Adolescents with vs without painful temporomandibular disorder (TMD) may have a greater risk for migraine and a greater frequency of headaches, according to a study published in the Journal of Pain.

In this case-control study, adolescents age 13 to 15 years who were recruited for an epidemiologic      study in Brazil were enrolled (n=83 and n=68, with and without painful TMD, respectively). Participants were classified according to the Second Edition of the International Classification for Headache Disorders as having no headaches, probable migraine, migraine, probable tension-type headache (TTH), and TTH. The presence of TMD was determined using the Brazilian-Portuguese version of the Research Diagnostic Criteria for Temporomandibular Disorders.

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In this cohort, migraine was more common in patients with vs without painful TMD (odds ratio [OR], 3.0; 95% CI, 1.47-6.19; P =.033). The presence of TMD was also associated with increased odds of low-frequency headaches (OR, 2.8; 95% CI, 1.36-5.69; P =.005). The incidence of probable TTH and TTH was comparable in participants with vs without TMD. Painful TMD was found to be associated with an increase in headache frequency (P =.005). Migraine was the only factor that had a significant association with a greater number of painful sites on palpation in the trigeminal area (P =.001).

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Study limitations include the small number of patients with TTH and the sole inclusion of adolescents.

“[C]oncomitant of comorbid conditions is more effective and may prevent worsening and chronification. Thus, greater interaction between orofacial pain specialists and neurologists is essential to achieve better control of both conditions,” the researchers noted.


Fernandes G, Arruda MA, Bigal ME, Camparis CM, Goncalves DAG. Painful temporomandibular disorder is associated with migraine in adolescents: a case-control study. Journal of Pain. doi: 10.1016/j.jpain.2019.03.010

This article originally appeared on Clinical Pain Advisor