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Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain

Anderson, Gary C.a,*; John, Mike T.b; Ohrbach, Richardc; Nixdorf, Donald R.d; Schiffman, Eric L.e; Truelove, Edmond S.f; List, Thomasg

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doi: 10.1016/j.pain.2010.11.007
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The relationship of the frequency of temple headache to signs and symptoms of temporomandibular joint (TMJ) disorders (TMD) was investigated in a subset of a larger convenience sample of community TMD cases. The study sample included 86 painful TMD, nonheadache subjects; 309 painful TMD subjects with varied frequency of temple headaches; and 149 subjects without painful TMD or headache for descriptive comparison. Painful TMD included Research Diagnostic Criteria for Temporomandibular Disorders diagnoses of myofascial pain, TMJ arthralgia, and TMJ osteoarthritis. Mild to moderate-intensity temple headaches were classified by frequency using criteria based on the International Classification of Headache Disorder, 2nd edition, classification of tension-type headache. Outcomes included TMD signs and symptoms (pain duration, pain intensity, number of painful masticatory sites on palpation, mandibular range of motion), pressure pain thresholds, and temple headache resulting from masticatory provocation tests. Trend analyses across the painful TMD groups showed a substantial trend for aggravation of all of the TMD signs and symptoms associated with increased frequency of the temple headaches. In addition, increased headache frequency showed significant trends associated with reduced PPTs and reported temple headache with masticatory provocation tests. In conclusion, these findings suggest that these headaches may be TMD related, as well as suggesting a possible role for peripheral and central sensitization in TMD patients.

Subjects with painful temporomandibular disorders (TMD) showed significant trends for increased signs and symptoms of TMD associated with increased frequency of concurrent temple headaches.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

aUniversity of Minnesota School of Dentistry, Department of Developmental and Surgical Sciences, Minneapolis, MN, USA

bUniversity of Minnesota School of Dentistry/School of Public Health, Department of Diagnostic and Biological Sciences, Minneapolis, MN, USA

cUniversity at Buffalo School of Dental Medicine, Department of Oral Diagnostic Sciences, Buffalo, NY, USA

dUniversity of Minnesota School of Dentistry, Department of Diagnostic and Biological Sciences and Department of Neurology, Minneapolis, MN, USA

eUniversity of Minnesota School of Dentistry, Department of Diagnostic and Biological Sciences, Minneapolis, MN, USA

fUniversity of Washington, School of Dentistry, Department of Oral Medicine, Seattle, WA, USA

gDepartment of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Malmö, Sweden

*Corresponding author. Address: University of Minnesota School of Dentistry, Department of Developmental and Surgical Sciences, 6-296 Moos Tower, 515 Delaware Street SE, Minneapolis, MN 55455, USA. Tel.: +1 612 624 3908; fax: +1 612 624 0777.

E-mail: ander018@umn.edu

Submitted March 12, 2010; revised November 5, 2010; accepted November 8, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.
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