A group of 248 randomly selected high school girls, aged 15-16 years, completed a questionnaire and were examined clinically with regard to various oral habits and signs and symptoms of temporomandibular disorders (TMD). Common habits reported in the literature, such as gum chewing, nail biting, biting foreign objects, clenching and bruxism, eating seeds and crushing ice, as well as two less reported habits, 'jaw play' and continuous arm leaning, were evaluated. The most outstanding finding was the high prevalence and intensity of gum chewing among our study group: 92% of the girls chewed daily and 48% chewed gum for more than 3 h a day (intensive gum chewing). Statistically significant associations were found between intensive gum chewing and muscle sensitivity (P<0.001) and joint noises (P<0. 05), and between crushing ice and muscle sensitivity to palpation (P<0.005). A positive association was found between 'jaw play' and joint disturbances: reported joint noises (P<0.01), catching of the joint (P<0.01) and joint tension (P<0.001). A positive association was also found between arm leaning and reported joint noises (P<0. 05), catching (P<0.05), and joint tension (P<0.005). There was no association between the presence of bruxism and muscle sensitivity to palpation or joint disturbances. The potential harmful effects of intensive gum chewing, 'jaw play', continuous arm leaning and ice crushing are presented in this study. In light of these findings, the professional community should address these habits with proper data gathering, examination and consultation.

Jaw play was the most detrimental habit in TMD; intensive gum chewing was a potentially contributing factor for joint noises and pain. Oral parafunctions (except chewing gum) were significantly associated between themselves and suggest a behavioural pattern of "jaw hyperactivity".

The purpose of this study was to assess the short-term psychosocial impact of dental aesthetic improvement in adult subjects. Sixty-nine adult patients (61 females and 8 males, aged 21-59 years) requesting aesthetic dental improvement were prospectively and randomly recruited for the study in a private orthodontic office. A general interview included patient motivation and expectations from treatment. After clinical examination, discussion of the mode of treatment and the expected outcome, the patients were requested to complete the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) with several additions. The duration of their treatment was 6-14 months, and the main goals were tooth alignment, crowding alleviation, or space closure. After removal of the appliances, they completed an identical PIDAQ. Each patient served as his/her own control. Assessment of the impact of aesthetic improvement was based on the responses to the same questions relating to the patients' perceived dental aesthetics before and after treatment, their self-esteem, and changes in their social behaviour resulting from the treatment. The data were analysed using Cohen's and Pearson's correlation analyses and chi-square and Student's t-tests. A statistically significant improvement (P < 0.001) was found for all four factors: dental self-confidence (DSC), social impact (SI), psychological impact (PI), and aesthetic concern (AC). The reliability of the questionnaire, using Cronbach's alpha, was between 0.709 and 0.947. The degree of significance was not related to age, marital status, education, or gender. Dental aesthetics generated a significant improvement in adult patients' quality of life for the period examined (up to 6 months post-treatment).

The prevalence of mandibular dysfunction in a sample of 369 Israeli schoolchildren was found to be 56.4%, indicating that one or more of the cardinal symptoms were present. It increased with age from about 51% in the 10-13 year old group to 67.8% in the 16-18 year olds. The most common cardinal sign of dysfunction was joint sounds (35.8%), which increased with age from 28% in the youngest group to 44.3% in the oldest group. The second most common sign was joint sensitivity to palpation (30.4%), which showed a slight increase in the oldest group. Sensitivity of the superficial muscles was recorded third, with 20%. Joint pain and restriction of mandibular movement appeared infrequently. Two of the more common cardinal symptoms, namely joint sounds and muscle sensitivity, were statistically related to several possible aetiological factors and to age and sex. Analysis of association showed that the probability of muscle sensitivity increased in the presence of malocclusion and/or joint sensitivity to palpation. It also showed that age, occlusal wear, locking of the jaw and joint sensitivity to palpation increased the probability of joint sounds.

A group of 248 girls, aged 15-16 years, were randomly selected and examined both clinically and by questionnaire with regard to the signs and symptoms of temporomandibular disorders (TMD), generalized joint laxity (GJL), range of mandibular opening, temporomandibular joint (TMJ) hypermobility and presence of oral parafunctions. The prevalence of GJL was 43% and that of TMJ hypermobility (TMJH) was 27.3%. A significant, albeit weak, correlation was found between the two. In the presence of joint click, both active and passive opening were significantly larger. When either muscle or joint sensitivity to palpation was present, the difference between the active and passive range of mouth opening increased significantly. The presence of reported clicks was negatively associated with GJL. This association was not valid in the presence of parafunction. Some of the signs and symptoms of TMD affected the range of mouth opening. In the presence of joint clicks, the mean active and passive mandibular opening were significantly larger. In the presence of joint and muscle sensitivity to palpation, the difference between passive and active mouth opening was larger. This was possibly because of the effect of pain on the full active range of opening, which was invalid in the registration of the passive mandibular opening. GJL, when present, did not seem to jeopardize the health of the stomatognathic system as expressed in the signs and symptoms of TMD. There was a negative association between GJL and the presence of reported joint clicks and catch. When a parafunction was present in addition to GJL, this association was invalid but not reversed, as has been previously reported.