Background/Objectives: Temporomandibular disorders (TMD) are common in pediatric patients, yet limited data exist on orthodontists’ knowledge, confidence, and clinical practices related to pediatric TMD. This cross-sectional study aimed to characterize orthodontists’ perceived knowledge, confidence, training, and practice patterns, and examine associations between routine screening behaviors and perceived confidence. Methods: A 34-item anonymous survey was distributed to orthodontists and orthodontic residents enrolled in or graduated from U.S. Commission on Dental Accreditation (CODA)-accredited programs. The survey assessed perceived knowledge, confidence in screening, diagnosis, and management of pediatric TMD, adequacy of residency training (on 0–10 numerical rating scale), frequency of routine TMD screening and examination practices, and referral patterns. Respondents were compared in study outcomes according to years of clinical practice with ANOVA. Respondents were categorized according to frequency of TMD screening (always/some of the time vs. sometimes/never) and compared in study outcomes using independent t-tests. Results: Out of 83 respondents, perceived knowledge (56.8 ± 26.9), confidence with screening (62.0 ± 30.5), diagnosis (59.4 ± 29.8), and management (50.8 ± 30.9) of pediatric TMD were moderate. Less than half of respondents (45.8%) reported routinely screening pediatric patients using standardized screening questions. Orthodontists who reported routine screening demonstrated significantly greater perceived knowledge and confidence in screening, diagnosis, and management compared with those who screened less frequently (all p’s ≤ 0.018, effect size between 0.57 and 0.78). Greater use of specific history-taking and clinical examination components was also associated with higher perceived confidence (all p’s between 0.001 and 0.046, effect size between 0.53 and 1.01). Confidence differed by years in practice, with lower scores reported among residents and mid-career practitioners (p < 0.05). Conclusions: Variability exists in orthodontists’ perceived knowledge, confidence, and clinical practices regarding pediatric TMD. Routine screening was associated with greater perceived competence. These findings highlight potential alignment between structured screening behaviors and self-reported confidence and may inform educational strategies in orthodontic training.

Background/Objectives: Omega-3 polyunsaturated fatty acids (PUFAs) influence lipid-mediated inflammatory pathways implicated in migraine, yet randomized trial data evaluating biologic effects of omega-3 supplementation in youth with migraine remain limited. This pilot quasi-randomized clinical trial aimed to determine whether 12 weeks of omega-3 PUFA supplementation produces measurable changes in whole-blood EPA and DHA levels in children and adolescents with migraine, and to characterize changes in patient-reported measures of pain, migraine-related disability, and psychological distress. Methods: We conducted a parallel-group, quasi-randomized, double-blind, placebo-controlled trial in children and adolescents (ages 10–17) with migraine diagnosed per International Classification of Headache Disorders, 3rd edition criteria, recruited from pediatric neurology clinics at two academic medical centers. Of 57 participants allocated 1:1 to daily omega-3 PUFA supplementation (340 mg EPA + 510 mg DHA) or coconut oil placebo for 12 weeks, 44 completed the study and were analyzed. The primary outcome was change in whole-blood omega-3 PUFA index. Secondary outcomes included patient-reported measures of pain intensity, pain interference, migraine-related disability, and psychological distress. Exploratory outcomes included changes in omega-6/omega-3 and arachidonic acid/eicosapentaenoic acid (AA/EPA) ratios. Between-group differences were evaluated using ANCOVA adjusting for baseline values. Results: Omega-3 supplementation significantly altered lipid biomarker profiles. Compared with placebo, the intervention group demonstrated greater increases in omega-3 PUFA index (adjusted mean difference 1.64; 95% CI 0.94–2.35; p < 0.001) and greater reductions in omega-6/omega-3 ratio (−2.57; 95% CI −4.25 to −0.90; p = 0.003) and AA/EPA ratio (−13.52; 95% CI −21.55 to −5.49; p = 0.002), consistent with the increase in whole-blood omega-3 levels. No significant between-group differences were observed in patient-reported outcomes. Conclusions: Omega-3 PUFA supplementation significantly altered lipid biomarker profiles in youth with migraine over 12 weeks, supporting a measurable whole-blood EPA + DHA response in this proof-of-concept trial. Future larger-scale trials with longer duration are needed to evaluate clinical effects.