Signs and symptoms of first-onset TMD and sociodemographic predictors of its development: The OPPERA prospective cohort study

Although cross-sectional studies of temporomandibular disorder (TMD) often report elevated prevalence in youngwomen, they do not address the risk of its development. Hereweevaluate sociodemographic predictors of TMD incidence in a community-based prospective cohort study of U.S. adults. Symptoms and pain-related disability inTMDcases are also described. People aged 18 to 44 years with no history ofTMD were enrolled at 4 study sites when they completed questionnaires about sociodemographic characteristics. Duringthe median 2.8-year follow-upperiod, 2,737 participantscompleted quarterly screening questionnaires. Those reporting symptoms were examined clinically and 260 had first-onset TMD. Additional questionnaires asked about severity and impact of their symptoms. Univariate and multivariable Cox regression models quantified associations between sociodemographic characteristics and TMD incidence. First-onset TMD developed in 3.9% of participants per annum, typically producing mild to moderate levels of pain and disability in cases. TMD incidence was positively associated with age, whereas females had only slightly greater incidence than males. Compared to whites, Asians had lower TMD incidence whereas African Americans had greater incidence, although the latter was attenuated somewhat after adjusting for satisfaction with socioeconomic circumstances. Perspective: In this study of 18- to 44-year-olds, TMD developed at a higher rate than reported previously for similar age groups. TMD incidence was positively associated with age but weakly associated with gender, thereby differing from demographic patterns of prevalence found in some cross-sectional studies.Experiences related to agingmerit investigation as etiologic influences ondevelopment of TMD.