Evaluation of temporomandibular joint disorder in headache patients

Abstract

Objective

The present study is aimed at determining the percentage of temporomandibular joint disorder (TMD) in patients admitted to the neurology outpatient clinic with a headache complaint and to evaluate the association of TMD with the presence of bruxism and headache traits.

Materials and methods

A total of 349 headache patients were included in the study. The headache type, characteristics of the headache (incidence, duration, and severity of attacks), and the scores of the migraine disability scale (MIDAS) and Allodynia Symptom Scale (ASC-12T) were examined considering the presence of sleep bruxism. The International Classification of Headache Disorders (ICHD-3 Beta) criteria were used for diagnosing headaches. The presence of TMD was evaluated by using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). All patients diagnosed with TMD and/or bruxism were evaluated by a dentist.

Results

A total of 349 patients, 259 females and 90 males, were included in the study. The mean age of the patients was 36 years. Primary and secondary headaches were diagnosed in 317 (90.80%) and 32 (9.20%) patients, respectively. In the primary headache group, there were 227 migraines (182 females, 45 males), 74 tension-type headaches (TTH) (48 females, 26 males), and 15 trigeminal autonomic cephalalgias (TACs) (7 females, 8 males) patients. The remaining patients were diagnosed with other types of diagnoses. The rate of patients with chronic headache was 86.50%. TMD was detected in 89 (25.50%) of the patients while sleep bruxism was present in 80 (23.30%) patients. TMD was detected in 68 (30.0%) migraine patients and 13 (17.60%) TTH patients. The rate of TMD was statistically significantly higher in migraine patients compared to the TTH patients (p=0.037).

Conclusion

Our cross-sectional outpatient-based study determined the incidence of TMD in headache patients as 25%. Among the primary headaches, the incidence of TMD was higher in migraine patients compared to the other diagnoses. Considering these data, the presence of TMD is a clinical condition that should be considered in the pathophysiology of headache, primarily migraine, and especially in cases of non-response to treatment.

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References

  1. 1.

    Headache Classification Committee of the International Headache Society (IHS) (2013) The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 33(9):629–808

    Article  Google Scholar 

  2. 2.

    List T, Jensen RH (2017) Temporomandibular disorders: old ideas and new concepts. Cephalalgia 37(7):692–704

    Article  Google Scholar 

  3. 3.

    Canto G, De L, Singh V, Bigal ME, Major PW, Flores-Mir C (2014) Association between tension-type headache and migraine with sleep bruxism: a systematic review. Headache 54:1460–1469

    Article  Google Scholar 

  4. 4.

    American academy of sleep medicine (2014) International Classification of Sleep Disorders. In: Diagnostic and coding manual, 3rd edn. American Academy of Sleep Medicine, Westchester

    Google Scholar 

  5. 5.

    Graff-Radford SB, Abbott JJ (2016) Temporomandibular disorders and headache. Oral Maxillofac Surg Clin North Am 28(3):335–349

    Article  Google Scholar 

  6. 6.

    Yalın OÖ, Uludüz D, Sungur MA, Sart H, Özge A (2017) Identification of allodynic migraine patients with the Turkish version of the allodynia symptom checklist: reliability and consistency study. Arch Neuropsychiatr 54:260–266

    Article  Google Scholar 

  7. 7.

    Dora B, Dora D.D. (2017) Headache Pages: 309-310. Editör Akbostancı M.C. Istanbul Tıp Kitapevleri, 1st Edition. ISBN-978-605-9528-04-7.

  8. 8.

    Dworkin SF, LeResche L (1992) Research diagnostic criteria for temporomandibular disorders: review criteria, examinations and specifications, critique. J Craniomandib Disord Facial Oral Pain 6:301–355

    CAS  Google Scholar 

  9. 9.

    Ertaş M, Baykan B, Orhan EK, Zarifoglu M, Karli N, Saip S, Siva A (2012) One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. Headache 13(2):147–157

    Google Scholar 

  10. 10.

    Özge A, Uludüz D, Yalın OÖ, Demirci S, Karadaş Ö (2018) Chronic migraine: burden, comorbidities, and treatmet. Turk J Neurol 24:117–125

    Article  Google Scholar 

  11. 11.

