Healthy Thoughts

April 2009

Dental related headaches

By James M. Spitzer DDS

Who would ever think they should discuss their frequent headaches (two or more a week) with their dentist. There are several causes of headaches such as diet, medications, hormones, trauma, allergies, environmental toxins, muscle tension or muscle imbalance. Most of the headaches we help patients with are caused by an imbalance of muscles related to an improper fitting together of the teeth. Frequent clenching or grinding during sleep or while awake cause muscle tension, which can lead to muscle tension headaches.

In ideal function the back teeth on both sides should contact evenly when the jaw joints (TMJ’s) are in their proper resting position. A dentist needs to manipulate the patient’s jaw to locate the correct position. Many patients will clench their teeth together in a habitual unnatural position to get their teeth to come together the best they can. Some common symptoms of muscle fatigue are headaches in the temple areas, sore jaws, neck pain or upper back pain. Most dental headaches will follow a pattern such as occurring in the same location in the head or the same time of day depending on when the patient clenches. Those that clench or grind during sleep will often wake up with a headache or sore jaws that usually improve as they are up awhile. Those that clench during the day will usually feel headaches later in the day. Both will often have trouble chewing gum or chewy foods because the muscles are tired before they start. Stressful days are usually more difficult because that is when the most clenching occurs.

One simple treatment is a precise adjustment of the teeth to balance the muscles which then relaxes them. This is called occlusal equilibration. Another treatment is to fabricate a mouthpiece, which is usually worn at night for the purpose of simulating an ideal fitting of the teeth.

Dentists can often help some migraine sufferers as well. When minute lateral movements of the jaw are restricted, it can trigger the development of a migraine. An appliance that snaps onto the front teeth during sleep frees up the lateral movement eliminating the muscle tension that can trigger migraines. Studies show that up to 70% of migraines are less intense or less often without medication.

Studies have also shown that incompatible dental materials can contribute to headaches. Many patients cannot wear certain kinds of jewelry. For those that have a compatibility problem, blood tests are available to determine which products are best for the patient.

Most dental headaches do not require medication to resolve the problem. Proper treatment starts with identifying the cause of the headache since medications are only a temporary solution by reducing the symptoms. Talk to your dentist about your headaches. Your comfort is always our concern and long-term relief may be right around the corner.

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