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BMC Oral Health
BMC Oral Health
BMC Oral Health
1472-6831
BioMed Central London

39232738
4705
10.1186/s12903-024-04705-9
Research
The link between cutaneous allodynia and pain/sensitivity in teeth and gums during migraine episodes
http://orcid.org/0000-0002-8414-8613
Yilmaz Melis 1
http://orcid.org/0000-0001-8761-0298
Kale Ediz dtedizkale@yahoo.com

2
http://orcid.org/0000-0003-2797-2398
Ozge Aynur 3
1 https://ror.org/04nqdwb39 grid.411691.a 0000 0001 0694 8546 Faculty of Dentistry, Department of Endodontics, Mersin University, Private Practice, Mersin, Turkey
2 https://ror.org/04nqdwb39 grid.411691.a 0000 0001 0694 8546 Faculty of Dentistry, Department of Prosthodontics, Mersin University, Mersin, Turkey
3 https://ror.org/04nqdwb39 grid.411691.a 0000 0001 0694 8546 Faculty of Medicine, Department of Neurology, Mersin University, Mersin, Turkey
4 9 2024
4 9 2024
2024
24 104317 3 2024
5 8 2024
© The Author(s) 2024
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Background

Migraine is one of the most common primary headaches worldwide, while toothache is the most common pain in the orofacial region. The association of migraine pain, and oral pain is unknown. This study aims to investigate the association between migraine and dental and gingival pain with the presence of allodynia.

Methods

A questionnaire comprising demographic data with the ID-Migraine (IDM) tool, an Allodynia Symptom Checklist (ASC), and inquiries about pain and sensitivity in the teeth and gums during migraine attacks was administered to the participants and 762 responded the survey. The study classified participants based on the ASC, and the relationship between allodynia and pain/sensitivity in the teeth and/or gums during migraine attacks was analyzed. The statistical analyses utilized Chi-square tests and the Fisher-Exact test.

Results

Among 762 migraine patients, 430 (56.44%) were classified as allodynia (+), while 332 (43.56%) were classified as allodynia (−) (p < 0.001). Additionally, 285 participants (37.5%) reported experiencing pain and sensitivity in the teeth and gums during migraine attacks, with a significant relationship observed between allodynia and pain/sensitivity in the teeth and/or gums during migraine attacks (p < 0.001).

Conclusion

The findings of this study have important clinical implications. For migraine patients who are non-allodynic, the presence of pain and sensitivity in their teeth and gums during migraine attacks may indicate underlying dental diseases or the need for dental treatment especially root canal treatment. However, for allodynic patients, such symptoms may not necessarily indicate the presence of dental diseases or the need for dental treatment especially root canal treatment. These results underscore the significance of considering the presence of allodynia in the assessment and management of oral symptoms during migraine attacks.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-024-04705-9.

Keywords

Migraine
ID-Migraine
Allodynia Symptom Checklist
Pain/sensitivity in teeth
Pain/sensitivity in gum
issue-copyright-statement© BioMed Central Ltd., part of Springer Nature 2024
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pmcIntroduction

Orofacial pain is a prevalent complaint encountered in outpatient departments globally, often co-occurring with migraines and/or tooth and gum pain [1–3]. The origin of orofacial pain may be related to various pathological conditions in cranial nerves or dentoalveolar structures and also myofascial or temporomandibular joint disorders [4–6]. Orofacial pain may be idiopathic and may also resemble primary headaches like migraine [6–8]. Migraine, as a prevalent primary headache, is characterized by recurrent episodes and has a multifactorial initiation with a genetic basis supported by neurovascular mechanisms [9–13]. Typically, migraine pain originates unilaterally from the supraorbital area, occasionally extending from the facial region and reaching its peak there [14]. Cranial allodynia, a symptom of central sensitization, is commonly associated with migraine, characterized by the perception of pain or discomfort in response to non-harmful stimuli such as touch, often accompanied by motor and sensory symptoms [15, 16].

The role of non-headache pain in central sensitization remains a topic of ongoing debate. Furthermore, the involvement of orofacial pains in this process and the challenges in their diagnosis remain ambiguous [15, 17]. Differential diagnosis of orofacial pain poses a significant challenge for medical and dental practitioners, necessitating careful attention [15]. According to the International Classification of Orofacial Pain (ICOP), pulpal pain associated with central sensitization and the manifestation of allodynia serve as indicators for the need for differential diagnosis [6, 18]. Therefore, when assessing dental pain, it is crucial to consider the presence of potential allodynia as a sign of central sensitization.

Toothache is the most common acute pain observed in the orofacial region and can be easily mistaken for primary headaches [19]. Although not that often misdiagnosed with headache, toothaches should also be differentiated with pain of the sinuses [4]. This confusion can be attributed to dentists’ limited knowledge about headaches and pain of the sinuses as forms of orofacial pain, posing a potential threat to patients who may undergo unnecessary therapies that could harm their oral health [20, 21].

Although both cutaneous allodynia associated with migraines and pulpal pain are rooted in the mechanism of central sensitization, the extent of their influence on each other remains unclear. Some case reports and series have explored the correlation between migraine pain and tooth and soft tissue pain [22–26]. For instance, Gross [26] reported a case where a patient complained of severe gum pain. However, the literature lacks substantial findings to establish a stronger link between their interaction.

