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

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.