Comparing chronic migraines with TMD pain, a study

Another study I recently read took at look at chronic migraines and temporomandibular disorder (TMD) pain. The researchers wanted to compare patients with chronic migraines and chronic TMD on disability, pain and fear avoidance factors. While the study didn’t utilize dental offices, they did take a look at a neurology department and a TMD consult in a tertiary care center. There were a total of 50 patients with chronic migraines and 51 with chronic TMD.

Results from this study showed that there were significant differences between those with migraines and those with TMD. However, there were no differences between the chronic migraine group and the neck disability, visual analog scale and kinesiophobia groups. For chronic TMD, the combination of neck disability and kinesiophobia was a significant covariate model of craniofacial pain and disability. For chronic migraine patients, the regression model showed that neck disability was a significant predictive factor for headache impact.

The differences between the chronic migraine group and chronic TMD group were found in craniofacial pain and disability, pain catastrophizing and headache impact. But these groups were found to be similar for pain intensity, neck disability and kinesiophobia.

We can take this study to further help us in treating our patients who are suffering from chronic pain, whether it is due to migraines or TMD. By understanding these relationships, we might be able to take preventive measures or catch conditions earlier in the process.

What other studies are out there that could better guide us in understanding our patients’ pain and discomfort?

Sleep disorders common among non-cystic fibrosis bronchiectasis patients, study says

Let’s take a look at another connection with sleep breathing disorders. Adults with non-cystic fibrosis bronchiectasis (NCFB) suffer from sleep disorders stemming from less oxygen in the blood, according to a study.

What is bronchiectasis though? It is a chronic condition characterized by abnormal widening of airways. This can lead to their destruction, a buildup of excess mucus and a decline in lung function.  

Sleep orders, specifically obstructive sleep apnea, affect 45 percent of the world’s population. Of this, about three to seven percent of young men and about 2.5 percent of young women in the Western world have sleep apnea. A risk increases in people with respiratory disorders.

Despite confirmed links between a number of respiratory diseases and sleep disorders, states the study, the relationship between bronchiectasis and sleep disorders have still not been investigated extensively. For this reason, this research team looked to dive into the connection.

What were the results?

It was found that 41 percent of patients had sleep apnea associated with low blood oxygen levels and 71 percent snored. On top of that, 53 percent of patients experienced excessive daytime sleepiness, a percentage higher than the general population.

This study brings to our attention just how important it is to complete further research on various connections with sleep disorders, such as sleep apnea. By conducting further research and expanding our education, we can further provide our patients with even better care.

What conditions have you noticed a link with sleep apnea? Is there adequate research out there?

The mechanisms of craniofacial pain

A recent journal looked at the mechanisms of craniofacial pain. The researchers worked to highlight peripheral and central adaptations that might promote chronification of pain in craniofacial pain states, including migraines and temporomandibular disorders (TMD). Pain is a common symptom that is associated with disorders of the craniofacial tissues, such as the teeth and their supporting structure, the temporomandibular joint (TMJ) and the muscles of the head.

Most acute craniofacial pain conditions are easily recognized and well managed. However, others, especially those that are chronic such as migraines and TMD, present clinical challenges for dentists and physicians. While the mechanisms of chronic craniofacial pain in patients remains limited, both clinical and preclinical investigations suggest changes in afferent inputs to the brain occur in chronic pain. This results in amplification of nociception, which promotes and sustains chronic craniofacial pain states.

Through an increased understanding of the physiological and pathological processing of nociception in the trigeminal system, we can learn about new perspectives for the mechanistic understanding of acute craniofacial pain conditions. This also helps with the peripheral and central adaptations that are related to chronic pain. We can offer improvements in treatment for chronic and acute craniofacial pain conditions.

What are your thoughts on this? Does this information help improve treatment options for your patients?

Chronic Migraines Worsen Jaw Pain

Headaches and migraines are bad enough, but add jaw pain on top of that and our patients are bound to be miserable. To make matters worse, frequent migraines can actually increase a patient’s risk for developing temporomandibular disorder (TMD), according to a recent study published in the Journal of Manipulative and Physiological Therapeutics. As a result, patients will not only experience migraines, but jaw pain, clicking and even difficulty with chewing.

The connection between migraines and jaw pain

In the study, researchers found that people who experience migraines on 15 or more days of the month were three times more likely to exhibit severe symptoms of TMD. Previous studies suggested there was a link between migraines and TMD, but this current study is actually the first of its kind to study migraine frequency and jaw pain severity.

Of the 84 women in their early mid-thirties that were observed, 32 had episodic migraines and 32 had no history of migraines. TMD symptoms were observed in 54 percent of the women with no history of migraines, 80 of those with episodic migraines and all of the women with chronic migraines.

This is an interesting study because we might not place enough emphasis on this link between migraines and TMD. As dentists, we need to look at all aspects of conditions. If your patients suffer from migraines, it is important to also determine if they have TMD for the best treatment options.