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Saturday, December 20, 2014

Headaches, Migraines, TMJ, TMD and other CranioMandibular Disorders


This article in the clinical journal of pain makes clear the comorbidities of Headache and TMD. They also show a high correlation of TMD to Migraines.

The article points to central facilitation of nociceptive input in headache syndromes. This is what I call an input/output or I/o error.
"TMD, TMD subtypes, and TMD severity are independently associated with specific headache syndromes and with headache frequency. This differential association suggests that the presence of central facilitation of nociceptive inputs may be of importance, as positive association was observed only when muscular TMD pain was involved."

Clin J Pain. 2011 Sep;27(7):611-5.

Temporomandibular disorders are differentially associated with headache diagnoses: a controlled study.

Source

Department of Dental Materials and Prosthodontics, Araraquara Dental School, Sao Paulo State University, São Paulo, Brazil. danielagg@foar.unesp.br

Abstract

OBJECTIVES:

Temporomandibular disorders (TMDs) are considered to be comorbid with headaches. Earlier population studies have suggested thatTMD may also be a risk factor for migraine progression. If that is true, TMD should be associated with specific headache syndromes (eg, migraineand chronic migraine), but not with headaches overall. Accordingly, our aim was to explore the relationship between TMD subtypes and severity with primary headaches in a controlled clinical study.

METHODS:

The sample consisted of 300 individuals. TMDs were assessed using the Research Diagnostic Criteria for TMD, and primary headache was classified according to International Classification for Headache Disorders-2. Univariate and multivariate models assessed headache diagnoses and frequency as a function of the parameters of TMD.

RESULTS:

Relative to those without TMD, individuals with myofascial TMD were significantly more likely to have chronic daily headaches (CDHs) [relative risk (RR)=7.8; 95% confidence interval (CI), 3.1-19.6], migraine (RR=4.4; 95% CI, 1.7-11.7), and episodic tension-type headache (RR=4.4; 95% CI, 1.5-12.6). Grade of TMD pain was associated with increased odds of CDH (P<0.0001), migraine (P<0.0001), and episodic tension-type headache (P<0.05). TMD severity was also associated with headache frequency. In multivariate analyses, TMD was associated with migraine and CDH (P=0.001). Painful TMD (P=0.0034) and grade of TMD pain (P<0.001) were associated with headache frequency.

DISCUSSION:

TMD, TMD subtypes, and TMD severity are independently associated with specific headache syndromes and with headache frequency. This differential association suggests that the presence of central facilitation of nociceptive inputs may be of importance, as positive association was observed only when muscular TMD pain was involved.
PMID:
21368664
[PubMed - indexed for MEDLINE]

posted by Dr Shapira at 7:21 AM

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