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PReS-FINAL-2261: Prevalence of orofacial symptoms and signs in patients with juvenile fibromyalgia


Fibromyalgia may coexist with other clinical conditions such temporomandibular disorders (TMD). Temporomandibular disorder is a term embracing clinical disorders that involve the masticatory musculature, the temporomandibular joints, and associated structures.


The purpose of this study was to assess the prevalence of orofacial symptoms and signs in patients with juvenile fibromyalgia.


Twenty-eight consecutive patients (22 girls) who presented to our outpatient pediatric rheumatology clinic and fulfilled the ACR criteria of fibromyalgia were included in this study. All patients underwent a rheumatologic examination performed by a pediatric rheumatologist, and an orofacial examination performed by a single dentist at the same data. The patients were interviewed according to a standardized questionnaire concerning the presence of orofacial pain and functional impairment and were submitted to a clinical evaluation following a structured protocol.


The mean age at the evaluation was 13 years (range 8- 18 years) and the mean follow-up time was 3.3 years (0.3 to 12). Orofacial symptoms were reported in 14 (50%) of patients. The most common subjective symptoms were impaired ability with chewing (50%), pain in function (28.6%), and pain at rest (17.8%). We found that the vast majority of our patients (89.3%)reported pain on palpation in at least two of six sites in the orofacial region, but only 7 (25%) had pain during mandibular movements, and nobody had restrictions to open their mouths 40 mm or more.


Although palpation of the orofacial region is not included in the diagnostic criteria for fibromyalgia, a large number of juvenile patients presented with pain on palpation in this region. This study suggests the need for interdisciplinary strategies to effectively diagnose and treat this chronic condition.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Len, C., Zwir, L., Fraga, M. et al. PReS-FINAL-2261: Prevalence of orofacial symptoms and signs in patients with juvenile fibromyalgia. Pediatr Rheumatol 11 (Suppl 2), P251 (2013).

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