Prevalence of painful temporomandibular disorders in individuals with post-traumatic headache attributed to mild traumatic brain injury

Abstract

Objectives: Studies assessing the presence of painful temporomandibular disorders (TMD) in post-traumatic headache (PTH) attributed to mild traumatic brain injury are lacking. We aimed to (1) measure the prevalence of painful TMD and assess its association with demographic and trauma-related factors in patients with PTH and (2) compare the headache characteristics and post-concussion burden between the PTH patients with and without painful TMD.

Methods: This study embedded in a population-based epidemiologic cohort study (N = 2,832) assessed mild traumatic brain injury patients (18-60 years) 2-4 months after their trauma. PTH patients (n = 382) were identified and invited to fill out questionnaires assessing post-concussion symptoms and burden, headache characteristics, presence of painful TMD and demographics.

Results: The prevalence of painful TMD was 22.5%. Living with a partner/spouse (OR = 0.31, 95% CI: 0.13-0.75, P = 0.010) and having a secondary education (OR = 0.28, 95% CI: 0.08-0.99, P = 0.048) was significantly associated with decreased risk of having painful TMD. PTH patients with painful TMD reported significantly higher headache intensity (P < 0.042), increased symptom burden (P = 0.007), reduced workability after trauma (P = 0.019) and were frequently on full-time sick leave compared to those without painful TMD.

Conclusions: PTH patients had a high prevalence of painful TMD. Living with a partner/spouse and having a secondary education decreased the risk of having painful TMD. Patients with painful TMD were significantly heavily burdened compared to those without painful TMD.

Clinical relevance: Presence of painful TMD in PTH patients may compromise the rehabilitation plan and complicate the management of these patients.

Keywords: Concussion; Mild traumatic brain injury; Orofacial pain; Post-traumatic headache; Temporomandibular disorders.