Most Common Jaw Problems in Kids and Teens

Jaw problems in kids and teens can cause physical pain and then absenteeism from school (or work). But what are some common jaw problems? Is it possible to treat these problems?

Temporomandibular disorder (TMD), jaw deformities, jaw fractures, and jaw pain are some of the most common jaw problems.

What is temporomandibular disorder (TMD)?

Temporomandibular disorder (TMD) causes jaw dysfunction and muscle pain. This muscle disorder leads to clinical symptoms in the teeth, tongue, muscles of mastication, and temporomandibular joints.

Sustained pain can arise due to changes in motor behavior caused by movement disorders and musculoskeletal pain.

Previously, TMD was believed to occur only in adult patients. However, recent studies indicate that TMD is more prevalent in pediatric and adolescent patients. In this age group of patients, TMD triggers pain in the muscles of mastication and temporomandibular joints. Furthermore, pediatric patients with TMD have asymmetrical or limited mouth openings.

One study reported that the prevalence of TMD in children and adolescents ranged from 6 to 68%. The severity and incidence of TMD in pediatric and adolescent patients are influenced by emotional stress. People who are more prone to TMD often are female, older, and those who experience emotional stress.

TMD treatment has three main methods:

1. Relaxation or stress management.
2. Orthotics.
3. Medication.

Relaxing the muscles of mastication and then maintaining this relaxed state throughout the day can help relieve TMD symptoms.

From an orthotic point of view, wearing an occlusal orthotic for jaw support during the day can help treat TMD.

What are the jaw deformities observed in children and teens?

Although there are forty different types of jaw deformities, here we discuss two common ones. Cleft palate and hemifacial microsomia are the most common types of jaw deformity.

The underdevelopment of the facial bones causes these deformities where the jaw is incomplete. For example, the occurrence of agenesis in the condylar processes is found in hemifacial microsomia. Incompleteness can also occur in embryological processes that fail to fuse, causing cleft palate.

A cleft palate is caused by a failure of the process of fusion of the maxillary palatal shelves. The clefts appear at locations where facial fusion has failed to occur. It is strongly influenced by the process of embryological development when the disorder occurs.

Other congenital abnormalities, such as congenital heart disease, usually accompany cleft palate. Various syndrome disorders such as DiGeorge syndrome, Shprintzen syndrome, conotruncal anomaly face syndrome, and Stickler syndrome are also associated with cleft palate.

The main risk factors of cleft palate are a combination of genetic and environmental factors- diseases suffered by the mother during pregnancy, medications, and malnutrition.

Hemifacial microsomia (HFM) is an asymmetric congenital malformation of the branchial arch. The exact cause of HFM is not known with certainty. Usually, the development of the pharyngeal arch will be disturbed during the first four weeks of pregnancy due to a combination of genetic and environmental factors.

Surgery is performed to correct cleft palate conditions. It aims to improve the quality of the patient's speech. Surgeons combine and modify the intravelar veloplasty and a two-flap palatoplasty with double opposing z-plasty. This surgical technique is employed to reposition the levator labii muscle (muscles of the lips).

Interestingly, robotic surgery is possible in cleft palate surgery. The advantages of robotic surgery include high fidelity, three-dimensional visualization, and comprehensive articulation. Its future implementation will be more massive when the process has been validated.

Improving facial symmetry, normal occlusion, and jaw function are the main goals of reconstructive surgery for HFM. Cartilage grafts, usually taken from the temporal bones, are used to augment the hypoplastic mandible.

Another surgical procedure, mandibular distraction osteogenesis (MDO), can be performed to lengthen and expand the mandibular bone. MDO has a lower recurrence rate of asymmetry.

Are jaw fractures common?

A jaw fracture is a dislocation or break where the lower jaw moves out of its proper position. This movement can occur at one or both temporomandibular joints where the jawbone connects to the skull.

Jaw fractures consist of maxillary and mandibular fractures due to blunt trauma, such as:

• Falling from a height.
• Being hit with a blunt object.
• Accidents.

Clinical manifestations of jaw fracture include difficulty chewing, worsened speech movements, pain, and resulting facial asymmetry.

The mandibular fracture is the third most common type of facial fracture after nasal fracture and cheekbone fracture.

Jaw fractures have several symptoms, including:

In more severe conditions, jaw fractures can cause loose teeth, facial numbness, airway blockage, and ear pain.

Surgery is a necessary action to overcome the fracture of the jawbone. Jaw braces are used to connect the lower jaw to the maxillary teeth.

This procedure is performed for four to six weeks to stabilize the jaw position. Teeth that are loose due to a jaw fracture will usually be held together using an elastic band for several weeks. Furthermore, severe jaw fractures require surgery to realign the jawbone and keep it in its proper position. This procedure usually uses medical-grade metal and screws.

Dental problems causing jaw pain

Some dental problems can trigger jaw pain. Teeth grinding, decayed teeth, periodontal abscesses, jaw injuries, and temporomandibular joint dysfunction are considered to be the causes of jaw pain.

Teeth grinding, also known as bruxism, is triggered by stress and anxiety, which can cause jaw pain. The condition most often occurs in children and adolescents, especially while sleeping. Continuous grinding of teeth can cause the jaw to become inflamed and swollen. This condition can be overcome by giving painkillers such as paracetamol or ibuprofen.

Jaw pain can also be caused by dental pulp inflammation caused by tooth decay. Dental caries and infection can trigger this condition. This tooth decay affects about 60 to 90% of school children worldwide. The symptoms felt can be relieved with oral analgesics.

Jaw pain is the main symptom when experiencing temporomandibular disorder (TMD). Pain will occur when chewing, opening the mouth, and speaking. Pain arises due to abnormal conditions in the muscles or jaw joints. This condition can be relieved by administering pain medications, anti-inflammatory drugs, anti-anxiety medications, and muscle relaxants.

Jaw problems are common in children and adolescents. The most common jaw problems are TMD, jaw deformities, jaw fractures, and jaw pain. With the help of proper dental and medical care, jaw problems can be treated effectively.