Headache Because of Problems with Teeth, Mouth, Jaws, or Dentures in Chronic Temporomandibular Disorder Patients: A Case-Control Study.

Tadej Ostrc,Sabina Frankovič,Ksenija Rener-Sitar,Zvezdan Pirtošek

doi:10.3390/ijerph19053052

Abstract

This study aimed to characterize self-reported headaches because of problems with the teeth, mouth, jaws, or dentures (HATMJD) in chronic patients with temporomandibular disorders (TMDs) in order to compare their results with those of TMD patients without such headaches and to investigate the associations of HATMJD with depression, anxiety, physical symptoms, oral behaviors, and sleep quality. We conducted a case–control study on consecutive chronic TMD patients referred to the University Medical Center of Ljubljana, Slovenia. A self-reported HATMJD was extracted from item #12 in the 49-item version of the Oral Health Impact Profile questionnaire. Axis II instruments of the Diagnostic Criteria for TMD (i.e., for screening of depression, anxiety, specific comorbid functional disorders, and oral behaviors) and the Pittsburgh Sleep Quality Index were used in this study. In total, 177 TMD patients (77.4% women; mean age: 36.3 years) participated in this study; 109 (61.6%) patients were classified as TMD patients with HATMJD. TMD patients with at least mild depressive and anxiety symptoms, with at least low somatic symptom severity, and a high number of parafunctional behaviors had more HATMJD. Parafunctional behavior and sleep quality were the most prominent predictive factors of the occurrence of HATMJD. TMD patients with HATMJD have more psychosocial dysfunction, a higher frequency of oral behaviors, and poorer sleep quality than TMD patients without such headaches.

Highlights

Introduction published maps and institutional affilMany clinical studies have confirmed associations between temporomandibular disorders (TMD) and tension-type headaches or migraine [1–4]
Axis II instruments of the Diagnostic Criteria for TMD and the Pittsburgh Sleep Quality Index were used in this study
Of all included TMD patients, 109 (61.6%) patients were classified as TMD patients with HATMJD, whereas 68 (38.4%) TMD patients reported no presence of HATMJD

Summary

Introduction

Many clinical studies have confirmed associations between temporomandibular disorders (TMD) and tension-type headaches or migraine [1–4]. TMD and headaches may have common pathogenesis, causation, or common disruptive factors [3,5,6]. Musculoskeletal pain in the orofacial area is more common in people with headaches [7]. TMD in patients with severe headaches have more significant pain intensity [7–12]. It is generally accepted that TMDs have a multifactorial etiology and that psychosocial components, including oral behaviors and trauma, contribute to the development, exacerbation, and progression to chronic TMD [13,14]. The role of psychological factors in the development of TMD disorders is still not entirely clear [15]. Some studies have concluded that patients with chewing muscle pain are more prone to stress and depression [16,17]. Stress and anxiety are the well-known psychological factors that correlate with

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Discussion

Conclusion