Purpose: To determine changes in orofacial pain perception in community-based children by assessing the pressure pain threshold (PPT) with an algometer and pain intensity by manual palpation (MP). Methods: A total of 100 children from the community aged 7 to 12 years were assessed. Thirty-eight children reported pain in the orofacial region. Of these children,10 reported joint pain (GJ), 12 reported joint and muscle pain(GJMM), 5 reported muscle pain (GMM), 11 reported pain during mastication(GMAST), and 62 reported no pain. An ANOVA (p<0.05) was used to determine the differences in pain intensity and PPT among groups. Results: Significantly higher pain intensity upon MP was observed for the temporalis muscle in the GJMM, GMAST and GJ groups compared to the remaining groups. The PPT values were significantly lower in the masseter, temporalis muscles, TMJ and thenar region in the GJMM group compared to the other groups. Conclusion: MP more accurately differentiated symptomatic subjects from symptom-free TMD subjects, and PPT values were more sensitive to the discrimination of pain in the orofacial sites assessed. In addition, the changes in perception at a larger number of sites among children reporting mixed pain may suggest the presence of a possible mechanism of central sensitization.

Smith BH, Hopton JL, Chambers WA. Chronic pain in primary care. Fam Pract, 16(5):475-82, 1999.
Chronic pain in primary care
Fam Pract
, vol. 
16
 (pg. 
475
-
82
)
Chambers CT, Giesbrecht K, Craig KD, Bennett SM, Huntsman E. A comparison of faces scales for the measurement of pediatric pain: children's and parents' ratings. Pain,83(1):25-35, 1999.
A comparison of faces scales for the measurement of pediatric pain: children's and parents' ratings
Pain
, vol. 
83
 (pg. 
25
-
35
)
Greene CS, Klasser GD, Epstein JB. Revision of the American Association of Dental Research's Science Information Statement about Temporomandibular Disorders. J Can Dent Assoc, 76:115, 2010.
Revision of the American Association of Dental Research's Science Information Statement about Temporomandibular Disorders
J Can Dent Assoc
, vol. 
76
 pg. 
115
 
Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord, 6: 301-355, 1992.
Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique
J Craniomandib Disord
, vol. 
6
 (pg. 
301
-
355
)
Schiffman EL, Ohrbach R, Truelove EL, Tai F, Anderson GC, Pan W, Gonzalez YM, John MT, Sommers E, List T, Velly AM, Kang W, Look JO. The Research Diagnostic Criteria for Temporomandibular Disorders. V: methods used to establish and validate revised Axis I diagnostic algorithms. J Orofac Pain, 24(1):63-78, 2010.
The Research Diagnostic Criteria for Temporomandibular Disorders. V: methods used to establish and validate revised Axis I diagnostic algorithms
J Orofac Pain
, vol. 
24
 (pg. 
63
-
78
)
Reid KI, Gracely RH, Dubner RA. The influence of time, facial side, and location on pain-pressure thresholds in chronic myogenous temporomandibular disorder. J Orofac Pain, 8:258-265, 1994.
The influence of time, facial side, and location on pain-pressure thresholds in chronic myogenous temporomandibular disorder
J Orofac Pain
, vol. 
8
 (pg. 
258
-
265
)
Chaves TC, Nagamine HM, de Sousa LM, de Oliveira AS, Grossi DB. Comparison between the reliability levels of manual palpation and pressure pain threshold in children who reported orofacial pain. Man Ther, 15(5):508-12, 2010.
Comparison between the reliability levels of manual palpation and pressure pain threshold in children who reported orofacial pain
Man Ther
, vol. 
15
 (pg. 
508
-
12
)
Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain 1987; 30:115-126.
Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold
Pain
, vol. 
30
 (pg. 
115
-
126
)
Chaves TC, Nagamine HM, Sousa LM, Oliveira AS, Bevilaqua-Grossi D. Intra-and Inter agreement of pressure pain threshold for masticatory structures in children reporting orofacial pain related to temporomandibular disorders and symptom-free children. J Orofac Pain, 21:133-142, 2007.
Intra-and Inter agreement of pressure pain threshold for masticatory structures in children reporting orofacial pain related to temporomandibular disorders and symptom-free children
J Orofac Pain
, vol. 
21
 (pg. 
