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Headache and Oral Parafunctional Behaviors

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Abstract

This study tested the hypotheses that individuals with headaches would show significantly more oral parafunctional behaviors than non-headache controls, be diagnosed with one or more temporomandibular disorders (TMD) significantly more frequently than controls, and would report significantly less pain and other symptoms of headache after participating in a habit reversal treatment to reduce oral parafunctional behaviors, compared to a wait list control. In Phase I, individuals with and without self-reported headaches were examined by a blinded examiner and participated in a week-long experience sampling protocol (ESM) to assess oral parafunctional behaviors, pain, and emotional states. In Phase II, those with headaches were randomly assigned to either a habit reversal treatment or to a wait list control group. In the last, sixth week of the program, participants again completed an ESM protocol. Results showed that headache patients were significantly more likely to report oral parafunctional behaviors than non-headache controls and to receive a Research Diagnostic Criteria/TMD diagnosis. Results from Phase II showed general improvement in both groups on pain and parafunctions. Individuals with headaches engage in significantly higher rates and intensities of oral parafunctional behaviors. Treatment of these behaviors using habit reversal techniques appears to have the same effect on pain as waiting.

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References

  • Anderson, G. C., John, M. T., Ohrbach, R., Nixdorf, D. R., Schiffman, E. L., Truelove, E. S., et al. (2011). Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain. Pain, 152, 765–771.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ballegaard, V., Thede-Schmidt-Hansen, P., Svensson, P., & Jensen, R. (2008). Are headache and temporomandibular disorders related? A blinded study. Cephalalgia, 28, 832–841.

    Article  PubMed  Google Scholar 

  • Bevilaqua Grossi, D., Lipton, R. B., & Bigal, M. E. (2009). Temporomandibular disorders and migraine chronification. Current Pain and Headache Reports, 13, 314–318.

    Article  PubMed  Google Scholar 

  • Chen, C. Y., Palla, S., Erni, S., Sieber, M., & Gallo, L. M. (2007). Nonfunctional tooth contact in healthy controls and patients with myogenous facial pain. Journal of Orofacial Pain, 21, 185–193.

    PubMed  Google Scholar 

  • Doepel, M., Nilner, M., Ekberg, E., Vahlberg, T., & Bell, Y. (2011). Headache: Short- and long-term effectiveness of a prefabricated appliance compared to a stabilization appliance. Acta Odontologica Scandinavica, 69, 129–136.

    Article  PubMed  Google Scholar 

  • Dworkin, S. F., & LeResche, L. (1992). Research diagnostic criteria for temporomandibular disorder: Review, criteria, exams and specification, critique. Journal of Craniomandibular Disorders, 6, 301–355.

    PubMed  Google Scholar 

  • Glaros, A. G., & Burton, E. (2004). Parafunctional clenching, pain, and effort in temporomandibular disorders. Journal of Behavioral Medicine, 27, 91–100.

    Article  PubMed  Google Scholar 

  • Glaros, A. G., Kim-Weroha, N., Lausten, L., & Franklin, K.-L. (2007a). Comparison of habit reversal and a behaviorally-modified dental treatment for temporomandibular disorders: A pilot investigation. Applied Psychophysiology & Biofeedback, 32, 149–154.

    Article  Google Scholar 

  • Glaros, A. G., Owais, Z., & Lausten, L. (2007b). Parafunctional activity and TMD pain: A potential mechanism for the effectiveness of splint therapy. Journal of Oral Rehabilitation, 34, 97–104. doi:10.1111/j.1365-2842.2006.01660.x.

    Article  PubMed  Google Scholar 

  • Glaros, A. G., Urban, D., & Locke, J. (2007c). Temporomandibular disorders and headache: Evidence for diagnostic and behavioural overlap. Cephalalgia, 27, 542–549.

    Article  PubMed  Google Scholar 

  • Glaros, A. G., Williams, K., & Lausten, L. (2005). The role of parafunctions, emotions and stress in predicting facial pain. Journal of the American Dental Association, 136, 451–458.

    Article  PubMed  Google Scholar 

  • Gonçalves, D. A., Camparis, C. M., Speciali, J. G., Franco, A. L., Castanharo, S. M., & Bigal, M. E. (2011). Temporomandibular disorders are differentially associated with headache diagnoses: A controlled study. Clinical Journal of Pain, 27, 611–615.

