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Study suggests tension headache may actually be TMJD

10 percent of the U.S. population suffer from TMJD severe enough to warrant treatment. These patients experience debilitating pain that can destroy quality of life. Diagnosing the disorder is problematic, however, due to overlap with other conditions, Ohrbach said.

TMJD usually involves more than a single symptom, rarely has a single cause and frequently involves multiple factors, including behavioral and emotional responses. Lacking a firm set of diagnostic tools, physicians and dentists often depend on their individual judgment to decide if a patient does or does not have the disorder, he noted.

The diagnostic criteria for TMJD being tested in this project are part of the established Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Headache diagnosis is based on the International Headache Society (IHS) guidelines. All examiners were been trained to use the "gold-standard" criteria for tension-type headache established by the IHS.

The study compared the diagnostic procedures for pain and the reproduction of "pain" vs. "headache" during the clinical examination. Procedures included a range of functional and orthopedic tests and standard pain sensitivity to pressure applied to the muscles associated with headache. The types of headaches considered included sub-clinical headaches, tension-type headaches and headaches exhibiting more symptoms than are accepted for tension-type headaches, such as the "mixed headache," migraine or "migraine-type" headaches

The study involved 583 participants -- 82.3 percent female and 17.7 percent male -- who were recruited as cases from the community based on the presence of symptoms clearly associated with TMJD. Based on IHS criteria, 31.5 percent, or 152 participants, were diagnosed with tension-type headache by the examiners.

Additional researchers on the study were Yoly Gondalez, D.D.S., from UB; John O. Look, D.D.S., Ph.D., Eric L. Schiffman, D.D.S., and Wei Pan, Ph.D.
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Contact: Lois Baker
ljbaker@buffalo.edu
716-645-5000 x1417
University at Buffalo
12-May-2006


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