Prevalence of parafunctional habits and temporomandibular dysfunction symptoms in patients attending a tertiary headache clinic

Abstract

Objetive: To investigate the most prevalent forms of headache in a tertiary outpatient service, and to assess the frequency of associated parafunctional habits and temporo mandibular dysfunction symptoms (TMD). Method: All new patients referred to the Headache Outpatient Service in UNIMES during 2008 were prospectively assessed by the neurologist and the dental surgeon. results: Eighty new patients were assessed; chronic migraine and episodic migraine without aura were the most prevalent conditions, accounting for 66.3% of all cases. There was significantly higher use of analgesics/days for the chronic migraine patients. The prevalence of parafunctional habits was 47.5% and the prevalence of TMD symptoms was 35%. conclusion: The high prevalence of primary headaches, parafunctional habits and TMD symptoms and the inadequate use of analgesic drugs suggest that primary healthcare units need further training in the field of headache and orofacial pain. Key words: headache, migraine, temporomandibular dysfunction.Prevalência de hábitos parafuncionais e de sintomas de disfunção temporomandibular em pacientes atendidos em um ambulatório terciário de cefaléias resuMO Objetivo: Investigar as formas prevalentes de cefaléia em um ambulatório terciário e analisar a frequência de hábitos parafuncionais e de sintomas de disfunção temporomandibular (DTM) associados. Método: Todos os pacientes novos encaminhados ao Serviço de Cefaléias da UNIMES durante 2008 foram avaliados de forma prospectiva pelo neurologista e pelo cirurgião dentista. resultados: Oitenta pacientes novos foram avaliados; enxaqueca crônica e enxaqueca episódica sem aura foram as condições mais prevalentes, perfazendo 66,3% de todos os casos. Houve uso significativamente alto de analgésicos/dias pelos pacientes com enxaqueca crônica. A prevalência de hábitos parafuncionais foi 47,5% e a prevalência de sintomas de DTM foi 35%. conclusão: A alta prevalência de cefaléias primárias, hábitos parafuncionais, sintomas de DTM e o uso inadequado de drogas analgésicas sugerem que as unidades básicas de saúde necessitam maior treinamento no campo da cefaléia e da dor orofacial. Palavras-chave: cefaléia, enxaqueca, disfunção temporomandibular. Correspondence Yara Dadalti Fragoso

Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache

“…Menstrual migraine is well known to be more severe and refractory to treatment than non-menstrual migraine 10,24 , and a limitation of our study was not to characterize this migraine subgroup, since this would require longitudinal follow-up and use of dairies. We found strong association between migraine and TMD pain, as previously described 10,[12][13][14][15][16][17][18][19][20] . Gonçalves et al, in a population-based study, found that TMD symptoms are more likely to occur among those who present any headache type.…”

“…Additionally, TMD is a risk factor for increased headache frequency 10,[12][13][14][15][16][17][18][19][20] . Nonetheless, as with many of the identified risk factors for increased migraine frequency, most of the studies diagnosed both migraine and TMD based on self-reported symptoms or on questionnaires.…”

Temporomandibular disorders dysfunction in headache patients

“…Additionally, the clinical signs of TMD, such as tenderness in masticatory muscles and TMJ pain were also statically more common in headache patients, especially those ones with CDH in relation to subjects without headache, corroborating with others studies that also found a higher prevalence of masticatory muscle tenderness and TMJ pain in headache patients (5,7,10,15,24,25). …”

Headache attributed to TMD Is Associated With the Presence of Comorbid Bodily Pain: A Case‐Control Study

“…There is a significant positive association between temporomandibular pain and primary headaches . Headache patients were more likely to receive a diagnosis of myofascial pain (according to the RDC/TMD) than patients without headaches .…”