Temporomandibular Disorders in Children and Adolescents, Including Those with Special Health Care Needs

Abstract

This best practice assists dental practitioners in recognizing and diagnosing temporomandibular disorders
and identifying evidence-based treatment options. Temporomandibular disorders are a group of
musculoskeletal and neuromuscular conditions that include clinical signs and symptoms involving the
muscles of mastication, the temporomandibular joint, and associated structures and occasionally occur in
infants, children, adolescents, and individuals with special health care needs. Temporomandibular
disorders generally are classified into two broad categories: temporomandibular joint conditions and
masticatory muscle disorders. Diagnosing temporomandibular disorders should be based on a screening
history, clinical examination, and diagnostic aids (e.g., temporomandibular joint imaging). Temporomandibular disorder treatment goals include restoring function, decreasing pain, reducing risk factors, and improving quality of life. Treatment approaches include reversible and irreversible therapies. Common reversible approaches include patient education, physical therapy, behavioral therapy, pharmacotherapy, and occlusal splints. Meanwhile, with limited evidence for effectiveness of irreversible therapies (e.g., occlusal adjustments, orthodontic treatment, surgery), such approaches should be avoided in children.

This document was developed through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs to offer updated information and guidance on acquired temporomandibular disorders in children and adolescents, including individuals with special health care needs.

^{KEYWORDS: EVIDENCE-BASED DENTISTRY; PEDIATRIC DENTISTRY; TEMPOROMANDIBULAR DISORDERS, TEMPOROMANDIBULAR JOINT}