Migraine and Temporomandibular Disorders

A study by Franco, et al as­sessed the prevalence of primary headaches in adults with temporomandibular disorders (TMD) who were evaluated in a specialty orofacial pain clinic; the study also as­sessed controls without TMD. The study sample in­volved 158 individuals with TMD seen at a university-based specialty clinic, as well as 68 controls. The research diagnostic criteria for TMD were used to diagnose the TMD patients. Primary head­aches were as­sessed using a structured in­terview and classified according to the second edition of the “International Clas­si­f­i­cation for Headache Dis­orders” (Cephalalgia, 2004, Volume 24, Supplement 1).
     Data were analyzed by chi-square tests with a significance level of 5% and odds ratio (OR) tests with a 95% confidence interval (CI). The study found that primary headaches occurred in 45.6% of the control group: 30.9% with migraines and 14.7% with tension-type headaches (TTH). Primary headaches  occurred in 85.5% of individuals with TMD: the mi­graine was the most prevalent at 55.3%, followed by TTH at 30.2%; and 14.5% had no primary head­aches. In con­trast to controls, the OR for primary head­aches in TMD pa­tients was 7.05 (95% CI = 3.65 to 13.61; P = .000); for mi­graines the OR was 2.76 (95% CI = 1.50 to 5.06; P = .001); and for TTH the OR was 2.51 (95% CI = 1.18 to 5.35; P = .014). Myo­fascial pain/arthralgia was the most common TMD diagnosis (53.2%). The presence of primary or specific headaches was not associated with the time since the onset of TMD (P = .714). Mi­graine frequency was positively as­sociated with TMD pain severity (P = .000).
     The study concluded that TMD was associated with increased primary head­aches prevalence rates. The mi­graine was the most common primary head­aches diagnosis in individuals with TMD.