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Friday, July 30, 2010

Migraine is Most Common Primary Headache in Patients with Temporomandibular Disorders

A recent article in the Journal of Orofacial Pain identifies Migraine as the most frequent primary headache in patients with temporomandibular disorders. The majority of migraines are actually trigeminally moderated and it is no surprise that they would be common. Tension type headaches were the second most common headache. Headaches occured in 45.6 % of control group and 85.5 % of TMD group.

Patients with chronic migraines and tension headaches who are looking for relief should consider the utilization of neuromuscular dentistry.

A neuromuscular diagnostic orthotic is the first step in changing the quality of life. It is a well established fact that the trigeminal nerves are an integral part of most chronic migraine and tension headaches. Neuromuscular dentistry is probably the best approach to correcting the physiologic causes of migraine. Aitional information on the treatment of TMJ disorders and chronic headaches utilizing neuromuscular dentistry cn be found in Sleep and Health Journal.

J Orofac Pain. 2010 Summer;24(3):287-92.
Migraine is the Most Prevalent Primary Headache in Individuals with Temporomandibular Disorders.
Franco AL, Goncalves DA, Castanharo SM, Speciali JG, Bigal ME, Camparis CM.

Aims: To assess the prevalence of primary headaches (HA) in adults with temporomandibular disorders (TMD) who were assessed in a specialty orofacial pain clinic, as well as in controls without TMD. Methods: The sample consisted of 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. HAs were assessed using a structured interview and classified according to the Second Edition of the International Classification for Headache Disorders. Data were analyzed by chi-square tests with a significance level of 5% and odds ratio (OR) tests with a 95% confidence interval (CI). Results: HAs occurred in 45.6% of the control group (30.9% had migraine and 14.7% had tension-type headache [TTH]) and in 85.5% of individuals with TMD. Among individuals with TMD, migraine was the most prevalent primary HA (55.3%), followed by TTH (30.2%); 14.5% had no HA. In contrast to controls, the odds ratio (OR) for HA in those with TMD was 7.05 (95% confidence interval [CI] = 3.65-13.61; P = .000), for migraine, the OR was 2.76 (95% CI = 1.50-5.06; P = .001), and for TTH, the OR was 2.51 (95% CI = 1.18-5.35; P = .014). Myofascial pain/arthralgia was the most common TMD diagnosis (53.2%). The presence of HA or specific HAs was not associated with the time since the onset of TMD (P = .714). However, migraine frequency was positively associated with TMD pain severity (P = .000). Conclusion: TMD was associated with increased primary HA prevalence rates. Migraine was the most common primary HA diagnosis in individuals with TMD. J Orofac Pain 2010;24:287-292.

PMID: 20664830 [PubMed - in process]

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posted by Dr Shapira at 2:19 PM

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