# Exploring the Bidirectional Association Between Migraine and Temporomandibular Disorders: A Systematic Review and Meta‐Analysis

## TL;DR

This study finds that migraine and temporomandibular disorders are strongly linked in both directions, suggesting that people with one condition are more likely to have the other.

## Contribution

The study provides the first comprehensive meta-analysis of the bidirectional relationship between migraine and TMD in adults.

## Key findings

- Patients with migraine are significantly more likely to have TMD (odds ratio 6.08).
- Patients with TMD are more likely to have migraine (odds ratio 2.64).
- The evidence certainty for these findings was rated as high.

## Abstract

Migraine and temporomandibular disorders (TMD) are comorbid conditions that are highly frequent among patients.

This systematic review with meta‐analysis (MA) aimed to evaluate the bidirectional association between migraine and TMD in adults.

The protocol was registered with the International Prospective Register of Systematic Reviews. The literature was searched in 5 main databases and 3 grey literature databases from inception until May 12, 2025. The review included observational cross‐sectional studies that based TMD classification on the Research Diagnostic Criteria for TMD (RDC/TMD) or the Diagnostic Criteria for TMD (DC/TMD), and migraine was diagnosed according to any edition of the International Classification of Headache Disorders (ICHD). The risk of bias (Joanna Briggs Institute Meta‐Analysis of Statistics Assessment and Review Instrument tools) and the certainty of evidence (GRADE) were assessed.

From 7329 studies, 17 were included in the qualitative assessment and 6 in the quantitative analysis. Seven studies were classified as low risk of bias, nine as moderate, and one as high. The qualitative assessment demonstrated an association between both conditions. MA revealed that patients with migraine were significantly more likely to have TMD (OR = 6.08; 95% CI: 4.80–7.68), and patients with TMD were more likely to have migraine (OR = 2.64; 95% CI: 2.19–3.18). The certainty of evidence was rated high.

The study identified a strong bidirectional association between migraine and TMD. Clinicians should systematically screen for both conditions, especially in the presence of one of them, to optimize treatment outcomes.

DC/TMD: Diagnostic Criteria for Temporomandibular Disorders; RDC/TMD: Research Diagnostic Criteria for Temporomandibular Disorders; ICHD: International Classification of Headache Disorders. OR: Odds Ratio.