title: Prevalence and association of headaches, temporomandibular joint disorders, and occlusal interferences.
abstract: BACKGROUND
  Although an interaction of malocclusion, parafunction, and temporomandibular joint disorders (TMD) can be inferred from the experience of daily practice, scientific evidence to corroborate this hypothesis does not exist. However, there are indications that TMD and headaches may be intertwined.
  
  
  OBJECTIVE
  The purpose of this study was to identify the presence or absence of an association of occlusal interferences, parafunction, TMD, or physiologic, muscular, or prosthodontic factors with the occurrence of headache.
  
  
  METHODS
  In a private practice population of 1031 subjects (436 men and 595 women, mean age 49.6 years) the demographic parameters, headache and general pain history, habits and general personal information were recorded. Clinical examination for dental, muscular, and temporomandibular joint pathology was accomplished. Data were statistically analyzed using the Mann-Whitney U, Kruskal-Wallis, and Chi-Square tests (α = .05). A multinomial logistic regression analysis was performed with respect to confounding variables.
  
  
  RESULTS
  Headache affliction was found to affect women more frequently than men (1.7:1). Students and non academics were more prone to suffer from headache. Parafunction (P=.001), TMD (P=.001) and gross differences between centric occlusion and maximum intercuspation of more than a 3 mm visible track marked with 8 μm articulation foil (P=.001) significantly influenced the presence of headache. Headache intensity and frequency decreased with age. While tension-type headache was most frequently diagnosed, the parameters studied were not significantly associated with one certain headache diagnosis more frequently than others.
  
  
  CONCLUSIONS
  Stomatognathic factors of TMD, parafunction, and gross differences between centric occlusion and maximum intercuspation of more than 3 mm are associated with headache. These findings should be interpreted with caution due to the cross-sectional nature of this study.
authors.affiliation: Private Practice, Ansbach, Germany. matthias_troeltzsch@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Troeltzsch
authors.forename: M
authors.initials: M
authors.lastname: Troeltzsch
authors.forename: R J
authors.initials: RJ
authors.lastname: Cronin
authors.forename: A H
authors.initials: AH
authors.lastname: Brodine
authors.forename: R
authors.initials: R
authors.lastname: Frankenberger
authors.forename: K
authors.initials: K
authors.lastname: Messlinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002012:Bruxism / Q000150:complications*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003769:Dental Occlusion, Traumatic / Q000150:complications*; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000150:complications*; D019217:Tooth Attrition / Q000150:complications*; D055815:Young Adult