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Association between oral habits and headache in patients with painful TMD

Grant number: 19/18861-9
Support Opportunities:Scholarships in Brazil - Scientific Initiation
Effective date (Start): January 01, 2020
Effective date (End): June 30, 2021
Field of knowledge:Health Sciences - Dentistry
Principal Investigator:Daniela Aparecida de Godoi Gonçalves
Grantee:Deise Isabela Moreira dos Anjos
Host Institution: Faculdade de Odontologia (FOAr). Universidade Estadual Paulista (UNESP). Campus de Araraquara. Araraquara , SP, Brazil


Introduction: Temporomandibular Disorders (TMD) is one of the most common painful conditions in the orofacial region. Its pathophysiology may involve peripheral and central sensitization processes. It is often associated with comorbid conditions, such as primary headache and secondary headache attributed to TMD. The presence and the frequency of parafunctional oral habits may influence these conditions, worsening their prognosis, and increasing treatment refractoriness. Aim: The general objective of the present study will be to investigate the influence of parafunctional habits on the association between TMD and migraine, and between TMD and headache attributed to TMD, after correct identification and correction of confounding factors. Material and Methods: A total of 103 adult individuals, aged between 20 to 65 years, were evaluated. TMD was classified according to the RDC-TMD criteria. The presence and frequency of parafunctional oral habits were assessed using an Oral Habits Questionnaire. Primary headaches were assessed according to the The International Classification of Headache Disorders, 3rd edition. The evaluation of secondary headache was made according to the criteria proposed by Schiffman et al. 2012. Data Analysis: The sample will be stratified into 3 groups: TMD, TMD and migraine (TMD-M); TMD and headache attributed to TMD (TMD-cA). Descriptive statistics will be used to characterize the sample according to the study groups. Demographic data, depression symptoms, anxiety symptoms and parafunctional habits will be analyzed for each group. The Mann-Whitney and Kruskal-Wallis tests will be used for quantitative variables with normal distribution, and the Chi-square and Fisher Exact tests for qualitative variables, with a significance level of p> 0.05. Furthermore, independent regression models will be constructed to verify if the presence and frequency of parafunctional habits (dependent variables) influence the association between TMD and the headache in question (independent variables). The variables: age, gender, ethnic-racial and socioeconomic classification, depressive and anxiety symptoms may be included as possible confounders.

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