Painful and non-painful comorbidities associated with short- and long-term painful temporomandibular disorders: A cross-sectional study among adolescents from Brazil, Canada and France

J Oral Rehabil. 2022 Mar;49(3):273-282. doi: 10.1111/joor.13280. Epub 2021 Dec 27.


Background: Temporomandibular disorder (TMD) pain is common among adolescents. The association between painful TMD and other comorbidities has been demonstrated. However, the difference between short-term (<6 months) and long-term (≥ 6 months) painful TMD is not yet clear.

Objective: The aim of this study was to assess the association between comorbidities and short- and long-term painful TMD among adolescents.

Methods: In this cross-sectional study, adolescents were recruited from Montreal (Canada), Nice (France) and Arceburgo (Brazil). Self-reported painful TMD, comorbidities, school absence and analgesic intake were assessed using reliable instruments. Multivariable logistic regression analyses were conducted to assess the study aims.

Results: The prevalence of short- and long-term painful TMD was estimated at 22.29% and 9.93% respectively. The number of comorbidities was associated with short- (OR = 1.71, 95%CI = 1.53-1.90) and long-term painful TMD (OR = 1.79, 95%CI = 1.55-2.08) compared to controls. Frequent headaches (ORshort-term = 4.39, 95%CI = 3.23-5.98, ORlong-term = 3.69, 95%CI = 2.45-5.57) and back pain (ORshort-term = 1.46, 95%CI = 1.06-2.03, ORlong-term = 1.69, 95%CI = 1.11-2.59) were associated with both painful TMD groups. Frequent neck pain (OR = 2.23, 95%CI = 1.53-3.26) and allergies were only associated with short-term painful TMD (OR = 1.54, 95%CI = 1.13-2.10). Frequent stomach pain was related to long-term (OR = 2.01, 95%CI = 1.35-3.26), and it was the only comorbidity significantly more frequent among the long than short-term TMD (OR = 1.82, 95%CI: 1.14-2.90). These analyses were adjusted by sex, age and city.

Conclusion: In this multi-centre study, both short- and long-term painful TMD are associated with frequent headaches and back pain, whereas frequent neck pain and allergies are related to only short-term and frequent stomach pain with long-term painful TMD.

Keywords: adolescents; comorbidities; epidemiology; oro-facial pain; pain; temporomandibular disorders.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Brazil / epidemiology
  • Comorbidity
  • Cross-Sectional Studies
  • Facial Pain / epidemiology
  • Facial Pain / etiology
  • Humans
  • Neck Pain / epidemiology
  • Temporomandibular Joint Disorders* / complications
  • Temporomandibular Joint Disorders* / epidemiology