    Franco AL, Gonçalves Daniela AG, Castanharo SM, Speciali JG, Bigal ME, Camparis CM (2010) Migraine is the most prevalent primary headache in individuals with temporomandibular disorders. J Orofac Pain 24:287–292

    PubMed  Google Scholar 

  12. 12.

    Andersona GC, John MT, Ohrbach R, Nixdorf DR, Schiffman EL, Truelove ES, List T Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain. J Pain 152(2011):765–771

  13. 13.

    Benoliel R, Sela G, Teich S, Sharav Y (2011) Painful temporomandibular disorders and headaches in 359 dental and medical students temporomandibular katılmak. Quintessence Int 42:73–78

    PubMed  Google Scholar 

  14. 14.

    Afrashtehfar KI, Afrashtehfar CDM, Nelly H (2014) Managing a patient with sleep bruxism. J Can Dent Assoc 80:e48

    PubMed  Google Scholar 

  15. 15.

    Özen NE (2007) Psychiatric aspect of temporomandibular disorders and bruxism. Clin Psychiatry 10:148–156

    Google Scholar 

  16. 16.

    Barder G, Levigne G (2000) Sleep buruxism; an overview of an oromandibular sleep movement disorder. Sleep Med Rev 4:27–43

    Article  Google Scholar 

  17. 17.

    Lavigne GJ, Kato T, Kolta A et al (2003) Neurobiological mechanisms involved in sleep bruxism. Crit Rev Oral Biol Med 14:30–46

    CAS  Article  Google Scholar 

  18. 18.

    Kato T, Thie NM, Huynh N et al (2003) Topical review: sleep bruxism and the role of peripheral sensory influences. J Orofac Pain 17:191–213

    PubMed  Google Scholar 

  19. 19.

    Fernandes G, Franco AL, de Godoi Gonçalves DA, Geraldo Speciali J, Bigal ME, Camparis CM (2013) Temporomandibular disorders, sleep bruxism, and primary headaches are mutually associated. J Orofac Pain 27:14–20

    PubMed  Google Scholar 

  20. 20.

    Lipton RB, Bigal ME, Ashina S, Burstein R, Silberstein S, Reed ML, Stewart WF (2008) Cutaneous allodynia in the migraine population. Ann Neurol 63:148–158

    Article  Google Scholar 

  21. 21.

    Bigal ME, Lipton RB (2008) Clinical course of migraine: conceptualizing migraine transformation. Neurology 71:848–855

    Article  Google Scholar 

  22. 22.

    Louter MA, Bosker JE, van Oosterhout WP, van Zwet EW, Zitman FG, Ferrari MD, Terwindt GM (2013) Cutaneous allodynia as a predictor of migraine chronification. Brain 136:3489–3496

    Article  Google Scholar 

  23. 23.

    De Luca CG, Singh V, Bigal ME, Major PW, Flores-Mir C (2014) Association between tension-type headache and migraine with sleep bruxism: a systematic review. Headache 54:1460–1469

    Article  Google Scholar 

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Funding

The authors declared that this study received no financial support.

Author information

Affiliations

Authors

Contributions

Medical practice: F.M. and O.C.D. Design: F.M., O.Ö.Y., and U.E. Data collection or processing: F.M. Analysis or interpretation: U.E. and O.Ö.Y. Literature search: F.M. Writing: F.M.

Corresponding author

Correspondence to Fergane Memmedova.

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Ethical approval

This study was approved by T.R. Health Sicences University İstanbul Tranining and Research Hospital Ethical Committe (Date: 14 March 2017, Number: 972).

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Informed consent was signed by the patients.

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Internally peer-reviewed.

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The authors declare no conflict of interest.

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Memmedova, F., Emre, U., Yalın, O.Ö. et al. Evaluation of temporomandibular joint disorder in headache patients. Neurol Sci (2021). https://doi.org/10.1007/s10072-021-05119-z

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Keywords

  • Headache
  • Migraine
  • TMD
  • Bruxism