Temporomandibular disorders in children and adolescents: an underexplored condition in need of developmentally informed diagnostic guidance

INTRODUCTION: Temporomandibular disorders (TMD) are increasingly recognized in children and adolescents, yet their diagnosis and clinical management remain less clearly defined than in adult populations. Despite evidence that TMD symptoms often emerge during critical periods of craniofacial growth and that TMD-related pain in adolescence substantially increases the risk of persistence into adulthood, pediatric TMD remains underrepresented in research, clinical guidelines, and professional education. AREAS COVERED: The review synthesizes emerging consensus on age-appropriate screening tools and diagnostic frameworks based on adaptations of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for children and adolescents; highlights the importance of interdisciplinary, biopsychosocial approaches for early identification, prognosis, and management of pediatric TMD; and identifies key gaps in epidemiology, diagnostic validation, and longitudinal outcomes. When pediatric-specific evidence is available, this review summarizes practical approaches to screening, clinical examination, and psychosocial assessment that are feasible in primary care and pediatric dental settings. Gaps in the validation of diagnostic tools and thresholds across developmental stages are identified as pressing research priorities, as they directly influence epidemiological estimates, clinical decision-making, and care pathways.