The aim of this study was to investigate the potential interaction between pain and sensitivity in teeth and gums during migraine attacks by evaluating the role of central sensitization (allodynia). The null hypothesis was that the presence of central sensitization (allodynia) would not influence pain and sensitivity in teeth and gums during migraine attacks.

Materials and methods

This study utilized the follow-up records of all migraine patients registered to a 25 years experienced neurologist office in Mersin, TURKEY between December 2010-May 2020. The study was conducted and written in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines to ensure comprehensive and transparent reporting of observational studies [27]. Ethical approval was obtained from the Mersin University Clinical Research Ethics Committee (decision number: 2020/377).

Patients previously diagnosed with any type of migraine according to the latest edition of the International Classification of Headache Disorders (ICHD-3) [28] were invited to participate voluntarily through text messages sent to their mobile phones and 762 of them agreed to participate in the study. The inclusion criteria were defined in adherence to the STROBE guidelines, ensuring the transparent reporting of participant selection. The survey presented to the participants consisted of 3 sections, comprising a total of 16 items, in line with the STROBE checklist for reporting observational studies. These sections included demographic data with the ID-Migraine (IDM) Scale [29], survey item regarding pain/sensitivity in teeth and/or gums during migraine attacks, and the Allodynia Symptom Checklist (ASC) (Table 1) [30]. The use of validated tools such as the IDM and the ASC aligns with the STROBE guidelines for accurate data collection methods.

Table 1 The allodynia symptom checklist and scores. The severity and the presence of allodynia is calculated based on the total score attained from the Allodynia Symptom Checklist

	Not valid for me	Never	Rarely	Less than half of	half or more than the half	
Combing your hair	0	0	0	1	2	
Pulling your hair back	0	0	0	1	2	
Shaving your face	0	0	0	1	2	
Wearing eyeglasses	0	0	0	1	2	
Wearing contact lenses	0	0	0	1	2	
Wearing earrings	0	0	0	1	2	
Wearing a necklace	0	0	0	1	2	
Wearing tight clothing	0	0	0	1	2	
Taking a shower (when shower water hits your faces)	0	0	0	1	2	
Resting your face or head on a pillow	0	0	0	1	2	
Exposure to heat (e.g., cooking, washing your face with hot water)	0	0	0	1	2	
Exposure to cold (e.g., using an ice pack, washing your face with cold water)	0	0	0	1	2	
Notes: The table of scores is as follows: scores from 0 to 3 indicate no allodynia, 3 to 5 indicate mild allodynia, 6 to 8 indicate moderate allodynia and over 9 indicates severe allodynia. Scores 0–3 indicate absence of allodynia, scores 3 > indicate presence of allodynia

Patients with headache disorders other than migraine and with active neoplasm, neurological diseases that could affect skin sensation such as multiple sclerosis, stroke, or peripheral neuropathy, that had severe liver or kidney metabolic diseases, severe psychiatric diseases, a history of substance abuse, pregnant or nursing patients, and participants under the age of 18 were excluded from the study, as per the predefined criteria in accordance with the STROBE guidelines. The rigorous application of inclusion and exclusion criteria ensures the transparency and reproducibility of participant selection, as recommended by the STROBE statement.

The statistical analyses were conducted in line with the STROBE guidelines, employing descriptive statistics, including frequency and percentages, to analyze the presence of allodynia and pain/sensitivity in teeth and/or gums during migraine attacks. Chi-square tests were performed to examine the relationship between these variables, and the Fisher-Exact test was used when cell values expected to be smaller than 5 exceeded 25%, adhering to the statistical analysis recommendations in the STROBE statement. Pairwise comparisons were conducted to identify specific levels causing differences, and Bonferroni corrections were applied when necessary, ensuring the robustness and accuracy of the statistical analyses as outlined in the STROBE guidelines. The statistical analyses were performed using the Statistica v.13.3.1 software program (TIBCO Software Inc. CA, USA), with a significance level set at α = 0.05, in accordance with the STROBE recommendations for transparent reporting of statistical methods.

The comprehensive adherence to the STROBE guidelines in participant selection, data collection, and statistical analyses ensures the transparency, reliability, and reproducibility of the study findings, aligning with the rigorous standards set forth by the STROBE statement.

Results

The study included a total of 762 participants, with the majority being women (n = 620, 81.3%). The age distribution revealed that the highest proportion of participants belonged to the 35–65 age group (n = 475, 62.3%), followed by the 18–34 age group (n = 277, 36.4%). Details of the study population have been summarized in Table 2.

