presently and earlier symptoms of dysfunction of the masticatory system more often and had sought advice more often, than men. Pain on movement of the mandible was more common among younger individuals, while other symptoms of dysfunction were relatively equally common in all age groups. Oral parafu...

Chewing Ability in Relation to Dental and General Health

Answers were obtained from 1106 (91 %) of a randomly selected sample of persons, aged 15–74 years, who were sent a questionnaire on chewing ability, chewing habits and some general and oral disorders. The questionnaire revealed that chewing ability was closely correlated to the number of residual teeth, but a loss of up to 7 teeth did not seem to entail an assessment of impairment. One fourth of the complete denture wearers reported that they could not chew all sorts of food. Unilateral chewing was reported by about one third, was more frequent in individuals with an unequal distribution of teeth and was correlated to impaired chewing ability. Both reduced chewing ability and unilateral chewing was closely correlated to increasing number of symptoms of dysfunction of the masticatory system. In all age-groups reduced chewing ability and unilateral chewing were reported more frequently by people who considered their general state of health impaired than by the healthy subjects.

Symptoms of functional disturbances of the masticatory system: A comparison of frequencies in a population sample and in a group of patients

With the aid of questionnaires symptoms of mandibular dysfunction and some general and oral conditions were studied in a group of previous patients and in a randomly selected population sample. From the two materials answers were obtained from 82 persons (81%) and 1.106 (91%) respectively. The results confirmed that women are heavily overrepresented in patient materials. This differs from the fairly equal sex distribution found in population studies of mandibular dysfunction. The most frequent symptoms of mandibular dysfunction were TMJ-sounds which appeared in 39 and 79% and pain on opening the mouth which appeared in 12 and 42% of the population and patient samples respectively. All symptoms of mandibular dysfunction, headache, clenching of the teeth and unilateral chewing appeared significantly more often in the previous patients, but the number of natural teeth did not differ in the two samples. The general state of health was poorer and general joint -- muscle symptoms were more common in the previous patients as well as in those of the population sample with symptoms of mandibular dysfunction. This finding suggests that functional disturbances of the masticatory system often may be related to impaired general health.

Changes in the temporomandibular joint after surgical treatment. A radiologic follow-up study.

Abstract The temporomandibular-joint operation is an effective method of eliminating pain and improving the function of the masticatory apparatus in patients with severe, long-standing functional disorders arising from pathologic changes in the intra-articular components of the joint. However, surgical measures should be resorted to only when conservative methods have proved to be ineffective. Strict indications should be observed, and, in the diagnosis of damage to the intra-articular soft tissues, arthrography provides a valuable aid.

Craniomandibular disorders in adult populations of West Bothnia, Sweden

A randomly selected sample of 1992 adults (995 men and 997 women) representing four equally sized age groups of 25-, 35-, 50-, and 65-years-old inhabitants of West Bothnia were studied for prevalence of symptoms and clinical signs of mandibular dysfunction. Of the sample 79% completed a questionnaire and a clinical examination. The chewing inability increased with age. Recurrent headaches (once a week or more often) were reported to occur in 11% to 15% of the four age groups, and the duration of headaches was generally more than 2 years. Tooth-clenching, which was the most frequent oral parafunction, was reported significantly more often in women, whereas attrition was more severe in men. The commonest clinical finding was temporomandibular joint clicking, which varied between 13% and 35% in the different age groups. Crepitation was observed more often in women and increased with age. The jaw muscles were more frequently tender to palpation in women and the elderly. The mean maximal mouth opening capacity varied between 55 mm and 44 mm, decreasing with age, and was for the whole sample significantly higher among men. Since signs and symptoms of craniomandibular disorders were common findings in all age groups, routine dental examination should always include functional evaluation of the stomatognathic system.

Mandibular dysfunction in adolescents Prevalence of symptoms

The prevalence of symptoms of mandibular dysfunction was studied in 285 17-year-old adolescents living in the municipality of Skellefteå. They answered a questionnaire concerning general state of health and occurrence of headache, facial pain, or temporomandibular problems. A fifth of the subjects reported some symptoms involving the masticatory system. There was no statistically significant difference between sexes. Of the sample 13% had mild symptoms and 7% had severe symptoms of dysfunction. The most frequent symptoms were clicking sounds from the temporomandibular joint (13%) and a feeling of fatigue in the jaws (6%). Recurrent headache (once a week or more) was reported by 12% and appeared significantly more often among the girls (p less than 0.001). Three-quarters used both sides for chewing, and oral parafunctional habits were reported by 68%. Since mild and moderate symptoms of mandibular dysfunction and headache obviously make an early appearance, a routine dental examination should include screening of these symptoms to identify patients who should be observed more closely.

