Headaches and pain referred to the teeth: frequency and potential neurophysiologic mechanisms

Resumo

To assess frequency of pain referred to the teeth in occipital
neuralgia, migraine and tension-type headache. Material and methods:
153 patients presenting with bruxing behavior and craniomandibular
disorders (CMDs). Clinical examination, questionnaires, palpation,
criteria for CMDs, bruxing behavior (BB), occipital neuralgia (ON),
migraine (MIG), tension-type headache (TTH) and pain referred to
the teeth. Results: Mean ages in the ON, MIG and TTH patients
and controls were about 38.0, 37.0, 33.0 and 36.6 years, respectively
(p = 0.17). The frequencies of dental pains in the subgroups ON and
MIG were 37.1% and 25% (p = 0.52), ON and TTH, 37.1% and 18.6%
(p = 0.03), ON and Controls 37.1% and 6.7% (p = 0.006), MIG and
TTH 25% and 18.6% (p = 0.51), MIG and Controls 25% and 6.6%
(p = 0.16) and TTH and controls 18.6% and 6.7% (p = 0.15). The
frequencies of pain referred to the teeth decreased from the ON to
the MIG, and then to the TTH and Control groups (x-square for
independence p < 0.002, x-square for trends p < 0.001). Conclusion:
The ON subgroup demonstrated the highest frequency of dental pain
referred to the teeth. This frequency increased with the severity of
pain. Neurophysiological mechanisms may explain higher frequency
of referred pain associated with the severity of headache.