The Prevalence of Temporomandibular Disorder in African Americans
Doyle, Nicole J.
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This pilot study collected a convenience sample of adult residents of the Dallas, Texas metropolitan area to estimate the prevalence of temporomandibular disorder (TMD) in African Americans. Additionally, the study also collected the same data on Caucasians for comparisons against the African American numbers on all measures. At the conception of this study, there existed no prior studies focusing primarily on prevalence of TMD in African Americans. The study administered a survey of acute jaw pain symptoms to a convenience sample of 274 participants 18 years and older, 129 African Americans, 116 Caucasians and 29 of other races. The survey assessed TMD symptoms using 19 questions derived from the Research Diagnostic Criteria for TMD. The overall prevalence of TMD for total sample of 274 was 22.3%, with a higher prevalence of TMD in women (25.3%) than in men (16%). The prevalence of TMD among African Americans was 22% with a higher prevalence among females (24.4%) than males (15.6%). Among Caucasians, the prevalence of TMD was 22.5%, with a higher prevalence among females (23.7%) than males (20%). Caucasians reported greater rates of tinnitus, low back pain (p<.05), clenching and grinding (p<.1), while African Americans reported greater rates of teeth problems (p<.1). For all-participants, African American and Caucasian samples, discriminant analysis showed the ability of the symptoms listed on the survey to classify correctly the participants as having TMD or as not having TMD approached 100%. Among the top predictors of TMD for African Americans were earache and sounds around ears, while among top predictors for Caucasians were a diagnosis of TMD and joint locking. Distinct symptom clusters found within the overall sample as well as a 2-symptom cluster within both African American and Caucasian samples, yielded highly significant differences. In treatment seeking for TMD symptoms, both African Americans and Caucasians with private insurance types sought treatment at the same rates (60%). TMD rates for this sample were notably higher than found in other national studies (about 4-8%). However, where definitions of and measurement instruments for TMD differ among prevalence studies, it appears that prevalence rates tend to differ.