Orofacial pain in young adults and associated childhood and adulthood factors: results of the population study, Wales, United Kingdom

Tatiana V Macfarlane, Pamela Kenealy, H Anne Kingdon, Benght Mohlin, J Richard Pilley, Caroline W Mwangi, Lindsay Hunter, Steve Richmond, William C Shaw
Community Dentistry and Oral Epidemiology 2009, 37 (5): 438-50

OBJECTIVES: The aim of the study was to investigate the prevalence of orofacial pain (OFP) among young adults (30-31 years old) and to determine the effect of childhood and adulthood risk factors on the occurrence of OFP.

METHODS: Prospective cohort study to investigate dental and social effects of malocclusion and effectiveness of orthodontic treatment was conducted in Wales, United Kingdom. At 20-year follow-up 337 subjects aged 30-31 participated (74% from previous follow-up aged 19-20 and 33% from the baseline) and were asked about OFP.

RESULTS: The prevalence of OFP was 23% (95% CI: 19%, 28%). Childhood factors, socio-demographic, lifestyle, health behavior factors, history of orthodontic treatment and tooth wear were not associated with OFP. Participants with OFP were more likely to report that their teeth did not fit together properly [odds ratio (OR) = 12.4, 95% CI: 2.7-56.5) and reported previous trauma to the jaws (2.3; 1.3-4.2). Both diurnal and nocturnal teeth clenching and grinding were significantly associated with OFP (3.1; 1.4-7.1). Participants with frequent headaches had increased risk of having OFP (3.7; 1.6-8.4) while having reported 4-10 types of pain in other parts of the body other than the head, was associated with OR = 9.2 (3.7-23.0). An increased tendency to have OFP was seen in those individuals with higher levels of psychological distress (2.3; 1.4-3.9), high score on Life Event Inventory (2.6; 1.3-5.3), depressive symptoms (2.2; 1.2-4.0) and stress (2.2; 1.2-4.0). High self-esteem associated with lower risk of OFP (0.5; 0.3-0.9).

CONCLUSIONS: This study shows that OFP is frequently reported by young adults aged 30-31 and supports a multifactorial etiology with factors from many domains, including local mechanical factors, psychological and co-morbidities. However, none of the childhood factors considered in this study were associated with OFP in adulthood.

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