Pain, headache, and oromandibular structures

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By Michael J Marmura MD

TMJ and other oromandibular causes of pain and headache is also known as or subsumes Craniomandibular disorders, Head pain relating to oromandibular structures, Oromandibular disorders, and Temporomandibular joint dysfunction syndrome. -ed.

The relationship of headache and oromandibular disorders, such as temporomandibular joint dysfunction, is confusing to many physicians. In this clinical article, Dr. Michael Marmura of the Jefferson Headache Center at Thomas Jefferson University explores this complex relationship and specifically describes overlapping disorders, such as atypical odontalgia and “lower-half migraine,” that create diagnostic difficulties. This summary also includes guidance for treatment of oromandibular disorders and associated headache.

Key Points

  • Temporomandibular joint disorders are common and are comorbid with headache disorders, such as migraine.
  • Central sensitization appears to be a common problem in temporomandibular joint disorders, atypical odontalgia, and chronic headaches.
  • It is unclear whether successful treatment of temporomandibular joint disorders will improve headache severity or frequency.
  • In many common headache disorders, such as migraine, cluster headache, and trigeminal neuralgia, pain refers to dental structures.