Headaches are generally classified into several basic types: Sinus, Cluster, Tension and Migraine. The type of headache you have can be determined by discussing it with your physician or dentist. While headaches are typically treated by your physician, improper occlusion (your bite) may play a significant role in certain types of headaches as well as other head and neck pain.
One type of headache, tension headache is by far the most common- estimated by some to be the cause of much as 90% of all headaches. Furthermore, they are headaches that are most typically associated with the pain of the muscles of your forehead.
If you occasionally experience this type of headache, they are typically controlled by over the counter pain medications. However, if they continually persist with some regularity and over a long period of time, it is recommended to discuss them with your dentist.
Headaches and your Bite
The muscles of the temple area of the forehead are muscles that play an important role in the posturing as well as the closing of the jaw. If your occlusion (bite) is not ideal, it may lead to abnormal tension in these muscles. When the bite is not corrected, the muscles may remain tense for long periods of time. The muscles that are contracted are not given a chance to rest and then suffer from poor circulation. The lack of required oxygen and the accumulation of waste products of metabolism results in the pain felt in your muscles (headache).
A headache is just one symptom that may be attributed to poor occlusion (bite). Other symptoms such as pain or noise in the jaw joint, facial pain, neck pain, ringing in the ears, tingling in the fingertips, and difficulty chewing may also be related to your bite and should be discussed with your dentist.
Diagnosis and Treatment
To determine if your headaches are caused by your bite, following a thorough history and clinical examination, the dentist can determine if a neuromuscular orthotic might help. An orthotic is a device that fits to your lower teeth that can temporarily change your bite (and jaw position)to a different spot where the muscles are not so tense. If your headaches go away with the bite change-then it was your bite! Once you know the cause, appriopriate treatment options can be offered.
It makes sense to find the bite that gets rid of your headaches first before engaging in definitive dental work such as orthodontics or crowns. With a reversible orthotic (acrylic device you wear on your bottom teeth 24 hours per day), you can participate in a diagnostic period whereby your final jaw position can be determined. It is important you wear the orthotic full time over an approximate 3 month period as directed so we know the real result of the new jaw position before engaging in dental treatment that is more definitive. Once you feel better and we can measure the improvement with the help of biomedical instrumentation, you can choose to build the new bite position right into your teeth using a few different options (Phase 2):
1. Just keep the orthotic in your mouth
2. Move your teeth into the position that your orthotic is holding for you (no more orthotic) with orthodontics
3. Replacing old dental work with new white bonded restorations built to the jaw position determined by your orthotic.
4. Do a combination of the above
The orthotic is a diagnositc process that lasts approximately 3 months but varies with each person. It is important to follow Dr. Heit's direction exactly to optimize your diagnosis and therefore your result.
There are many people who engage this diagnostic process prior to their dental treatment plan involving orthodontics or crowns as a preventative measure to optimize their jaw posture for their dental work.
These people may not have the symptoms associated with chronic pain or TMD prior to dental treatment but have many signs (evidence on their teeth such as heavy wear from grinding). Dr. Heit can help you determine if there are signs of a non-optimal bite during the examination of your teeth, jaw bones and soft tissues of your mouth before treatment with the help of biomedical instrumentation to analyse chewing function and jaw position.
What if the headaches don't go away?
If the headaches do not go away, other causes can be investigated using a multidisciplinary approach with medical doctors and other disciplines to try to find the cause and treat your chronic pain. Many times, there is more than one cause and addressing all possible causes might be the solution you are looking for. There are patients who have 80% of their pain eliminated with the orthotic and, through the professional collaboration, have eliminated the rest of their pain. It is important to take the time to find out what might work for you.
Dr. Heit is a general dentist.
For more information call the office at (780) 429-4968