Oliver Schierz

Objective This study aimed to investigate whether the sex steroid precursor hormone dehydroepiandrosterone sulphate (DHEA‐S), sex hormone‐binding globulin (SHBG) and testosterone (TT) are associated with temporomandibular (TM) pain on palpation in male adolescents. Methods Out of the LIFE Child study dataset containing 1022 children and adolescents aged 10–18 years (496 males, 48.5%), we used a subsample of 273 male adolescents (mean age: 13.8 ± 2.3 years) in advanced pubertal development (PD) to analyse the association between hormones and TM pain. The Tanner scale was applied to describe the stage of PD. Pain on palpation of the temporalis and masseter muscles and the TM joints (palpation pain) was assessed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Serum levels of sex hormones (DHEA‐S, SHBG and TT) were determined using standardised laboratory analyses. Free TT was estimated from the ratio between TT and SHBG (free androgen index[FAI]). We calculated the risk of perceived positive palpation pain for male participants as a function of hormone levels (DHEA‐S, FAI) taking into account age and body mass index (BMI). Results Among more developed (Tanner stage 4–5) male adolescents, 22.7% ( n = 62) reported palpation pain in the TM region. In these participants, FAI levels were approximately half that of individuals without such pain ( p < .01). DHEA‐S levels were about 30% lower in the pain group ( p < .01). In multivariable regression analyses, the odds ratio (OR) for pain on palpation decreased to 0.75 (95% confidence interval [CI]: 0.57–0.98) per 10 units of FAI level compared to those without pain, after controlling for the effects of age and adjusted BMI. We observed the same effect for this subgroup per unit of DHEA‐S serum level (OR = 0.71; 95% CI: 0.53–0.94). Conclusion At subclinical lower levels of serum free TT and DHEA‐S, male adolescents are more likely to report pain on standardised palpation of the masticatory muscles and/or TM joints. This finding supports the hypothesis that sex hormones may influence pain reporting.

Background Information on the prevalence of temporomandibular disorders (TMD) or possible/probable bruxism in seniors is heterogeneous and sparse. Objectives To elucidate the prevalence of TMD and possible/probable bruxism in German adults aged 60 years and older. Methods Participants of the Interdisciplinary Longitudinal Study of Adult Development and Aging (ILSE) born between 1950–1952 (C1) and 1930–1932 (C2) were examined in 2014–2016 (fourth wave). The participants were surveyed and clinically examined by one calibrated examiner. Two questions of the Patient Health Questionnaire (PHQ) were utilised to evaluate self‐reported bruxism. The clinical examination included signs of probable bruxism and the RDC/TMD examination protocol. Results Data from 191 participants were available. No RDC/TMD diagnosis was made in 83.2%. Of the participants, 15.2% received a single diagnosis and 1.6% multiple diagnoses that included disc displacements (9.4%) and degenerative joint diseases (8.9%). A total of 24.7% reported bruxism that included self‐reported awake bruxism in 11.9% and sleep bruxism in 16.2%. Wear was clinically identified in 27.2% of the participants. No sex‐related differences were observed. Significant differences were detected for probable bruxism between C1 (14.1%) and C2 (54.3%). Conclusion In the German population aged 60 years and older, the prevalence of TMD is 16.8%. TMD is characterised by temporomandibular joint disorders, including disc displacements and degenerative joint disorders. Bruxism was observed in a quarter of the old population.