133
-
142
)
LeResche L, Mancl LA, Drangsholt MT, Huang G, Von Korff M. Predictors of onset of facial pain and temporomandibular disorders in early adolescence. Pain, 129(3):269-78, 2007.
Predictors of onset of facial pain and temporomandibular disorders in early adolescence
Pain
, vol. 
129
 (pg. 
269
-
78
)
Pereira LJ, Pereira-Cenci T, Del Bel Cury AA, Pereira SM, Pereira AC, Ambosano GM, Gavião MB. Risk indicators of temporomandibular disorder incidences in early adolescence. Pediatr Dent,32(4):324-8, 2010.
Risk indicators of temporomandibular disorder incidences in early adolescence
Pediatr Dent
, vol. 
32
 (pg. 
324
-
8
)
Köhler AA, Helkimo AN, Magnusson T, Hugoson A. Prevalence of symptoms and signs indicative of temporomandibular disorders in children and adolescents. A cross-sectional epidemiological investigation covering two decades. Eur Arch Paediatr Dent,10 1:16-25, 2009.
Prevalence of symptoms and signs indicative of temporomandibular disorders in children and adolescents. A cross-sectional epidemiological investigation covering two decades
Eur Arch Paediatr Dent
, vol. 
10
 (pg. 
16
-
25
)
Pereira LJ, Pereira-Cenci T, Pereira SM, Cury AA, Ambrosano GM, Pereira AC, Gavião MB. Psychological factors and the incidence of temporomandibular disorders in early adolescence. Braz Oral Res, 23(2):155-60, 2009.
Psychological factors and the incidence of temporomandibular disorders in early adolescence
Braz Oral Res
, vol. 
23
 (pg. 
155
-
60
)
Nilsson IM. Reliability, validity, incidence and impact of temporormandibular pain disorders in adolescents. Swed Dent J Suppl, 183:7-86, 2007.
Reliability, validity, incidence and impact of temporormandibular pain disorders in adolescents
Swed Dent J Suppl
, vol. 
183
 (pg. 
7
-
86
)
Magnusson T, Egermarki I, Carlsson GE. A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables. A final summary. Acta Odontol Scand, 63(2):99-109, 2005.
A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables. A final summary
Acta Odontol Scand
, vol. 
63
 (pg. 
99
-
109
)
Conti PC, Dos Santos Silva R, Rossetti LM, De Oliveira Ferreira Da Silva R, Do Valle AL, Gelmini M. Palpation of the lateral pterygoid area in the myofascial pain diagnosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod,105(3): 61-6, 2008.
Palpation of the lateral pterygoid area in the myofascial pain diagnosis
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
, vol. 
105
 (pg. 
61
-
6
)
Fonseca DM, Bonfate G, Valle AL, Freitas SFT. Diagnóstico pela anamnese da disfunção craniomandibular. Rev Gaucha Odontol, 42: 23-28, 1994.
Diagnóstico pela anamnese da disfunção craniomandibular
Rev Gaucha Odontol
, vol. 
42
 (pg. 
23
-
28
)
Conti PC, Ferreira MP, Pegoraro LF, Conti JV, Salvador MC. A cross-sectional study of prevalence and etiology of signs and symptoms of temporomandibular disorders in high school and university students. J Orofac Pain,10(3):254-62, 1996.
A cross-sectional study of prevalence and etiology of signs and symptoms of temporomandibular disorders in high school and university students
J Orofac Pain
, vol. 
10
 (pg. 
254
-
62
)
Campos JADB, Gonçalves DAG, Camparis CM, Speciali JG.Reliability of a questionnaire for diagnosing the severity of temporomandibular disorder. Rev bras fisioter, 13(1): 38-43, 2009.
Reliability of a questionnaire for diagnosing the severity of temporomandibular disorder
Rev bras fisioter
, vol. 
13
 (pg. 
38
-
43
)
Goulet JP, Clark GT, Flack VF, Liu C. The reproducibility of muscle and joint tenderness detection methods and maximum mandibular movement measurement for the temporomandibular system. J Orofac Pain, 12:17-26, 1998.
The reproducibility of muscle and joint tenderness detection methods and maximum mandibular movement measurement for the temporomandibular system
J Orofac Pain
, vol. 
12
 (pg. 
17
-
26
)
Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs, 14:9-17, 1988.
Pain in children: comparison of assessment scales
Pediatr Nurs
, vol. 
14
 (pg. 