    Article  PubMed  Google Scholar 

  • Gramling, S. E., Neblett, J., Grayson, R., & Townsend, D. (1996). Temporomandibular disorder: Efficacy of an oral habit reversal treatment program. Journal of Behavior Therapy and Experimental Psychiatry, 27, 245–255.

    Article  PubMed  Google Scholar 

  • Hoffmann, R. G., Kotchen, J. M., Kotchen, T. A., Cowley, T., Dasgupta, M., & Cowley, A. W, Jr. (2011). Temporomandibular disorders and associated clinical comorbidities. Clinical Journal of Pain, 27, 268–274.

    Article  PubMed  Google Scholar 

  • Ichesco, E., Quintero, A., Clauw, D. J., Peltier, S., Sundgren, P. M., Gerstner, G. E., et al. (2012). Altered functional connectivity between the insula and the cingulate cortex in patients with temporomandibular disorder: A pilot study. Headache, 52, 441–454.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kang, J. K., Ryu, J. W., Choi, J. H., Merrill, R. L., & Kim, S. T. (2010). Application of ICHD-II criteria for headaches in a TMJ and orofacial pain clinic. Cephalalgia, 30, 37–41.

    PubMed  Google Scholar 

  • Lim, P. F., Smith, S., Bhalang, K., Slade, G. D., & Maixner, W. (2010). Development of temporomandibular disorders is associated with greater bodily pain experience. Clinical Journal of Pain, 26, 116–120.

    Article  PubMed Central  PubMed  Google Scholar 

  • Look, J. O., Schiffman, E. L., Truelove, E. L., & Ahmad, M. (2010). Reliability and validity of axis I of the research diagnostic criteria for temporomandibular disorders (RDC/TMD) with proposed revisions. Journal of Oral Rehabilitation, 37, 744–759.

    Article  PubMed Central  PubMed  Google Scholar 

  • Olesen, J. (2006). International classification of headache disorders, second edition (ICHD-2): Current status and future revisions. Cephalalgia, 26, 1409–1410.

    Article  PubMed  Google Scholar 

  • Peterson, A. L., Dixon, D. C., Talcott, G. W., & Kelleher, W. J. (1993). Habit reversal treatment of temporomandibular disorders: A pilot investigation. Journal of Behavior Therapy and Experimental Psychiatry, 24, 49–55.

    Article  PubMed  Google Scholar 

  • Plesh, O., Noonan, C., Buchwald, D. S., Goldberg, J., & Afari, N. (2012). Temporomandibular disorder-type pain and migraine headache in women: A preliminary twin study. Journal of Orofacial Pain, 26, 91–98.

    PubMed  Google Scholar 

  • Sato, H., Saisu, H., Muraoka, W., Nakagawa, T., Svensson, P., & Wajima, K. (2012). Lack of temporal summation but distinct aftersensations to thermal stimulation in patients with combined tension-type headache and myofascial temporomandibular disorder. Journal of Orofacial Pain, 26, 288–295.

    PubMed  Google Scholar 

  • Schmidt, J. E., & Carlson, C. R. (2009). A controlled comparison of emotional reactivity and physiological response in masticatory muscle pain patients. Journal of Orofacial Pain, 23, 230–242.

    PubMed  Google Scholar 

  • Stuginski-Barbosa, J., Macedo, H. R., Bigal, M. E., & Speciali, J. G. (2010). Signs of temporomandibular disorders in migraine patients: A prospective, controlled study. Clinical Journal of Pain, 26, 418–421.

    Article  PubMed  Google Scholar 

  • Townsen, D., Nicholson, R. A., Buenaver, L., Bush, F., & Gramling, S. (2001). Use of a habit reversal treatment for temporomandibular pain in a minimal therapist contact format. Journal of Behavior Therapy and Experimental Psychiatry, 32, 221–239.

    Article  PubMed  Google Scholar 

  • Troeltzsch, M., Troeltzsch, M., Cronin, R. J., Brodine, A. H., Frankenberger, R., & Messlinger, K. (2011). Prevalence and association of headaches, temporomandibular joint disorders, and occlusal interferences. Journal of Prosthetic Dentistry, 105, 410–417.

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Dr. James Guillory and the KCUMB Summer Fellowship program for their support of this project. We’re grateful for the assistance provided by the staff of the Clinical Research Center.

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Correspondence to Alan G. Glaros.

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Glaros, A.G., Hanson, A.H. & Ryen, C.C. Headache and Oral Parafunctional Behaviors. Appl Psychophysiol Biofeedback 39, 59–66 (2014). https://doi.org/10.1007/s10484-014-9242-0

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