Table 2 Demographic and clinical features of migraine sufferers

		Women
n = 620
n (%)	Men
n = 142
n (%)	Total
n = 762
n (%)	P value	
Age	18–34	222 (35.8)	55 (38.7)	277 (36.4)	0.796	
35–65	390 (62.9)	85 (59.9)	475 (62.3)	
> 65	8 (1.3)	2 (1.4)	10 (1.3)	
Associated nausea	Yes	537 (86.6)	94 (66.2)	631 (82.8)	< 0.001**	
Photosensitivity	Yes	597 (96.3)	134 (94.4)	731 (95.9)	0.295	
Severe attacks to prevent activities	Yes	569 (91.8)	128 (90.1)	697 (91.5)	0.530	
Pain and sensitivity in the teeth and gums during migraine attacks	Yes	247 (40.0)	38 (26.8)	285 (37.5)	0.003*	
Allodynia Symptom Checklist	Allodynia+	386 (62.3)	44 (31.0)	430 (56.4)	< 0.001**	
Allodynia -	234 (37.7)	98 (69.0)	332 (43.6)	
*p < 0.05 **p < 0.001

Among the associated symptoms commonly experienced during migraine attacks, nausea was reported by a significant majority of participants (n = 631, 82.8%), with a higher proportion of women (86.6%) reporting this symptom compared to men (66.2%) (p < 0.001). Photosensitivity, another common feature of migraines, was reported by most participants (n = 731, 95.9%), with no significant difference observed between women and men (p = 0.295) given in Figure 1.

Fig. 1 Symptoms encountered during headache attacks and diagnosed through ID-Migraine questionnaire (M = Confirmed migraine patients)

The study also investigated the presence of pain and sensitivity in the teeth and gums during migraine attacks. A total of 285 participants (37.5%) reported experiencing these symptoms, with a higher proportion of women (40.0%) compared to men (26.8%) (p = 0.003). Furthermore, the presence of cutaneous allodynia, as assessed by the ASC, was examined. The results showed that 430 participants (56.4%) were classified as allodynic, with a significantly higher proportion of women (62.3%) classified as allodynic compared to men (31.0%) (p < 0.001).

The findings from this study suggest significant differences in the occurrence of associated symptoms, such as nausea and pain/sensitivity in the teeth and gums, between women and men with migraines. Additionally, the presence of allodynia appears to be more prevalent among women. These results contribute to a better understanding of the demographic and clinical characteristics of migraine sufferers and highlight the importance of considering gender differences in the assessment and management of migraines.

The presence of allodynia was found to be statistically associated with gender (p < 0.001), with female participants reporting the presence of allodynia more frequently than male participants. Furthermore, the findings indicated a significant relationship between allodynia and pain/sensitivity in the teeth and/or gums during migraine attacks (p < 0.001). Females reported significantly higher levels of pain/sensitivity in the teeth and/or gums during migraine attacks compared to males (p = 0.003). Figure 2 shows a potential explanation for the mentioning association between allodynia and pain/sensitivity in the teeth and/or gums during migraine attacks.

Fig. 2 Potential association between allodynia and pain/sensitivity in the teeth and gums in migraine patients

Notes: V2, maxiller branche of the trigeminal nerve; V3, mandibular branche of the trigeminal nerve; TG, trigeminal ganglion; TNC, trigeminal nucleus caudalis; SuS, superior salivatory nucleus; RVM, rostral ventromedial medulla; PAG, ventrolateral periaqueductal gray

Discussion

The association between migraine and pain/sensitivity in the oral cavity is a clinically significant conundrum that remains poorly understood and analyzed. In this preliminary study, our aim was to investigate the occurrence of pain/sensitivity in the teeth and gums during migraine attacks and explore its association with allodynia, which is characterized by pain in response to non-noxious stimuli such as touch.

Migraine is classified as a primary neurological craniofacial pain disorder characterized by neurovascular mechanisms, wherein neural processes prompt the dilation of meningeal blood vessels, subsequently triggering nociceptive activation within the trigeminovascular system [31]. Despite ongoing research, the precise pathophysiology of migraine remains incompletely understood; however, it is recognized that critical peripheral and central structures play integral roles [32]. On the other hand, orofacial pain, encompassing a broad spectrum of discomfort within the head, face, and neck region, often presents a complex interplay with migraine manifestations. Reports have detailed instances of migraine localized within the distribution area of the maxillary branch (V2) of the trigeminal nerve, leading to pain experienced in the maxillary region [33–35]. The V2 branch, which gives rise to the nervus meningeus medius, plays a pivotal role in innervating the dura mater of the anterior floor of the middle fossa [32]. This anatomical connection provides a plausible explanation for the observed localization of migraine-related pain in the maxillary area. Additionally, observations of migraine symptomatology in the territory of the mandibular branch (V3) further underscore the intricate relationship between migraine and orofacial pain [33–35]. It is noteworthy that the stimulation of the dura mater, as evidenced in animal electrophysiological experiments and human neurosurgery procedures, can evoke pain sensations within any of the three divisions (V1, V2, V3) of the trigeminal nerve, including those associated with orofacial regions [33, 36]. Hence, understanding the anatomical and physiological basis of migraine localization within the trigeminal nerve distribution is essential for elucidating the complex nature of orofacial pain and its relationship with migraine pathology [4, 5, 7, 32].

Data from the study participants, all of whom suffered from migraines, were recruited through a web-based survey by sending to their mobile phones.

Moreover, the use of IDM has been demonstrated in the literature due to its ease of use and effectiveness in confirming and classifying individuals with migraine [29] and previous literature has shown the successful implementation of the IDM tool in the Turkish population [37]. Since the survey in the study was not face-to-face and was administered via text message, the IDM tool was also included in the study.

