Assessing Temporomandibular Joint Hypermobility in a Young Population: A Pilot Study

Abstract

Introduction: Hypermobile individuals may be more common than once thought. Since these people tend to experience negative sequelae over the course of their lives, it would be beneficial to devise a simple test or set of tests to screen for these patients. The general dentist or orthodontist is in a unique position to assist as they see their patients for frequent recall. Aim: To evaluate if the maximum mandibular movements can be positively correlated to the Beighton score. Methods: 30 children aged 9 to 12 years old with no signs or symptoms of TMD were recruited and their maximum mandibular opening and lateral excursives were recorded, along with their Beighton score. They were also examined for the presence or absence of oral frena and the Gorlin sign. Participants completed the Grahame and Hakim questionnaire and were also asked about their tendency to bruise. Descriptive statistics, linear and ordinal regressions, and univariate analyses were used to analyze the collected data. P-values less than 0.05 were considered statistically significant. Results: Based on the small sample size of this study, there are no statistically significant relationships between the maximum mandibular border movements and the Beighton score in children of this age. Other signs, such as missing frena and presence of Gorlin sign, could not be evaluated due to the small number of affected individuals. Conclusions: Because a relationship between the Beighton score and the maximum mandibular border movements may exist, a larger cohort should be evaluated in the future. Additionally, while the Grahame and Hakim questionnaire has been found to be valid in adults, its validity in children is still questionable, but shows promise. Future avenues of improvement include measuring the knees when participants are standing, adding visual aids to the Grahame and Hakim questionnaire, and taking angular measurements of the maximum opening, instead of linear ones.