Headaches and Your Teeth
Healthy Teeth Can Cause You Pain
It is well known that pain from toothache and gum problems can spread to various parts of your head but are you aware that head and face pain can also arise from perfectly healthy teeth?
There are two main causes:
Occlusion - the way the teeth meet when they close together.
Parafunction - destructive habits such as grinding or clenching your teeth (grinding the teeth during sleep is also known as ‘Bruxism')
This isn't a small problem; in the UK, 1 in 4 people is affected to some degree.
If your teeth don't fit together properly, it can cause problems with your teeth, you gums, your jaw joints (TMJs - Tempero-Mandibular Joints) the muscles that open and close your mouth, and the muscles that move your jaw from side to side.
As with most things in the body, this is a two-way thing. If your teeth are out of line or broken down or missing or painful, it causes you to bite differently in order to avoid pain or to be able to chew. Similarly, if you bite abnormally, it puts strains on your teeth that they aren't equipped to deal with. This can make your teeth feel bruised and tender, it can make them loose and it can break fillings and shatter veneers.
The abnormal strains mentioned above will have a more dramatic effect on teeth that are already mobile, making them looser and speeding up gum recession.
If your jaw joints click when you open your mouth, if they are tender or painful, or if you have difficulty opening or closing, it's likely that this is caused by either occlusal problems or parafunction - or both.
If your jaw is not in the correct position, it forces the muscles that move your jaw to work abnormally. This can cause them to go into spasm (similar to cramp in your leg), leading to headaches, facial pain and stiff neck and shoulders.
Grinding and clenching of the teeth is usually stress-related and often occurs during sleep. This causes pain, which is an extra source of stress, so you clench or grind more... and so on.
If you clench or grind your teeth when you're awake - perhaps when things go wrong at work or if you've been kept waiting at the dentist (which would never happen here, obviously), simply being aware of the problem generally solves it - because you can make the decision to stop. It's not so simple if it happens when you're asleep, though.
Clenching and grinding your teeth causes the same problems as those mentioned above for occlusion. If you have an unbalanced occlusion AND parafunction, the problems multiply because not only are you overloading the teeth and their supporting structures but you are doing it in directions they were not designed to withstand even at normal levels.
So what can you do about it?
Your dentist will be able to treat the treat the problem in most cases. If not, he or she will refer you to a specialist.
The dentist will ask questions such as : Are you particularly stressed at the moment? Do your jaw joints ever click or grate? Do you wake up with a headache or a sore face? Has a sleeping partner mentioned that you grind your teeth at night? Are you aware of clenching your teeth when you're concentrating on a difficult task?
Then the dentist will examine you, checking your bite, feeling how your jaw joints move, testing for tender muscles, looking for worn or damaged teeth and so on.
As with most problems in life, the best solution is to treat the essential cause. If this is an incorrect bite, it needs to be remedied and there are various ways of doing that - for example, by reducing high spots or replacing missing teeth. Some people get instant relief from these measures. For others, it can be a lengthy business.
When someone is clenching or grinding, it's less straightforward because stress is usually the cause and that is not always easy to eliminate. In the past, psychoactive drugs were sometimes used but that is rare these days because they bring their own set of problems.
If we can't eliminate the cause of parafunctional activity, we have to minimize its effect of the on the teeth and their supporting structures while trying to break the self-reinforcing habit cycle.
This is usually achieved by means of a bite guard, made to fit over either your upper or lower teeth. The bite guard is made of plastic and can be either soft or hard, depending on individual need. With a bite guard in place, it's impossible to clench or grind your teeth. This prevents the chewing muscles going into spasm and causing pain, either directly or by pulling the jaw joints into an abnormal position in their sockets. Some people may need to wear a bite guard permanently for sleeping but in many cases, all that's required is a couple of weeks to break the habit cycle. Then you can leave the bite guard out - but keep it safe in case you need it again. Unfortunately, this problem does tend to recur from time to time.
Bite guards are available over the counter but it is far better to have one specially made for you. A ‘one size fits all' guard can put more pressure on certain vulnerable areas and actually make the problem worse.
Discomfort can also be reduced by the application of heat (hot water bottle), anti-inflammatory analgesics such as Ibuprofen and, sometimes, physiotherapy.
Tom Nolan is a dentist with over 30 years’ experience.
If you found this article useful, you should check out his book
Also available as a download. This book is packed with practical advice and will tell you everything you need to know to keep your mouth healthy, trouble-free and beautiful for the rest of your life.
You can get in touch via Tom's practice:The Dentist in Town.
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