Consistent with previous research [9, 11, 17, 38, 39], our findings indicated that migraine is more prevalent among women. In our study, women accounted for the majority (81.3%) of migraine patients. Analysis of the IDM responses and gender breakdown revealed that women experienced more nausea during migraine attacks (p < 0.001). Similarly, the study found that women were more likely to experience allodynia (p < 0.001). These results align with existing literature demonstrating that migraine prevalence and symptoms are more common in women [38–40].

The gold standard for identifying allodynia is the Quantitative Sensory Test (QST), but it is a costly procedure that requires special tools. Consequently, efforts have been made to develop alternative testing systems that are effective, quick, easy, and affordable [41]. One such system is the ASC, which allows for the identification of allodynia without the need for special devices or a clinical setting [30]. Studies conducted in Turkey and Brazil have demonstrated the effectiveness of this checklist in these populations [42, 43].

Literature has reported tenderness of intraoral tissues [44] and severe gum pain [26] during migraine attacks. Therefore, our survey included questions regarding both teeth and gum pain during migraine attacks. Although the intention was to assess mild pain experienced during attacks, the presence of allodynia was found to be associated with pain/sensitivity in the teeth and gums (p < 0.001). We did not find any publications in the literature either supporting or contradicting this result. However, our study also revealed that women experienced more gingival pain/sensitivity during attacks (p = 0.003). These findings align with existing literature demonstrating that migraine symptoms are more common in women [38–40].

This present study, which is preliminary in nature, is the first to evaluate the association between allodynia, dentistry, and pain/sensitivity in the oral cavity among migraine patients. It is important to acknowledge that as a survey study, the dental and neurological clinical conditions of the patients remain unknown and serve as limitations of our study. While the association between central sensitization and pulp pain is mentioned in ICOP [6], there is limited knowledge regarding the association between migraines, pain/sensitivity in the teeth/gums, and allodynia in the literature. Additionally, the current classifications of migraine, such as episodic and chronic orofacial migraine in ICOP [6], or with and without aura in ICHD-3 [27], do not specifically mention the presence of allodynia. Based on our results, it may be necessary in dentistry to classify migraine patients as allodynic or non-allodynic to avoid unnecessary treatments caused by the perception of pain and sensitivity in the teeth and gums among allodynic patients during attacks.

One of the limitations of this study is its reliance on a web-based survey, which may introduce self-selection bias and limit the generalizability of the findings. Additionally, the use of self-reported data and the absence of clinical assessments for dental and neurological conditions are important limitations to consider. The preliminary nature of the study and the lack of detailed clinical information about the dental and neurological conditions of the participants and the use of acute analgesics before or after headache episodes also serve as limitations. Future research should address these limitations by incorporating more robust methodologies, such as clinical examinations and larger, diverse samples, to enhance the validity and generalizability of the findings.

However, this study contributes to the understanding of the association between migraine and pain/sensitivity in the oral cavity, particularly in relation to allodynia. The findings underscore the importance of considering gender differences in the assessment and management of migraines, as women exhibited a higher prevalence of associated symptoms and allodynia. Furthermore, the identification of pain and sensitivity in the teeth and gums during migraine attacks highlights the potential need for comprehensive dental care in migraine management. This research provides a foundation for further investigation into the underlying mechanisms and clinical implications of the relationship between migraines, allodynia, and oral cavity symptoms, paving the way for targeted interventions and personalized treatment approaches for migraine sufferers.

The findings of this preliminary study provide valuable insights into the association between migraines and pain/sensitivity in the oral cavity, particularly in relation to allodynia. The study revealed a higher prevalence of associated symptoms and allodynia among women, emphasizing the need to consider gender differences in the assessment and management of migraines. Furthermore, the identification of pain and sensitivity in the teeth and gums during migraine attacks highlights the potential significance of comprehensive dental care in migraine management. These implications underscore the importance of multidisciplinary collaboration between dental and neurological fields in the management of migraines. Furthermore, it is of great importance to classify migraine patients as non-allodynic before planning dental treatments, in order to prevent the risk of planning or performing unnecessary dental treatments such as root canal treatment and tooth extraction due to the pain detected during migraine attacks.

The main advantage of this study is that existing migraine attack can be easily questioned by means of self-reported anamnesis at the dental clinics and by detecting allodynia with practical methods such as the ASC, possible wrong treatments can be prevented for the patients with complaint of pain of endodontically treated teeth. Also, at the neurology clinics, these patients can be given accurate information and guidance regarding the intraoral pain and sensitivity they may experience during a migraine attacks. The disadvantage of the study is that dentists need to know more about migraine as the main subject of neurology, in order to reach a differential diagnosis in these cases, thus the need for additional training is likely to arise.

Conclusion

In conclusion, this preliminary study sheds light on the association between migraines and pain/sensitivity in the oral cavity, with a specific focus on the presence of allodynia. The study findings underscore the importance of considering gender differences in the assessment and management of migraines. The identification of pain and sensitivity in the teeth and gums during migraine attacks further emphasizes the potential significance of comprehensive dental care in migraine management. Although the study has limitations, it provides valuable insights and lays the groundwork for future research in this field.

