Medical technology has changed the landscape of how diseases are diagnosed and treated. This has affected the dental field as well. One of the most significant changes has been our discovery of how amazingly connected systemic medical health is to dental health. Today more than ever, we understand the connection to the bacteria that live in our mouth and its effect on heart disease, stroke, diabetes and low birth weight babies.
We have also discovered the relationship between teeth, chewing muscles and migraine headaches. This is tremendously exciting news for people who suffer from chronic headache pain or migraines, and have relied on medications for relief. Daily pain can dramatically alter lives with negative effects on personality, families and careers. An understanding of how teeth uniquely position the jaw, and how the jaw relates to the muscles of the head and neck, has led to treatments that significantly relieve headache pain.
Headaches result from a multitude of factors and sources of origin. Modern dentistry has better learned to correctly diagnose and treat pain at its source. Generally speaking, headache pain that has a dental component is muscular in nature with neurological input from the teeth. Treatment therefore focuses on achieving muscle relaxation with modalities including cold laser, ultrasound, therapeutic massage, bite force balancing, and splint therapy. In many cases we also use therapeutic Botox. Botox is the only FDA approved treatment for migraines; the many other drugs being used are all off-label. I have found that proper combination of these treatments yields meaningful relief for pain in these patients.
Prevention can be very simple in that muscle hyperactivity and/or fatigue is at the root of this problem. Anything that causes the muscles of the head or neck to be active is the first place to look. Gum chewing, daytime clenching or nighttime grinding are common, so stopping or reducing these activities is important. Your dentist can recommend a solution that is appropriate. Typically nighttime mouthpieces have been utilized, but simple awareness has been shown to have very positive results.
Public awareness of a dental component in managing chronic headaches and migraines is happening, but slowly. Part of the challenge is the intersection of neurology, sports medicine and dentistry with no clear “owner.” If all of these disciplines are consulted, many people can be helped only after determining which approach is the most effective. Hopefully, reading an article about dentistry and pain management will lead someone to a better quality of life.
Written by Wayne Kinney, DDS