Dance Experience and Prevalence of Temporomandibular Disorder (TMD) Symptoms in Adults

ABSTRACT Temperomandibular disorders (TMD) are heterogeneous groups of female-predominant, biopsychosocial, orofacial pain disorders that involve temporomandibular joint (TMJ) dysfunction. Recent studies reported elevated TMD prevalence in professional ballet dancers (78%). Determining TMD prevalence in other dancer populations and whether dance experience correlates to TMD may increase awareness and understanding of risk and protective factors for dancers' health. PURPOSE: To test the hypothesis that dance experience associates with TMD symptoms, and treatment-seeking in dancers. METHODS: An anonymous online, availability-sampling survey of 42 adult respondents (18+ years of age) was conducted on dancers to self-report their dance experience, TMD symptoms, and associated treatment seeking. TMD symptoms were quantified using questions from the validated 3QTMD TMD epidemiologic screen and five symptom-frequency questions adapted from published research. Non-parametric tests were used to quantify associations between dance experience, TMD symptoms, and treatment-seeking. Statistical significance was set at p < 0.05. RESULTS: 33% of adult dancer respondents (86% women; 38.5 + 2.1 years of age) reported ever experiencing a TMD symptom; of these, 43% sought treatment. Earlier self-reported onset of dance experience was significantly associated with tired jaws (ρ = -0.34; p = 0.0274) and face or jaw pain (ρ = -0.52; p = 0.0004); the younger the starting age, the higher the prevalence of TMD symptoms. A younger starting age of dancing also was significantly associated with experiencing TMD symptoms at least weekly (p = 0.0026), with a mean starting age dancing at 4.71 years (± 0.50 years) to have experienced weekly TMD symptoms compared to 8.57 years ( 1.06 years) who did not. By age group, those who began dancing before age 6 had a higher prevalence of at least one weekly TMD symptom than those who started dancing at age 6 or later (50% versus 18%; p = 0.0488). The number of years danced and weekly hours danced did not significantly associate with TMD symptoms. TMD symptoms were significantly correlated with treatment-seeking (p = 0.0105). Of those who experienced TMD symptoms at least weekly, starting age of dancing did not show to be significantly associated with treatment-seeking (ρ = 0.135, p = 0.6460). Similarly, there was no statistically significant association between starting age by age groups, before age 6 versus age 6 or later, and having sought treatment (p = 1.0000). CONCLUSION: We observed an increased prevalence of TMD symptoms in dancers relative to population norms, but lower than those reported for professional ballet dancers (78%). A younger starting age of dancing significantly correlated with “at least weekly” TMD symptoms. Similarly, by age group, those who started dancing younger showed a higher prevalence of TMD symptoms than those who started dancing at a later age. TMD symptoms correlated with treatment-seeking. while the starting age of dancing did not. The duration of dance experience and number of hours danced weekly was not significantly associated with reported TMD symptoms or treatment-seeking. The findings warrant larger studies using clinical exams, consideration of sex differences, and whether the association persists in people who stopped dancing.