Relationship of Temporomandibular Disorders to Muscle Tension-Type Headaches and a Neuromuscular Orthosis Approach to Treatment

Abstract

A prominent etiological theory proposed for TMD related headache is that it results from a dysfunctional masticatory muscle system, wherein muscle hyperactivity is frequently caused by dental temporomandibular disharmony. The central goal of this article was to determine from a literature review of the subject whether there is significant evidence to support a relationship between headaches and TMD prevalence. A second purpose was to determine from such a review whether any relationship was one of cause and effect and whether treatment of the TMD condition can result in meaningful reduction or resolution of headaches. In the literature, there was a substantial amount of evidence for a positive relationship between TMD and the prevalence of headaches, and most importantly, that these were the muscle tension-type. Evidence for a cause and effect relationship was strong. It generally showed in numerous patients that TMD treatment of a large number of patients resulted in significant improvement in the physiological state of the masticatory system (muscles, joints and dental occlusion). Reduction or resolution of muscle tension-type headaches that were present was clinically significant. The authors concluded that TMD should be considered and explored as a possible causative factor when attempts are made to determine and resolve the cause of headaches in patients with this affliction. A benefit of resolving headaches at an early stage in their development is that it might result in the reduction of its potential for progression to a chronic and possibly migraine headache condition.

Additional information

Notes on contributors

Barry C. Cooper

Dr. Barry C. Cooper received his D.D.S. degree in 1963 from Columbia University School of Dental and Oral Surgery. He is currently a clinical associate professor, Department of Oral Biology and Pathology of the State University of New York (SUNY) Stony Brook School of Dental Medicine. He has held faculty positions at Columbia University School of Dental and Oral Surgery, New York Medical College, and Temple University School of Dentistry. Dr. Cooper is past international president of the International College of CranioMandibular Orthopedics (ICCMO). He maintains a private practice in Hewlett and Manhattan, NY, limited to the treatment of patients with TMD.

Israel Kleinberg

Dr. Israel Kleinberg is a distinguished professor and chairman of the Department of Oral Biology and Pathology at State University of New York at Stony Brook School of Dental Medicine. He holds a D.D.S. from the University of Toronto, a Ph.D. in biochemistry and physiology from the University of Durham in England, and a D.Sc. degree from the University of Manitoba in Canada. He has been instrumental in pioneering oral biology as a new dental and health science discipline. He has carried out extensive research on dental plaque, microbial ecology, saliva, dental caries, oral malodor, periodontal disease formation, and diagnostic instrumentation. Dr. Kleinberg has authored more than 300 scientific publications and has lectured to dental, medical, scientific, industrial, and lay organizations and groups throughout the world.