Background & Aims

Headache is a health problem that affects many people worldwide. Children and adolescents are increasingly affected by headache and the frequency of orthodontic interventions has also risen sharply in recent years. It is still strongly debated the burden of headache during school age, it’s impact on school performances and on quality of life of children and their families. Orthodontic interventions in pediatrics may be an important contributing factor responsible for forced adaptations of the arthrogenic and myogenic tissues of temporomandibular and craniocervical region. Consequently, studies are necessary to evaluate the degree of disability due to pediatric headache. This systematic review aimed to assess the prevalence of headache after orthodontic interventions in childhood and adolescence.

Methods

This systematic review followed the PRISMA guidelines. An extensive literature search was conducted in the following databases: MEDLINE, Embase, CINAHL, Web of Science, and Cochrane from inception until March 2024. Studies targeting patients between 7 and 18 years old, diagnosed with malocclusions, and receiving orthodontic treatment were included. The quality of studies was assessed using the QUIPS tool. Finally, the overall certainty of the evidence was evaluated by the GRADE approach.

Results

A A total of 995 studies were retrieved from searches and 43 were screened in full text. Six studies met the inclusion criteria with a pooled sample size of 1.073 participants. No statistically significant difference in the prevalence of headache was found between children who received orthodontic intervention compared to no treatment (OR 1.47 [CI 0.93; 2.31]; p = 0.40). However, it was observed that children with malocclusion who were treated orthodontically had significantly fewer headaches after treatment compared to untreated children with class II malocclusion (OR 0.23 [CI 0.11; 0.49]; p = 0.001). All studies had a high risk of bias and certainty of evidence was very low.

Conclusions

No increase in the prevalence of headaches was detected after orthodontic interventions in children and adolescents with malocclusions when compared to those who did not receive orthodontic treatment. However, there is a significant need for further research on this topic, as the conduct and quality of the existing studies need substantial improvement.

References

Robbins MS, Szperka C. Headache in Children and Adolescents. Vol 27.; 2021. doi:10.1212/CON.0000000000000993

Shamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (prisma-p) 2015: Elaboration and explanation. BMJ. Published online 2015:1-9. doi:10.1136/bmj.g7647

Hannan, K., Orthodontic braces and migraine headache: Prevalence of migraine headache in females aged 12-18 years with and without orthodontic braces. International Journal of Osteopathic Medicine, 2005. 8(4): p. 146-151

Henrikson, T. and M. Nilner, Temporomandibular disorders and the need for stomatognathic treatment in orthodontically treated and untreated girls. European Journal of Orthodontics, 2000. 22(3): p. 283-92

Musanovic, A., M. Ajanovic, L. Redzepagic Vrazalica, L. Kazazic, S. Tosum Poskovic, J. Mlaco Du-rek and S. Strujic Porovic (2021). “Prevalence of TMD among Children Provided with Fixed Orthodontic Treatment.” Acta Stomatologica Croatica 55(2): 159-167

Presenting Author

Luiz Felipe Tavares

Poster Authors

Luiz Felipe Tavares

MSc

Federal University of São Carlos / Hochschule Osnabrück

Lead Author

Reid Friesen

Faculties of Rehabilitation Medicine and Dentistry, University of Alberta, Edmonton, Canada

Lead Author

Pia Köning

Hochschule Osnabrück

Lead Author

Mareike Neuhaus

Hochschule Osnabrück

Lead Author

Susan Armijo-Olivo

PhD

Hochschule Osnabrück

Lead Author

Harry von Piekartz

Hochschule Osnabrück

Lead Author

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Headache