Epidemiologic studies of mandibular dysfunction: A critical review

There are serious doubts, however, about whether the findings of recent epidemiologic studies of mandibular dysfunction should be accepted without first raising critical questions regarding their validity.

Abstract

w hen epidemiologic methods identify a large percentage of the population as “sick” with some disease or disorder, concern may arise about a possible “epidemic.” In the case of mandibular dysfunction, recent epidemiologic studies suggest that as many as three fourths of the population may, to some degree, be affected by this disorder. If these studies are accepted as presented, the dental profession is obliged to attempt identification of the large number of affected individuals and then to either advise or treat them appropriately. There are serious doubts, however, about whether the findings of these studies should be accepted without first raising critical questions regarding their validity. Two major issues must be considered: (1) Have conventional epidemiologic methods been correctly applied to the study of mandibular dysfunction? (2) Have proper inferences been drawn from the findings? The concerns of population medicine, or epidemiology, are different from those of the clinical disciplines. In population medicine, groups replace individuals as the focus of study. The study of the distribution and dynamics of diseases in human populations can provide clinicians and researchers with answers to important questions, such as: (1) Can we identify those persons most likely to become ill? (2) What common features of susceptibility or exposure do these people share? (3) What is the natural history of the disease if not treated? In addition, epidemiologic studies may elucidate the causal relationships of a particular disease, which then establishes the basis for programs of prevention and control. Epidemiology has contributed dramati-