Crepitation and clicking as signs of TMD in preschool children.

Children [N = 540, age 5.1 +/- 0.72 (SD)], were tested for association between temporomandibular (TM) joint sounds and symptoms of TM disorder (TMD). The prevalence of TMJ sounds as found by auscultation and confirmed by self-report was 16.7%. There was significant association after Bonferroni correction between the presence of TM joint sounds, as reported by the children, and all but one of the eleven pain/dysfunction variables. There was significant association also between crepitation as heard at auscultation and palpation tenderness in the TMJ and masseter areas (p < 0.001), but not between clicking and any of the TMD variables. Agreement between subjects and examiners regarding the presence of TMJ sounds was poor (kappa = 0.097). The results indicate that joint sounds and TMD symptoms are common already in small children and thus demonstrate a possible early onset of TMD. Patients' own reports of TMJ sounds may have more clinical relevance than auscultation findings.