Headache、Migraine and Temporomandibular Disorder - 謝明吉、姜厚任 顎顏面 美學 重建 專科診所-風華整形聯合診所
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Physiology and pathology of the TMJ
Headache、Migraine and Temporomandibular Disorder


Headache、Migraine and Temporomandibular Disorder

Headaches are one of the most prevalent neurological symptoms. Approximately 51% of adults have had headaches. Therein, migraines, which severely affect the quality of everyday life, stands at around 12% prevalence in adults with 17-18% in females and 6% in males. This ratio is similar to the distribution of temporomandibular disorders (14% in females and 10% in males). In the US, approximately 23 million people are affected by migraines. Headaches account for the fourth highest number of outpatients under common symptoms. The US spends 1 to 17 billion on headache-related diseases annually.

Clinical relevance
Primary headaches such as migraines, tension-type and cluster headaches, and TMD are clinically considered comorbid diseases. This means that it is very likely that headaches and TMD symptoms may occur simultaneously in a patient(Gonçalves AG,2012. Gonçalves M, 2013) If the patient has more TMD symptoms (such as chewing pain, trismus and teeth grinding etc.) then the chances of the occurence of migraines is also higher. On the contrary, if the patient has a higher frequency of headaches, then the proportion of myofacial pain and temporomandicular joint symptoms are higher(Gonçalves DA,2009)。

Clinical studies on headaches in women show that a higher proportion of patients with migraines/chronic migraines also have TMD symptoms (86.6%:33.3%), and patients with myofacial pain (extra-articular) are comparable with those with intra-articular pain(Gonçalves M, 2013)。

Headaches affect the first branch of the trigeminal nerve and most TMDs involve the first and second branches of the trigeminal nerve, both of which use the nociceptive system. Many clinical examinations of temporomandibular disorders (such as muscle pressing, clench tests etc. ) often causes headaches simultaneously. Therefore,Schiffmanother scholars believe that part of headache symptoms may be caused by TMDs (Ekberg E, 2002), and this is especially true for headaches occuring in the temple area. Marklundobserved 371 students over a period of 2 years, and he found that students with TMD are three times more likely to have headaches compared with those without TMD within the 2 years.

Treatment policy
WrightWright aimed to give occlusional splint therapy to patients that had both TMD and chronic headaches. The headache index of patients decreased by 17% and there was an 18% reduction of painkiller use after five weeks after treatment. This further decreased by 39% and 46% respectively after 5 months (Marklund S,2010). Many other clinical studies have had similar findings where TMD treatment (such as occlusal splint therapy and botox injections) for patients with combined headaches and TMD can effectively reduce the frequency of headaches and painkiller use (Lim PF,2010). Further, Danielaclinical experiments have also found that combining migraine drug therapy and occlusal splint therapy is the most effective treatment for patients with both TMD and migraines(Daniela A,2012)。


Temporomandibular disorders also have a higher proportion of headache related symptoms especially temple pain

The best effects are achieved if you can use headache relief medication in addition to the treatment of joint and muscle symptoms.


Results of surgery vary among patients. Please consult your doctor.
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Results of surgery vary among patients. Please consult your doctor.