Prevalence of signs and symptoms of temporomandibular dysfunction in female adolescent athletes and non-athletes.

Objectives: To compare the prevalence of signs and symptoms of temporomandibular dysfunction (TMD) in female adolescent athletes and non-athletes and to examine the association between signs and symptoms of TMD in female adolescents in different Tanner stages.

Methods: The subjects were 89 female basketball and handball players ages 10-18 years and 72 female non-athlete adolescents ages 10-19 years selected from the Department of Pediatrics (School of Medicine, Federal University of São Paulo) as a control group. A survey was used to assess the signs and symptoms of TMD. According to the answers on the survey the adolescents were classified in two categories: no signs or symptoms present (score A-absent), at least one sign or symptom present (score P-present). The ones who got score "P" were submitted to a standardized functional examination of the masticatory system by four previously calibrated examiners. Pubertal status was assessed based on physical examination by physicians from our Division. The adolescents were classified according to Tanner stages into three subgroups: subgroup 1 (before the growth spurt), subgroup 2 (growth spurt period), subgroup 3 (end of growth spurt). Significant differences between athletes and non-athletes were assessed for categorical variables (Chi-square and Fisher's exact test) and for continuous variables (Mann-Whitney test). The level of significance used was 5%. There was significant agreement between raters, kappa-values (0.621-1.000) and ICC values (0.757-0.899).

Results: There was no significant difference between the athletes and non-athletes in exhibiting at least one sign or symptom of TMD (p=0.301). When comparing the adolescents who presented at least one symptom of TMD to the different subgroups of Tanner stages no statistically significant differences were found (p=0.124).

Conclusion: The lack of significant differences among female adolescent athletes and non-athletes and among the subgroups of Tanner stages may suggests that although contact sports increase the risk of temporomandibular joint lesions and estrogen levels are risk factor for onset of TMD, they do not impact significantly on the onset of this disorder, when considered alone.