Oral appliances for treating headache in patients with myofascial pain


The aim of this trial  was to compare the short- and long-term effectiveness of a prefabricated occlusal appliance with that of a stabilization appliance when treating headache in patients with myofascial pain.

A group of 66 patients attending two centres for Stomatognathic Physiology in Sweden and Finland 94% of whom suffered concomitantly from headache were randomly assigned to either a prefabricated (R) or a stabilization appliance (S) group. They were clinical evaluated and completed history questionnaires according to the Research Diagnostic Criteria for Temporomandibular Disorders at baseline and at 10-week and 6- and 12-month follow-ups.

They found

  • There were significant decreases in the frequency and intensity of headache in both groups at all follow-ups, without statistically significant differences between groups.
  • At baseline, 23 patients in both groups reported recurrent-continuous headache and, at 12 months, seven in the R group and four in the S group.
  • The mean intensity (numeric rating scale) of headache prior to treatment decreased significantly at 12 months from 5.3 to 2.1 in the R group and from 6.1 to 2.9 in the S group.
  • At the 12-month follow-up, 56% of patients in the R group reported a 30% reduction in intensity of headache and 50% a 50% reduction. In the S group, corresponding values were 39% and 36%, respectively.
  • Non-specific physical symptoms were significantly associated with frequency of headache at baseline and at 6 months, and with depression at 6 and 12 months.

They concluded:-

The effectiveness of the prefabricated appliance seems to be similar to that of the stabilization appliance in the treatment of headache in patients with myofascial pain in both the short and long term.

Doepel M, Nilner M, Ekberg E, Vahlberg T, Bell Y. Headache: short- and long-term effectiveness of a prefabricated appliance compared to a stabilization appliance. Acta Odontol Scand. 2011 May;69(3):129-36. Epub 2010 Dec 9. PubMedPMID: 21142584.

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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