Correlation between headache, cervical pain and bruxism: retrospective study on TMD patients

Abstract

Objectives. This study aims to establish whether headaches and cervical pain may have a positive association with bruxism in patients with temporomandibular disorders (tmd). In addition, possible correlations between these conditions and age, gender, and the circadian cycle are investigated. Materials and methods. A retrospective observational study was conducted on tmd patients based on the analysis of standardized medical records for the diagnosis of temporomandibular disorders (tmd). The study examined 216 medical records of patients treated for tmd at the linares oral rehabilitation institute (chile) between february 2015 and august 2020. Age, gender, and selected data from the dc/tmd questionnaire were extracted from the medical records of the patients under review. The examined data were subjected to the chi-square test, the mann-whitney non-parametric test, and the kruskal-wallis test. All analyses used a 5% significance level. Results. Of 216 tmd patient medical records reviewed, 125 were selected and included in the study (95 women aged 34.3 +/- 17.78 years; 30 men aged 28.3 +/- 18.26 years). 68% of the patients had probable sleep bruxism (sb), 85.6% had probable awake bruxism (ab), 64 64% had both. 34.4% of the patients experienced headaches, and 43.2% reported cervicalgia. Women showed more ab (p=0.03), secondary headaches (p=0.005), and myalgia of the masticatory muscles (p=0.04) than men. Younger patients showed a higher ab (p = 0.042). Patients with a high frequency of sb (more than 2-3 days per week) and with ab showed cervical pain (p=0.006 and p=0.000, respectively). In addition, patients with ab showed more headaches than the other groups (0.001), whereas patients without ab had a low frequency of myalgia (0.004). Conclusions. Tmds encompass a range of conditions, both painful and non-painful, that affect the temporomandibular joint, the masticatory muscles, and other associated structures. Symptoms commonly include pain and dysfunction of the masticatory muscles, temporomandibular joints (tmj), and joint noises. Other reported symptoms include painful comorbid conditions such as headache and cervical pain. The results of this retrospective observational study suggest that in tmd patients, secondary headache and cervical pain are associated with bruxism, particularly with ab more than with sb. A significant association between ab and children, adolescents, and young adults was found. Women with tmd showed a greater tendency to ab, headaches, and cervical pain. In addition, a significant relationship was found between headache, cervicalgia, and myalgia.