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.
