Headache Attributed to Temporomandibular Disorders: Axis I and II Findings According to the Diagnostic Criteria for Temporomandibular Disorders

Shoshana Reiter, Alona Emodi-Perlman, Hanita Kasiel, Waseem Abboud, Pessia Friedman-Rubin, Orit Winocur Arias, Yifat Manor

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: To analyze Axis I and II findings of patients diagnosed as having painful temporomandibular disorder (TMD) with headache attributed to TMD (HAattrTMD) in order to assess whether HAattrTMD is associated with a specific Axis I and II profile suggestive of the central sensitization process. Methods: This retrospective study included 220 patients with painful TMD divided into those with (n = 60) and those without (n = 160) HAattrTMD, and the patients were compared for Axis I and II results according to the Diagnostic Criteria for TMD (DC/TMD). A P value < .05 was considered statistically significant. Results: A total of 27.3% of the patients received a diagnosis of HAattrTMD. Myofascial pain with referral was significantly more common in the HAattrTMD group (P < .001), while local myalgia was significantly more common in the non-HAattrTMD group (P < .001). Characteristic pain intensity was significantly higher in the HAattrTMD group (P = .003), which also showed significantly higher levels of depression (P = .002), nonspecific physical symptoms (P = .004), graded chronic pain (P = .008), and pain catastrophizing (P = .013). Nonspecific physical symptoms were positively associated with HAattrTMD (odds ratio [OR] = 1.098, 95% CI = 1.006 to 1.200, P = .037). Local myalgia was negatively associated with HAattrTMD (OR = .295, 95% CI = 0.098 to 0.887, P = .030). Conclusions: Painful TMD patients who report headache in the temple area and are diagnosed as having local myalgia rather than myofascial pain with referral probably do not have HAattrTMD. The diagnosis of HAattrTMD may point to a central sensitization process and possible current/future chronic TMD conditions. J Oral Facial Pain Headache 2021;35:119–128. doi: 10.11607/ofph.2863

Original languageEnglish
Pages (from-to)119-128
Number of pages10
JournalJournal of Oral and Facial Pain and Headache
Volume35
Issue number2
DOIs
StatePublished - 2021

Keywords

  • Axis II
  • DC/TMD
  • headache attributed to TMD
  • local myalgia
  • myofascial pain with referral

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