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Background: Temporomandibular disorders (TMD) and headaches are prevalent among the global population. Patients often suffer from both conditions, and they are likely to be associated in a bidirectional way. However, the nature of the association remains unclear. Understanding the epidemiological aspects of the relationship between these conditions could have important clinical implications. Objective: To evaluate the prevalence of headaches in TMD patients as well as the prevalence of TMD in patients who suffer from headaches. Method: A systematic literature search was conducted using electronic databases. Studies published in English and those that used an acknowledged diagnostic criteria for TMD and headaches were included. Study quality was assessed using the Newcastle-Ottawa scale and meta-analyses were performed to generate pooled prevalence estimates. Result: Thirty-one studies met the selection criteria for the review; 16 studies evaluated the prevalence of headache in TMD patients and 15 studies evaluated the prevalence of TMD in headache patients. The included studies were of moderate-to-high quality. Meta-analyses revealed moderate-to-large heterogeneities across included studies. Pooled prevalence estimates from meta-analyses indicated similar rates of headaches in TMD patients and of TMD in headache patients (61.58%, 95% CI 45.26–76.66 and 59.42%, 95% CI 51.93–66.60, respectively). Migraines were more commonly observed in TMD patients (40.25%, 95% CI 35.37–45.23) compared to tension-type headaches (18.89%, 95% CI 12.36–26.44). The prevalence of headaches was particularly high in painful-TMD (82.80%, 95% CI 75.41–89.10). Conclusion: Despite large variance in prevalence rates across included studies, this review suggests headache and TMD frequently co-occur, particularly in the case of migraines and muscle related TMD. This association has important clinical, pathophysiological and therapeutic implications.

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Pain is often the reason for which patients seek help from the dental team. Although dental pain is likely to be the most common cause, chronic pain conditions, such as headaches, may also show similar symptoms to toothache, resulting in mismanagement and a delay in diagnosis. Many patients experience headaches, which are often debilitating. Despite this, dentists have a lack of knowledge about both headaches and neurovascular pain. The dental team should be able to identify when the pain is likely to be of neurovascular origin rather than toothache, and the team should be able to provide advice and an appropriate referral, if necessary. This should help reduce unnecessary dental treatment and improve the pain relief to these patients. CPD/Clinical Relevance: This article provides information on how to initially manage neurovascular pain primary care.