946 © 1998 Blackwell Science Ltd
Journal of Oral Rehabilitation 1998 25; 946–953
Self-reported symptoms of temporomandibular dysfunction
in a female university student population in Saudi Arabia
B.J. ZULQARNAIN, N. KHAN* & S. KHATTAB Department of Preventive Dental Sciences and *Division
of Biostatistics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
SUMMARY The symptoms of temporomandibular
dysfunction (TMD), reported by 705 female
university students of Riyadh, Saudi Arabia, are
analysed. The population is representative of the
educated class of Saudi Arabia. The most frequently
reported symptoms were jaw feeling tired (34·5%),
awareness of uncomfortable bite (31·3%), pain in
front of the ear (22·4%) and discomfort upon wide
opening (22·4%). The frequency of subjective
reactions was, pain interferes with activity (42%),
Introduction
Pain and tenderness of masticatory muscles, TMJ
sounds, and limitation of mandibular movement are
accepted as the cardinal sign s and symptoms of
temporomandibular dysfunction (TMD). Epidemio-
logical studies have generally concentrated more on
such signs and symptoms, usually self reported, than
on the various disorders of the temporomandibular
joint (Carlsson & DeBoever, 1994). The aetiology of
TMD remains controversial. The relative importance
of local, especially occlusal factors, social conditions,
psychologic and health status are still under discussion
(Carlsson, Kopp & Wodel, 1982).
Boman (1947) reported that one-third of his 1350
adults patients had or previously had symptoms of
arthrosis. Brussel (1949) reported that of the 85 students
studied, 59% had two or more clinical progressive
symptoms involving the TMJ. Markowitz & Gerry
(1949) reported that about 28% of the 700 selected
young healthy men (aged 19–30 years) they examined,
disturbed sleep (40·6%), taking of medication
(27·8%) and pain being frustrating or depressing
(26·8%). Some interesting relationships were found
between the reported symptoms and marital
status, residence and college of education. These
findings are similar to those reported in a Bedouin
community in Egypt, but lower than that in a
Saudi Arabian population attending dental clinics,
Saudi male dental students and high school
students.
had some sort of TMJ abnormality, e.g. pain, clicking,
and snapping. Rantanen (1954) found 24% of 2218
undergraduate students to have some type of TMJ
sound, or other disturbances of mandibular movements,
with symptoms more common in females (30%) than
in males (18%).
However, neither the definitions, nor the examination
methods used in the above-mentioned early studies
appear to meet current requirements for the epidemio-
logical investigations of the functional disorders of the
masticatory system.
More recently, Agerberg & Carlsson (1972, 1973)
reported that more than half of their, 15–74 years
old population sample had at least one symptoms of
dysfunction of the masticatory system, while almost
one-third had two or more symptoms. Helkimo (1974)
found that 43% of 15–65 years cohorts were aware
of symptoms of different types in association with
mandibular movements, usually TMJ sound. Solberg,
Woo & Houston, (1979) found subjective symptoms in
26%, and objective signs in 76% of university students,