Future directions

Moving forward, future research should focus on investigating the underlying mechanisms and clinical implications of the relationship between migraines, allodynia, and oral cavity symptoms. Additionally, studies should aim to address the limitations of this preliminary study by incorporating more robust methodologies, including clinical examinations and larger, diverse samples. Furthermore, longitudinal studies could provide insights into the long-term impact of allodynia on oral cavity symptoms in migraine patients. Investigating the effectiveness of targeted interventions and personalized treatment approaches for migraine sufferers based on the presence of allodynia and oral cavity symptoms should also be a focus of future research.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Acknowledgements

The authors gratefully thank to the Global Migraine and Pain Society for covering the open source APC expenses of this publication. The authors deny any conflicts of interest related to this study. There is no foundation that supports this research.

Author contributions

M.Y., A.O. conceived the ideas; M.Y. collected the data; and M.Y., A.O., and E.K. led the writing of the manuscript. Both authors read and approved the final manuscript.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Declarations

Ethics approval and consent to participate

This study was approved by the Mersin University Clinical Research Ethics Committee (decision number: 2020/377) and informed consent was obtained from all subjects under the ethics approval and consent to participate. All methods were carried out in accordance with relevant guidelines and regulations in the Helsinki Declaration.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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References

1. Fu H Fang P Zhou HY Zhou J Yu XW Ni M Acid-sensing ion channels in trigeminal ganglion neurons innervating the orofacial region contribute to orofacial inflammatory pain Clin Exp Pharmacol Physiol 2016 43 2 193 202 10.1111/1440-1681.12510 26510178
Fu H, Fang P, Zhou HY, Zhou J, Yu XW, Ni M, et al. Acid-sensing ion channels in trigeminal ganglion neurons innervating the orofacial region contribute to orofacial inflammatory pain. Clin Exp Pharmacol Physiol. 2016;43(2):193–202.26510178 10.1111/1440-1681.12510
2. James SL Abate D Abate KH Abay SM Abbafati C Abbasi N Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the global burden of Disease Study 2017 Lancet 2018 392 10159 1789 858 10.1016/S0140-6736(18)32279-7 30496104
James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the global burden of Disease Study 2017. Lancet. 2018;392(10159):1789–858.30496104 10.1016/S0140-6736(18)32279-7
3. Vos T Lim SS Abbafati C Abbas KM Abbasi M Abbasifard M Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of Disease Study 2019 Lancet 2020 396 10258 1204 22 10.1016/S0140-6736(20)30925-9 33069326
Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of Disease Study 2019. Lancet. 2020;396(10258):1204–22.33069326 10.1016/S0140-6736(20)30925-9
4. Straburzynski M Nowaczewska M Czapinska-Ciepiela EK Gryglas-Dworak A Budrewicz S Waliszewska-Prosół M Sinonasal symptoms in migraine without aura: results from the cross-sectional migraine in Poland study Front Neurol 2023 14 1321261 10.3389/fneur.2023.1321261 38046593
Straburzynski M, Nowaczewska M, Czapinska-Ciepiela EK, Gryglas-Dworak A, Budrewicz S, Waliszewska-Prosół M. Sinonasal symptoms in migraine without aura: results from the cross-sectional migraine in Poland study. Front Neurol. 2023;14:1321261.38046593 10.3389/fneur.2023.1321261
5. Emodi-Perlman A Eli I Smardz J Uziel N Wieckiewicz G Gilon E Grychowska N Wieckiewicz M Temporomandibular disorders and bruxism outbreak as a possible factor of orofacial pain worsening during the COVID-19 pandemic – concomitant research in two countries J Clin Med 2020 9 10 3250 10.3390/jcm9103250 33053640
Emodi-Perlman A, Eli I, Smardz J, Uziel N, Wieckiewicz G, Gilon E, Grychowska N, Wieckiewicz M. Temporomandibular disorders and bruxism outbreak as a possible factor of orofacial pain worsening during the COVID-19 pandemic – concomitant research in two countries. J Clin Med. 2020;9(10):3250.33053640 10.3390/jcm9103250
6. Committee ICoOP International classification of orofacial pain, (ICOP) Cephalalgia 2020 40 2 129 221 10.1177/0333102419893823 32103673
Committee ICoOP. International classification of orofacial pain, (ICOP). Cephalalgia. 2020;40(2):129–221.32103673 10.1177/0333102419893823
