Increased Risk of Migraine in Patients with Chronic Periodontitis: A Population-Based Cohort Study

Abstract

Migraine is considered to be a neurovascular disease that manifests as a throbbing headache, possibly caused by the activation of the trigeminovascular system. Several studies have supported the role of inflammation in the pathogenesis of migraine. Chronic periodontitis (CP) is an infectious inflammatory disease triggered by bacterial products evoking an immune response which could result in the destruction of the periodontium. However, little is known about the longitudinal association between CP and migraine. In this study, we designed a nationwide population-based cohort study to investigate the risk of migraine and CP exposure in Taiwan. In total, 68,282 patients with CP were identified from the National Health Insurance Research Database (NHIRD), and 68,282 comparisons were randomly captured and matched by age, sex, monthly income, urbanization and comorbidities. The association between CP exposure and migraine risk was evaluated by Cox proportional hazards regression models. In this study, 785 migraine patients were identified in the CP cohort, and 641 migraine cases were found in the non-CP cohort. The incidence rate of migraine was significantly higher in the CP cohort than the non-CP cohort (adjusted HR: 1.21, 95% CI: 1.09–1.34, p < 0.001) during the 13-year follow-up period. Females had a 2.69-fold higher risk for migraine than males (95% CI: 2.38–3.04, p < 0.001). In summary, CP is associated with an increased risk of subsequent migraine in Taiwan.

Association of periodontal disease with migraine: A large‐scale community‐based cross‐sectional study

“…One population‐based study demonstrated that patients with chronic periodontitis had increased subsequent risk of developing migraine 16 . Patients with chronic periodontitis had about 21% increased risk for migraine after follow‐up compared to patients without chronic periodontitis, 16 which was consistent with our findings. Migraine was reported to be linked with vascular dysfunction and inflammation.…”

“…28 There were limited differences on periodontal disease among individuals with or without migraine; however, the positive associations remained in stratification analyses and the results were consistent with previous studies. [13][14][15][16] Overdiagnosis of periodontal disease might be likely In conclusion, our study revealed that periodontal disease was positively associated with migraine, and the association was independent of genetic predisposition. Future investigations should focus on biological mechanisms to improve our understanding of the potential role of periodontal disease in migraine pathogenesis.…”

“…Periodontal disease is associated with several chronic disorders; therefore, local treatment interventions may reduce this systemic inflammatory surrogate and alleviate the related chronic comorbidities. 12 Recent epidemiological studies have suggested that periodontal disease is positively associated with migraine; [13][14][15][16] however, the findings cannot be generalized because these studies have enrolled mentally ill homeless adults 13 or clinic-based patients. 14,15 Disease identification based on self-reported information may lead to errors in estimations.…”

“…Recent epidemiological studies have suggested that periodontal disease is positively associated with migraine; 13–16 however, the findings cannot be generalized because these studies have enrolled mentally ill homeless adults 13 or clinic‐based patients 14,15 . Disease identification based on self‐reported information may lead to errors in estimations 15 .…”

Sex Differences in Periodontology as a Risk Factor for Cerebrovascular Diseases

“…Women had a 2.69 times higher risk of migraine than men (p < 0.001). Also, periodontitis was found to be associated with an increased risk for migraine [16]. Four times as many women have multiple sclerosis as men, and more and more women are developing it [17].…”