9
-
17
)
Visscher CM, Lobbezoo F, Naeije M. Comparison of algometry and palpation in the recognition of temporomandibular disorder pain complaints. J Orofac Pain, 18:214-219, 2004.
Comparison of algometry and palpation in the recognition of temporomandibular disorder pain complaints
J Orofac Pain
, vol. 
18
 (pg. 
214
-
219
)
Fredriksson L, Alstergren P, Kopp S. Pressure pain thresholds in the craniofacial region of female patients with rheumatoid arthritis. J Orofac Pain, 17: 326-332, 2003.
Pressure pain thresholds in the craniofacial region of female patients with rheumatoid arthritis
J Orofac Pain
, vol. 
17
 (pg. 
326
-
332
)
Landis RJ, Koch GG. The Measurement of Observer Agreement for Categorical Data. Biometrics, 33: 159-174, 1977.
The Measurement of Observer Agreement for Categorical Data
Biometrics
, vol. 
33
 (pg. 
159
-
174
)
Toscano P, Defabianis P Clinical evaluation of temporomandibular disorders in children and adolescents: a review of the literature. Eur J Paediatr Dent, 10(4):188-92, 2009.
Clinical evaluation of temporomandibular disorders in children and adolescents: a review of the literature
Eur J Paediatr Dent
, vol. 
10
 (pg. 
188
-
92
)
Franco AL, Gonçalves DA, Castanharo SM, Speciali JG, Bigal ME, Camparis CM. Migraine is the most prevalent primary headache in individuals with temporomandibular disorders. J Orofac Pain, 24(3):287-92, 2010.
Migraine is the most prevalent primary headache in individuals with temporomandibular disorders
J Orofac Pain
, vol. 
24
 (pg. 
287
-
92
)
Hirsch C, John MT, Lobbezoo F, Setz JM, Schaller HG. Incisal tooth wear and self-reported TMD pain in children and adolescents. Int J Prosthodont, 2004;17(2):205-10.
Incisal tooth wear and self-reported TMD pain in children and adolescents
Int J Prosthodont
, vol. 
17
 (pg. 
205
-
10
)
Lundeen TF, Sturdevant JR, George JM. Stress as a factor in muscle and temporomandibular joint pain. J Oral Rehabil, 14(5):447-56, 1987.
Stress as a factor in muscle and temporomandibular joint pain
J Oral Rehabil
, vol. 
14
 (pg. 
447
-
56
)
McCreary CP, Clark GT, Merril RL, Flack V, Oakley ME. Psychological distress and diagnostic subgroups of temporomandibular disorder patients. Pain 44(1):29-34, 1991.
Psychological distress and diagnostic subgroups of temporomandibular disorder patients
Pain
, vol. 
44
 (pg. 
29
-
34
)
Huang GJ, LeResche L, Critchlow CW, Martin MD, Drangsholt MT. Risk factors for diagnostic subgroups of painful temporomandibular disorders (TMD). J Dent Res, 81(4):284-8, 2002.
Risk factors for diagnostic subgroups of painful temporomandibular disorders (TMD)
J Dent Res
, vol. 
81
 (pg. 
284
-
8
)
Bevilaqua-Grossi D, Lipton RB, Napchan U, Grosberg B, Ashina S, Bigal ME. Temporomandibular disorders and cutaneous allodynia are associated in individuals with migraine. Cephalalgia, 30(4):425-32, 2010.
Temporomandibular disorders and cutaneous allodynia are associated in individuals with migraine
Cephalalgia
, vol. 
30
 (pg. 
425
-
32
)
Metsahonkala L, Anttila P, Laimi K, Aromaa M, Helenius H, Mikkelsson M, Jäppilä E, Viander S, Sillanpää M, Salminen J. Extracephalic tenderness and pressure pain threshold in children with headache. Eur J Pain,10(7):581-5, 2006.
Extracephalic tenderness and pressure pain threshold in children with headache
Eur J Pain
, vol. 
10
 (pg. 
581
-
5
)
Wahlund K, List T, Dworkin SF. Temporomandibular disorders in children and adolescents: reliability of a questionnaire, clinical examination, and diagnosis. J Orofac Pain, 12(1):42-51, 1998.
Temporomandibular disorders in children and adolescents: reliability of a questionnaire, clinical examination, and diagnosis
J Orofac Pain
, vol. 
12
 (pg. 
42
-
51
)
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