Association of unreplaced missing posterior teeth with migraine or severe headaches in US adults: A cross-sectional population study

The association between unreplaced missing posterior teeth and migraine has not been sufficiently reported. The purpose of this cross-sectional study was to investigate the relationships between unreplaced missing posterior teeth and migraine or severe headaches. Data from the US National Health and Nutrition Examination Survey 1999–2004 on 12 662 participants aged between 20 and 85 years were analyzed. The survey produced complete data on dentition examination, dietary intakes, and self-reported migraine or severe headaches. Weighted multivariable logistic regression analyses were performed (α=.05). A total of 20.28% of the participants had migraine or severe headaches. After adjusting demographic, clinical, and dietary covariates, the total number of missing teeth was not significantly associated with migraine or severe headaches, and only having both anterior and posterior missing teeth was significantly associated with migraine or severe headaches. The odds ratio (OR) and confidence interval (CI) was 1.32(1.09, 1.60) (P=.007). A significantly positive correlation was found between the number of unreplaced missing teeth and migraine or severe headaches. An increase of 1 in the number of unreplaced missing teeth was associated with a 3% increase in migraine or severe headaches (OR and CI: 1.03(1.01, 1.06), P=.012). However, no significant relationship was found between replaced missing teeth and migraine or severe headaches (OR and CI: 1.00(0.99, 1.01), P=.800). Furthermore, unreplaced missing posterior teeth and both unreplaced anterior and posterior teeth were significantly related with more migraine or severe headaches, but no significant association of unreplaced teeth was found with migraine or severe headaches only in the anterior zone in the adjusted model (OR and CI: anterior teeth unreplaced: 0.90(0.43, 1.88), P=.800; posterior teeth unreplaced: 1.14(1.00, 1.30), P=.047; both anterior and posterior teeth unreplaced: 1.61(1.16, 2.22), P=.007). Because of the important association between posterior missing teeth and migraine or severe headaches, further analyses found a 1 tooth increase in unreplaced posterior teeth was related to a 4% increment in migraine or severe headaches (OR and CI: 1.04(1.01, 1.07), P=.017); however, the number of replaced posterior teeth was not associated with migraine or severe headaches (OR and CI: 1.00(0.99, 1.02), P=.900). The number of unreplaced missing posterior teeth was positively associated with migraine or seve