Dorothy (not her real name) was referred to me by her physiotherapist. She had constant pain on the right side of her head which began immediately after having a filling placed in her upper right molar two years previously. To Dorothy, it felt like the pain was coming from that tooth. She had been examined by several dentists and physicians but no cause could be uncovered.
It seemed to me that if Dorothy felt the pain was coming from the filling, it did not matter if we could “uncover” a medical reason for the pain – we should just remove the restoration and see what happens. With her permission, I removed the amalgam and replaced it with a medicated filling – a temporary material that releases a soothing medication into the tooth. Unfortunately that did not relieve the pain.
I had also noticed that Dorothy bit her nails and suspected that it could be triggering a TMD (jaw joint) problem. To keep her from biting her nails, I made a small plastic appliance that went over her upper front teeth. In very short order, the pain went away. The appliance also helped Dorothy to break the nail biting habit. She is now pain free and no longer needs to wear the appliance.
The result of stress, ‘tension headaches’ are the most common, afflicting many headache sufferers. Ninety percent of all adults have had a tension headache, says the American Council for Headaches. Tension headaches are usually a steady ache rather than a throbbing pain; they affect both sides of the head. I believe psychological factors have been greatly overemphasized as a cause of tension headaches. So you might think that the only way to treat a tension headache would be to reduce the amount of tension or learn how to “relax” more, but that is not always possible or even easily accomplished. It is also not the only answer.
Many times people under stress will clench or grind their teeth, which is frequently the result of a misaligned bite. As a result, the tension headache is almost always accompanied by spasms of the muscles which help to open and close the jaw. To evaluate whether the headaches are bite related, we make a small mold fitting over the upper front teeth, which the patient waits for several days. Often, the headaches stop entirely or diminish greatly. We then know to go ahead and make minor but important, adjustments to reshape the teeth so the patient can have long lasting relief. When the bite is corrected, the strain is taken off the muscles which are free to relax and heal, while the patient continues to feel better and better.
TMD (temperomandibular disease) – formerly known as TMJ syndrome – is simply a dramatic extension of the classic tension headache. It is named for the Tempomandibular Joint which is in front of the ear where the lower jaw rests in the skull bone socket. Often related to clenching and misaligned bite, over time the TMD syndrome can result in extreme spasms and trauma to the muscles not only in the jaw, but down into the neck and shoulders. In many cases, even the back muscles are affected.
Between the top of the lower jaw, called the condyle, and the skull, is a cartilaginous disc. This serves as a cushion as the condyle moves forward and down when the mouth is opening. If this gets displaced slightly, there will occur a click or pop upon opening the mouth; sometimes the jaw may even lock. Some symptoms of TMD include dizziness, headaches, migraines, facial pain, tooth pain, pain down the arms into the fingers, lack of jaw opening, and pain upon jaw movement, ringing in the ears, grinding of the teeth and chronic neck and backache.
Since the site of the temporomandibular joint is at the intersection of three major energy meridians relating to the stomach, endocrine system and small intestine, relief of TMD can spark a tremendous healing process in the whole body, even relieving symptoms like stomach problems, chest pains and cold limbs.
Dr. BERTRAND R. STUART, DDS