7. Straburzyński M Agius M Boczarska-Jedynak A Brożek-Mądry M Dżaman E Gradek-Kwinta K Gryglas-Dworak E Nowaczewska A Sama M Smardz A Tsang J Więckiewicz HK Waliszewska-Prosół M The midfacial segment pain: little known disorder in need of scientific evaluation Cephalalgia 2024 44 1 3331024231226176 10.1177/03331024231226176 38215229
Straburzyński M, Agius M, Boczarska-Jedynak A, Brożek-Mądry M, Dżaman E, Gradek-Kwinta K, Gryglas-Dworak E, Nowaczewska A, Sama M, Smardz A, Tsang J, Więckiewicz HK, Waliszewska-Prosół M. The midfacial segment pain: little known disorder in need of scientific evaluation. Cephalalgia. 2024;44(1):3331024231226176.38215229 10.1177/03331024231226176
8. Khemiss M Chaabouni D Ben Khaled R Ben Khélifa M Place of placebo therapy in the treatment of burning mouth syndrome: a systematic review Dent Med Probl 2022 59 4 603 16 10.17219/dmp/152646 36548518
Khemiss M, Chaabouni D, Ben Khaled R, Ben Khélifa M. Place of placebo therapy in the treatment of burning mouth syndrome: a systematic review. Dent Med Probl. 2022;59(4):603–16.36548518 10.17219/dmp/152646
9. Bernstein JA Fox RW Martin VT Lockey RF Headache and facial pain: differential diagnosis and treatment J Allergy Clin Immunol Pract 2013 1 3 242 51 10.1016/j.jaip.2013.03.014 24565480
Bernstein JA, Fox RW, Martin VT, Lockey RF. Headache and facial pain: differential diagnosis and treatment. J Allergy Clin Immunol Pract. 2013;1(3):242–51.24565480 10.1016/j.jaip.2013.03.014
10. Burstein R Noseda R Borsook D Migraine: multiple processes, complex pathophysiology J Neurosci 2015 35 17 6619 29 10.1523/JNEUROSCI.0373-15.2015 25926442
Burstein R, Noseda R, Borsook D. Migraine: multiple processes, complex pathophysiology. J Neurosci. 2015;35(17):6619–29.25926442 10.1523/JNEUROSCI.0373-15.2015
11. Mier RW Dhadwal S Primary headaches Dent Clin N Am 2018 62 4 611 28 10.1016/j.cden.2018.06.006 30189986
Mier RW, Dhadwal S. Primary headaches. Dent Clin N Am. 2018;62(4):611–28.30189986 10.1016/j.cden.2018.06.006
12. Stovner LJ Hagen K Jensen R Katsarava Z Lipton RB Scher AI The global burden of headache: a documentation of headache prevalence and disability worldwide Cephalalgia 2007 27 3 193 210 10.1111/j.1468-2982.2007.01288.x 17381554
Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton RB, Scher AI, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27(3):193–210.17381554 10.1111/j.1468-2982.2007.01288.x
13. Stovner LJ Nichols E Steiner TJ Abd-Allah F Abdelalim A Al-Raddadi RM Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the global burden of Disease Study 2016 Lancet Neurol 2018 17 11 954 76 10.1016/S1474-4422(18)30322-3 30353868
Stovner LJ, Nichols E, Steiner TJ, Abd-Allah F, Abdelalim A, Al-Raddadi RM, et al. Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the global burden of Disease Study 2016. Lancet Neurol. 2018;17(11):954–76.30353868 10.1016/S1474-4422(18)30322-3
14. Ashina M Terwindt GM Al-Karagholi MAM De Boer I Lee MJ Hay DL Migraine: disease characterisation, biomarkers, and precision medicine Lancet 2021 397 10293 1496 504 10.1016/S0140-6736(20)32162-0 33773610
Ashina M, Terwindt GM, Al-Karagholi MAM, De Boer I, Lee MJ, Hay DL, et al. Migraine: disease characterisation, biomarkers, and precision medicine. Lancet. 2021;397(10293):1496–504.33773610 10.1016/S0140-6736(20)32162-0
15. de Tommaso M Sciruicchio V Migraine and central sensitization: clinical features, main comorbidities and therapeutic perspectives Curr Rheumatol Rev 2016 12 2 113 26 10.2174/1573397112666151231110813 26717950
de Tommaso M, Sciruicchio V. Migraine and central sensitization: clinical features, main comorbidities and therapeutic perspectives. Curr Rheumatol Rev. 2016;12(2):113–26.26717950 10.2174/1573397112666151231110813
16. Aguggia M Allodynia and migraine Neurol Sci 2012 33 9 11 10.1007/s10072-012-1034-9 22228269
Aguggia M. Allodynia and migraine. Neurol Sci. 2012;33:9–11.22228269 10.1007/s10072-012-1034-9
17. Pietrobon D Moskowitz MA Pathophysiology of migraine Annu Rev Physiol 2013 75 365 91 10.1146/annurev-physiol-030212-183717 23190076
Pietrobon D, Moskowitz MA. Pathophysiology of migraine. Annu Rev Physiol. 2013;75:365–91.23190076 10.1146/annurev-physiol-030212-183717
18. Pigg M Nixdorf DR Law AS Renton T Sharav Y Baad-Hansen L New international classification of orofacial pain: what is in it for endodontists? J Endod 2020 47 3 345 57 10.1016/j.joen.2020.12.002 33340605
Pigg M, Nixdorf DR, Law AS, Renton T, Sharav Y, Baad-Hansen L, et al. New international classification of orofacial pain: what is in it for endodontists? J Endod. 2020;47(3):345–57.33340605 10.1016/j.joen.2020.12.002
