Clinical utility of a validated headache screening questionnaire in patients with temporomandibular disorders (TMD)

Abstract

Temporomandibular disorders are a group of conditions characterized by chronic pain and/or dysfunction of the temporomandibular joint or associated masticatory muscles. Headache represents a common coexisting condition in patients with TMD. Both musculoskeletal and vascular headaches are associated with TMD. The migraine questionnaire is a 54-question self-administered questionnaire that is used frequently in headache clinics to evaluate patterns of headache, suggesting a diagnosis of migraine, tension-type, cluster, or other headaches. Of the 54 questions, 34 questions are specifically intended to screen for migraine, 10 questions specifically for tension-type headache, 7 questions specifically for cluster headache, and 3 for other headache syndromes. To determine the pattern of headache using a validated screening questionnaire inpatients with TMD. Thirty-five consecutive patients diagnosed with TMD seen at the University of Pennsylvania were given the questionnaire to complete. Thirty-five age- and sex-matched controls also completed the 54-question survey. Eighty-five percent of the TMD patients were female, compared with 65% in the control group. Twenty-three (65.7%) of the TMD patients complained of headache compared with twelve (34.2%) in the control group. Of the 23 TMD patients with headache, 22 (95.6%) answered affirmatively in a pattern suggestive of migraine headache compared with 9 in the control group. Tension type headache was the second most common diagnosis, followed by cluster headache. In general, headache complaints were significantly more common in females in both the TMD and control groups. Headache represents a common coexisting condition in patients with TMD. Women appear to suffer or report headache complaints to a greater degree than do men. Based on the results of this pilot study, headache with migrainous features appears to be very common in patients diagnosed with TMD as assessed by a validated screening headache questionnaire.