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Dental / Jaw

Headaches which have their origin from or related to the oral cavity itself, are limited. Most pains originating from the oral cavity (mouth), remain localised to the source of the pain. The main causes of pain originating from the mouth are:

1. Tooth Decay/Cavities
2. Cracked Teeth
3. A Dying Tooth
4. Gum (Periodontal) Infection [Especially associated with Wisdom Teeth]
5. Dental Abscesses originating from the Pulp Chamber (Nerve space within the Tooth)
6. Temporo-Mandibular Joint Dysfunction (TMD)- See TMD Section
7. Dry Socket (Post Extraction Infection)

Of these causes of pain, the first four almost always have their pain remaining in the mouth. They may sometimes have pain radiating from their oral source into neighbouring tissues. The pain seems to always remain more intense, close to it's source. It would be incorrect to list these as a source of 'headache'.

The final three on the list can all cause pain, which may often be described as a headache or facial pain.

Temporo-mandibular joint dysfunction (TMD) has been covered in a separate section, and is a common cause of facial pain / headache.

A dental abscess can cause pain in the face (usually from an upper tooth), or pain in the area of the lower jaw (mandible)- (usually from a lower tooth), due to a build up of pressure from an infection which is eminating from the pulp chamber of the tooth, causing pressure along tissue planes. The pain caused can be quite severe. This type of situation can also occur from other infections within the mouth, particularly from those related to the peridontium (gum region), and impacted wisdom teeth; but are much less common in occurrence. The appearance of a patient with this type of infection is quite obvious, and must be treated quickly with antibiotics. Fortunately, most infections in the oral tissues are diagnosed and treated before spreading, and drain away into the mouth.

A 'dry socket' is simply an infection on the surface of the bone, after an extraction. Due to it's position, it is protected somewhat from the body's natural defences, as well as antibiotics. Patients with this condition typically complain of pain in the general extraction area, and sometimes pain will be reported in the face, and radiating up into the temple and down into the neck. This facial / temple/ neck pain may be the only symptom. If the patient fails to get treatment early for this condition, the pain will continue to become more severe. This problem will always be associated with a recent extraction (2 to 10 days prior).

Other causes of pain from the oral cavity which could be said to cause headache / facial pain, are from mucosal (soft tissue) problems. Fortunately, these are rare in occurrence.

Some examples of these are: Lichen Planus / Acute Necrotising Ulcerative Gingivitis (ANUG) / and Bullous type disorders.

For further information on these issues, consult your family dentist or the Dental Association in your state.

Dental and Jaw problems may contribute to Headaches and Migraines, so it is important to have them professionally addressed. It is also important to investigate for other potential causes as many cases of Headaches and Migraines have more than one ingredient.

See Treatments Section

Author:

Jaw - TMJ & TMD

The joint of the lower jaw is known as the Temporo-Mandibular Joint (TMJ), and it joins the skull in close proximity to the ears. Problems arising within either of these joints are often referred to as Temporo-Mandibular joint Disorders, or (TMD).

TMD can arise from many factors and sources, including:

External sources of trauma; these include motor vehicle accidents, (MVA), often involving whiplash, or single blow to the head or neck, either as a result of a motor vehicle accident (MVA) or from a fall, fight or sports injury; trauma may also result from Oral Surgery procedures.

Internal trauma; this involves habits in which the joint is involved, for example, grinding or clenching the teeth; lip, cheek or nail biting, or holding foreign objects between the teeth e.g. pen/pencil chewing.

Muscle overactivity; when muscles associated with chewing are over used or used in an abnormal manner, either when awake or sleeping. This may also include abnormal head and neck posture.

Occlusion; this relates to the way the teeth bite together. An uneven "bite" can often produce TMD; similarly, if there are teeth missing, the teeth and jaw cannot function properly or evenly

Systemic or general health factors; degenerative or rheumatoid arthritis traumatic and infectious arthritic conditions can afflict the TMJ.

Internal joint structure; if there is an irregularity or structural problem with the joint and the cartilage on which it moves, (the disc), this produces a mechanical dysfunction

SYMPTOMS:

Pain

Pain is a very common symptom associated with TMD. The pain may be localized to a specific area, e.g. the muscles associated with chewing, in the area of the joint, (ie near the ear, mimicking ear ache), neck pain, head ache or migraines. If the teeth are the cause of the TMD, then any or all of the teeth may be sore, even to the point of individuals seeking to have the nerve removed from the tooth or even have the tooth extracted.

Joint sounds & jaw function

When the jaw is moved there should be no noises emanating from the joint area. In some cases of TMD, there are varying joint sounds which may occur when the jaw opens, and/or closes. Extreme joint problems may result in the jaw being "locked" open or "locked" shut so that the individual has difficulty either opening or closing the mouth. Normal jaw function involves a simple closure of the jaw without any deflection. This means that all the teeth should touch at the same time without the jaw being deflected out of a simple closing action.

A so called, premature contact, would occur when one or more teeth are out of alignment and correct dental interdigitation or "meshing together" of the teeth does not occur. Consequently, instead of the jaw closing smoothly, it is deflected out of its correct position. As a result of this, the TMJ is unable to close smoothly, this in turn, causes the muscles to be strained to varying degrees. It is this abnormal muscle activity that contributes to TMD and can contribute to headaches and migraines..

Jaw Problems may contribute to Headaches and Migraines, so it is important to have them professionally addressed. It is also important to investigate for other potential causes, as many cases of Headaches and Migraines have more than one ingredient.

See Treatments Section

Author:

Dental Specialist in Oral Medicine.

A referral from a dentist is NOT necessary.