Mandibular dysfunction in adolescents II. Prevalence of signs

The prevalence of signs of mandibular dysfunction was studied in 285 17-year-old adolescents living in the municipality of Skellefteå. They were subjected to a functional examination of the masticatory system. The commonest clinical signs were tenderness to palpation of the masticatory muscles (41%) and clicking sounds from the temporomandibular joints (22%). The tenderness to palpation was generally located to the lateral pterygoid muscle and the insertion of the temporal tendon. Girls were tender to palpation oftener (p less than 0.05) than boys. Unilateral contact in the retruded position was recorded in 77% of the subjects. Mediotrusion interferences were found in 30% of the subjects. Signs of clinical dysfunction were found in 56% and were significantly commoner in girls than in boys (p less than 0.01). Since mild and moderate signs of mandibular dysfunction obviously make an early appearance, a routine dental examination should include a functional evaluation of the stomatognathic system, to identify patients who should be observed more closely.

Maximal mandibular movements in children

The size of maximal active movements of the mandible were studied in children in two age groups. The younger group consisted of 33 children, aged 1-2 years, in whom mouth opening was recorded using an indirect method. Highly significant differences were found between 3 recordings with the third recording having the largest mean, 38.4 mm.The older group consisted of 75 boys and 75 girls, aged 6 years. None of them had pain or severe symptoms of dysfunction of the masticatory system. The mean maximal opening was 44.8 mm. The means found for maximal lateral movement to the right and to the left and for maximal protrusion were each about 8 mm. No differences in vertical or horizontal movements were found between the sexes. The mobility of the mandible varied greatly inter-individually, but as the various movements were highly significantly correlated in both boys and girls, the value found for one movement must be evaluated in relation to the sizes of the other movements.The ranges within which a pair of obse...

Temporomandibular joint sounds in adolescents: a longitudinal study.

A 2-year longitudinal study on signs and symptoms of mandibular dysfunction was performed with 285 17-year-old adolescents living in a certain geographic area in Skellefteå, Sweden. Crepitation was neither reported nor recorded in any subject. Both reports and recordings of TMJ clicking sounds fluctuated with time. The 2-year period prevalence was 24%, and 5.8% consistently reported TMJ clicking sounds. The corresponding figures for clinically recorded clickings were 36% and 9.3%, respectively. Both reported and recorded joint sounds were significantly more frequently found in 19-year-old girls than in boys. No consistent pattern of relationships between reported and recorded clicking sounds and single factors obtained by the questionnaire or clinically recorded variables could be found. Palpation tenderness in three muscle sites was to a varying degree related to both reports and recordings of clicking. Each year, significant relationships were found between reports of TMJ sounds and symptom indices. Recorded sounds were significantly related to a clinical index in the two oldest age groups. The prevalence of TMJ clicking sounds increases with age, and girls are more prone to have them than boys. In view of the natural longitudinal fluctuations, most clickings only need to be supervised, and when there is a demand for treatment, reversible methods are advocated in adolescents.

Headache and Dysfunction of the Masticatory System in Adolescents

An epidemiologic group of 285 17–year-old adolescents was studied with the aid of a questionnaire for frequency and intensity of headache and for symptoms of dysfunction of the masticatory system. They were also subjected to a functional examination of the masticatory system. Recurrent headaches occurred significantly more often among the girls (18%) than the boys (6%). Girls also reported significantly more intense headaches than boys. Fatigue in the jaws and difficulties in chewing were commoner in those with frequent and more intensive headaches. Tenderness to palpation of the masticatory muscles and impaired mandibular mobility were significantly commoner findings among those with recurrent headaches and those with more intense headaches. Tooth-grinding and clenching were related to frequency but not to intensity of headache. The investigation showed a significant relationship between frequency and intensity of headaches and signs and symptoms of dysfunction of the masticatory system.