Temporomandibular disorders prevalence and associated factors among adolescents in Al-Ahsa, Saudi Arabia: a school-based cross-sectional study

Abstract Background Temporomandibular disorders (TMDs) are conditions affecting the temporomandibular joint and its surrounding structures, characterized by common clinical symptoms. Therefore, this study aimed to identify clinical types, sociodemographic factors, and other factors associated with their occurrence among adolescents. Methods This school-based cross-sectional study was conducted in public schools from June to November 2024 in the Al-Ahsa region, Eastern Province, Saudi Arabia. A total of 866 adolescents were selected using a one-stage stratified cluster random sampling technique. The study utilized the DC-TMD questionnaire and clinical examination tool validated for adolescent populations. Results Of the selected participants, 60.5% were late adolescents. Boys represented 54.3%. Sibling rank showed that 31.1% were first-born. The prevalence of TMD among the participants was 15.2%. Myalgia was the most common TMD diagnosis, followed by arthralgia. Girls (0.45; 0.34–0.72, p ≤ 0.01) and first-born individuals (0.065; 0.44–0.95, p ≤ 0.03) had significantly higher odds of TMD. Those who reported being unhappy at school or experiencing chaotic family environments had increased odds of TMD (1.8; 1.26–2.67, p ≤ 0.001). Furthermore, nervous disposition, comorbidities, and perceived poor general health were associated with a higher prevalence of TMD (0.23; 0.09–0.55, p ≤ 0.001). The multiple logistic regression model, including gender, age group, and birth order, explained 4% of the variance in TMD prevalence. After adding psychosocial factors, the explained variance increased to 8%. Gender and general health remained significant predictors (p ≤ 0.001). Conclusions The quite high prevalence of TMD, particularly among girls, and its associations with comorbidities and psychological distress emphasize the interconnectedness of TMD with broader health conditions. These findings highlight the critical need for clinicians to prioritize early screening with gender-specific approaches in managing TMD among adolescents.