19. Oksuz N Özge A Gray zones in the trigeminal autonomic cephalalgias Neurol Sci Neurophysiol 2023 40 1 15 10.4103/nsn.nsn_108_22
Oksuz N, Özge A. Gray zones in the trigeminal autonomic cephalalgias. Neurol Sci Neurophysiol. 2023;40(1):15.10.4103/nsn.nsn_108_22
20. Renton T Tooth-related pain or not? Headache: J Head Face Pain 2020 60 1 235 46 10.1111/head.13689
Renton T. Tooth-related pain or not? Headache: J Head Face Pain. 2020;60(1):235–46.10.1111/head.13689
21. Kayaoglu G Ekici M Altunkaynak B Mechanical allodynia in healthy teeth adjacent and contralateral to endodontically diseased teeth: a clinical study J Endod 2020 46 5 611 18 10.1016/j.joen.2020.01.024 32145907
Kayaoglu G, Ekici M, Altunkaynak B. Mechanical allodynia in healthy teeth adjacent and contralateral to endodontically diseased teeth: a clinical study. J Endod. 2020;46(5):611–18.32145907 10.1016/j.joen.2020.01.024
22. Daline IH Nixdorf DR Law AS Pileggi R Group NDPBRNC 3-year outcome of patients with persistent pain after root canal treatment: the National Dental Practice-Based Research Network J Endod 2020 46 5 619 26 10.1016/j.joen.2020.01.018 32171563
Daline IH, Nixdorf DR, Law AS, Pileggi R, Group NDPBRNC. 3-year outcome of patients with persistent pain after root canal treatment: the National Dental Practice-Based Research Network. J Endod. 2020;46(5):619–26.32171563 10.1016/j.joen.2020.01.018
23. Nishihara C Hatori K Hsu YC Ozasa K Young A Imamura Y Orofacial pain and menstrually related migraine Acta Neurol Taiwanica 2019 28 4 131 38
Nishihara C, Hatori K, Hsu YC, Ozasa K, Young A, Imamura Y, et al. Orofacial pain and menstrually related migraine. Acta Neurol Taiwanica. 2019;28(4):131–38.
24. Pain O Midface migraine with concomitant dental disease: a report of two cases Quintessence Int 2018 49 849 54 30264060
Pain O. Midface migraine with concomitant dental disease: a report of two cases. Quintessence Int. 2018;49:849–54.30264060
25. Peñarrocha M Bandrés A Peñarrocha M Bagán JV Lower-half facial migraine: a report of 11 cases J Oral Maxillofac Surg 2004 62 12 1453 56 10.1016/j.joms.2004.01.027 15573344
Peñarrocha M, Bandrés A, Peñarrocha M, Bagán JV. Lower-half facial migraine: a report of 11 cases. J Oral Maxillofac Surg. 2004;62(12):1453–56.15573344 10.1016/j.joms.2004.01.027
26. Gross SG Dental presentations of cluster headaches Curr Pain Headache Rep 2006 10 2 126 29 10.1007/s11916-006-0023-1 16539865
Gross SG. Dental presentations of cluster headaches. Curr Pain Headache Rep. 2006;10(2):126–29.16539865 10.1007/s11916-006-0023-1
27. Von Elm E Altman DG Egger M Pocock SJ Gøtzsche PC Vandenbroucke JP The strengthening the reporting of Observational studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies Bull World Health Organ 2007 85 11 867 72 10.2471/BLT.07.045120 18038077
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of Observational studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Bull World Health Organ. 2007;85(11):867–72.18038077 10.2471/BLT.07.045120
28. Olesen J International classification of headache disorders Lancet Neurol 2018 17 5 396 97 10.1016/S1474-4422(18)30085-1 29550365
Olesen J. International classification of headache disorders. Lancet Neurol. 2018;17(5):396–97.29550365 10.1016/S1474-4422(18)30085-1
29. Lipton RB Dodick D Sadovsky REAA Kolodner K Endicott J Hettiarachchi J A self-administered screener for migraine in primary care: the ID migraine™ validation study Neurol 2003 61 3 375 82 10.1212/01.WNL.0000078940.53438.83
Lipton RB, Dodick D, Sadovsky REAA, Kolodner K, Endicott J, Hettiarachchi J, et al. A self-administered screener for migraine in primary care: the ID migraine™ validation study. Neurol. 2003;61(3):375–82.10.1212/01.WNL.0000078940.53438.83
30. Lipton RB Bigal ME Ashina S Burstein R Silberstein S Reed ML Cutaneous allodynia in the migraine population Ann Neurol 2008 63 2 148 58 10.1002/ana.21211 18059010
Lipton RB, Bigal ME, Ashina S, Burstein R, Silberstein S, Reed ML, et al. Cutaneous allodynia in the migraine population. Ann Neurol. 2008;63(2):148–58.18059010 10.1002/ana.21211
31. Akerman S Holland PR Goadsby PJ Diencephalic and brainstem mechanisms in migraine Nat Rev Neurosci 2011 12 10 570 84 10.1038/nrn3057 21931334
Akerman S, Holland PR, Goadsby PJ. Diencephalic and brainstem mechanisms in migraine. Nat Rev Neurosci. 2011;12(10):570–84.21931334 10.1038/nrn3057
32. Romero-Reyes M, Uyanik JM. Orofacial pain management: current perspectives. J P Res. 2014;99–115.
