Prevalence of Painful Temporomandibular Disorders and Overlapping Primary Headaches Among Young Adults

TY - JOUR

T1 - Prevalence of Painful Temporomandibular Disorders and Overlapping Primary Headaches Among Young Adults

AU - Exposto, Cristina Rocha

AU - Mansoori, Mojdeh

AU - Bech, Bodil Hammer

AU - Baad-Hansen, Lene

N1 - © 2025 The Author(s). European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation ‐ EFIC ®.

PY - 2025/5

Y1 - 2025/5

N2 - BACKGROUND: Large population-based estimates of the prevalence of painful temporomandibular disorders (p-TMD) utilising standardised screening tools are scarce and have not investigated the prevalence of overlapping primary headaches. We aimed to estimate the prevalence of p-TMD in a large population of young adults (18 to 23 years) and to estimate the co-occurrence of p-TMD and two primary headaches, migraine and tension-type headache (TTH). The study also aimed to examine the extent of psychological (PHQ-4) and physical (PHQ-15) comorbidities and report prevalence across three gender categories (women, men and other).METHODS: Survey data from the Danish National Birth Cohort were collected (n = 11,982), in a cross-sectional observational design. A sensitivity analysis was conducted to address participation bias, revealing minimal impact on the estimates.RESULTS: The overall prevalence of p-TMD was 26.4% with gender-specific prevalence of women: 31.5%, other: 39.2% and men: 16.8%. Among those with p-TMD, 80.5% reported headaches at least once a month, and 13.8% over 15 days monthly. For the p-TMD individuals with a medical headache diagnosis, 31.9% experienced TTH and 10.9% migraine. The study also identified a higher proportion of moderate/severe psychological distress and physical symptoms in the p-TMD group compared to the non-p-TMD group. Logistic regression revealed a positive association between PHQ-4 and p-TMD, modified by gender (p = 0.016).CONCLUSIONS: High overall prevalence of p-TMD and overlapping primary headaches was found in young adults. In addition, the study reports gender-specific associations between p-TMD, psychological distress and physical comorbidities indicating that this association is stronger for men than for women.SIGNIFICANCE STATEMENT: This study found a higher-than-expected prevalence of painful temporomandibular disorders in young adults. It is based on a large population cohort and used standardised and validated screening tools. The study also reported common co-occurrence of primary headaches and explored gender differences. The study raises awareness for a possibly underestimated health burden in young individuals, particularly among individuals experiencing psychological distress and multiple physical symptoms.

AB - BACKGROUND: Large population-based estimates of the prevalence of painful temporomandibular disorders (p-TMD) utilising standardised screening tools are scarce and have not investigated the prevalence of overlapping primary headaches. We aimed to estimate the prevalence of p-TMD in a large population of young adults (18 to 23 years) and to estimate the co-occurrence of p-TMD and two primary headaches, migraine and tension-type headache (TTH). The study also aimed to examine the extent of psychological (PHQ-4) and physical (PHQ-15) comorbidities and report prevalence across three gender categories (women, men and other).METHODS: Survey data from the Danish National Birth Cohort were collected (n = 11,982), in a cross-sectional observational design. A sensitivity analysis was conducted to address participation bias, revealing minimal impact on the estimates.RESULTS: The overall prevalence of p-TMD was 26.4% with gender-specific prevalence of women: 31.5%, other: 39.2% and men: 16.8%. Among those with p-TMD, 80.5% reported headaches at least once a month, and 13.8% over 15 days monthly. For the p-TMD individuals with a medical headache diagnosis, 31.9% experienced TTH and 10.9% migraine. The study also identified a higher proportion of moderate/severe psychological distress and physical symptoms in the p-TMD group compared to the non-p-TMD group. Logistic regression revealed a positive association between PHQ-4 and p-TMD, modified by gender (p = 0.016).CONCLUSIONS: High overall prevalence of p-TMD and overlapping primary headaches was found in young adults. In addition, the study reports gender-specific associations between p-TMD, psychological distress and physical comorbidities indicating that this association is stronger for men than for women.SIGNIFICANCE STATEMENT: This study found a higher-than-expected prevalence of painful temporomandibular disorders in young adults. It is based on a large population cohort and used standardised and validated screening tools. The study also reported common co-occurrence of primary headaches and explored gender differences. The study raises awareness for a possibly underestimated health burden in young individuals, particularly among individuals experiencing psychological distress and multiple physical symptoms.

KW - Adolescent

KW - Adult

KW - Cohort Studies

KW - Comorbidity

KW - Cross-Sectional Studies

KW - Denmark/epidemiology

KW - Dentistry

KW - Facial pain

KW - Female

KW - Gender diversity

KW - Headache Disorders, Primary/epidemiology

KW - Headache/epidemiology

KW - Headaches

KW - Humans

KW - Male

KW - Migraine Disorders/epidemiology

KW - Population health

KW - Prevalence

KW - Temporomandibular Joint Disorders/epidemiology

KW - Tension-Type Headache/epidemiology

KW - Young Adult

KW - dentistry

KW - gender diversity

KW - headaches

KW - temporomandibular disorders

KW - population health

KW - facial pain

KW - cohort studies

UR - http://www.scopus.com/inward/record.url?scp=105002019876&partnerID=8YFLogxK

U2 - 10.1002/ejp.70013

DO - 10.1002/ejp.70013

M3 - Journal article

C2 - 40152614

SN - 1090-3801

VL - 29

JO - European journal of pain (London, England)

JF - European journal of pain (London, England)

IS - 5

M1 - e70013

ER -