33. Daudia AT Jones NS Facial migraine in a rhinological setting Clin Otolaryngol Allied Sci 2002 27 6 521 5 10.1046/j.1365-2273.2002.00628.x 12472524
Daudia AT, Jones NS. Facial migraine in a rhinological setting. Clin Otolaryngol Allied Sci. 2002;27(6):521–5.12472524 10.1046/j.1365-2273.2002.00628.x
34. Obermann M Mueller D Yoon MS Pageler L Diener H Katsarava Z Migraine with isolated facial pain: a diagnostic challenge Cephalalgia 2007 27 11 1278 82 10.1111/j.1468-2982.2007.01413.x 17850354
Obermann M, Mueller D, Yoon MS, Pageler L, Diener H, Katsarava Z. Migraine with isolated facial pain: a diagnostic challenge. Cephalalgia. 2007;27(11):1278–82.17850354 10.1111/j.1468-2982.2007.01413.x
35. Silberstein SD Lipton RB Dalessio DJ Wolff’s Headache and other Head Pain 2001 7 New York Oxford University Press 478 9
Silberstein SD, Lipton RB, Dalessio DJ, editors. Wolff’s Headache and other Head Pain. 7th ed. New York: Oxford University Press; 2001. pp. 478–9.
36. Benoliel R Elishoov H Sharav Y Orofacial pain with vascular-type features Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997 84 5 506 12 10.1016/S1079-2104(97)90267-5 9394383
Benoliel R, Elishoov H, Sharav Y. Orofacial pain with vascular-type features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;84(5):506–12.9394383 10.1016/S1079-2104(97)90267-5
37. Karli N Ertas M Baykan B Uzunkaya O Saip S Zarifoglu M The validation of ID Migraine™ screener in neurology outpatient clinics in Turkey J Headache Pain 2007 8 4 217 23 10.1007/s10194-007-0397-4 17901923
Karli N, Ertas M, Baykan B, Uzunkaya O, Saip S, Zarifoglu M, et al. The validation of ID Migraine™ screener in neurology outpatient clinics in Turkey. J Headache Pain. 2007;8(4):217–23.17901923 10.1007/s10194-007-0397-4
38. Ashina M Migraine N Engl J Med 2020 10.1056/NEJMra1915327 33211930
Ashina M, Migraine. N Engl J Med. 2020. 10.1056/NEJMra191532733211930 10.1056/NEJMra1915327
39. Todd C Lagman-Bartolome AM Lay C Women and migraine: the role of hormones Curr Neurol Neurosci Rep 2018 18 7 42 10.1007/s11910-018-0845-3 29855724
Todd C, Lagman-Bartolome AM, Lay C. Women and migraine: the role of hormones. Curr Neurol Neurosci Rep. 2018;18(7):42.29855724 10.1007/s11910-018-0845-3
40. Buse DC Loder EW Gorman JA Stewart WF Reed ML Fanning KM Sex differences in the prevalence, symptoms, and associated features of migraine, probable migraine and other severe headache: results of the American Migraine Prevalence and Prevention (AMPP) Study Headache 2013 53 8 1278 99 10.1111/head.12150 23808666
Buse DC, Loder EW, Gorman JA, Stewart WF, Reed ML, Fanning KM, et al. Sex differences in the prevalence, symptoms, and associated features of migraine, probable migraine and other severe headache: results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache. 2013;53(8):1278–99.23808666 10.1111/head.12150
41. Zhu GC Böttger K Slater H Cook C Farrell SF Hailey L Concurrent validity of a low-cost and time‐efficient clinical sensory test battery to evaluate somatosensory dysfunction Eur J Pain 2019 23 10 1826 38 10.1002/ejp.1456 31325385
Zhu GC, Böttger K, Slater H, Cook C, Farrell SF, Hailey L, et al. Concurrent validity of a low-cost and time‐efficient clinical sensory test battery to evaluate somatosensory dysfunction. Eur J Pain. 2019;23(10):1826–38.31325385 10.1002/ejp.1456
42. Florencio LL Chaves TC Branisso LB Gonçalves MC Dach F Speciali JG 12 item Allodynia Symptom Checklist/Brasil: cross-cultural adaptation, internal consistency and reproducibility Arq Neuro-Psiquiatr 2012 70 11 852 56 10.1590/S0004-282X2012001100006
Florencio LL, Chaves TC, Branisso LB, Gonçalves MC, Dach F, Speciali JG, et al. 12 item Allodynia Symptom Checklist/Brasil: cross-cultural adaptation, internal consistency and reproducibility. Arq Neuro-Psiquiatr. 2012;70(11):852–56.10.1590/S0004-282X2012001100006
43. Yalin OÖ Uludüz D Sungur MA Sart H Özge A Identification of allodynic migraine patients with the Turkish version of the allodynia symptom checklist: reliability and consistency study Arch Neuropsychiatry 2017 54 3 260 10.5152/npa.2016.15953
Yalin OÖ, Uludüz D, Sungur MA, Sart H, Özge A. Identification of allodynic migraine patients with the Turkish version of the allodynia symptom checklist: reliability and consistency study. Arch Neuropsychiatry. 2017;54(3):260.10.5152/npa.2016.15953
44. Friedman MH Local inflammation as a mediator of migraine and tension-type headache Headache 2004 44 8 767 71 10.1111/j.1526-4610.2004.04143.x 15330822
Friedman MH. Local inflammation as a mediator of migraine and tension-type headache. Headache. 2004;44(8):767–71.15330822 10.1111/j.1526-4610.2004.04143.x
