A. PATRIC COHEN, DDS, FAGD
435 North Bedford Drive #405
Beverly Hills, California
310-271-7727

Beverly Hills Neuromuscular Dentistry Solutions provided by LVI Cosmetic Dentist Dr. A. Patric Cohen - Serving Beverly Hills and Los Angeles CA.

Call 310-271-7727 or Email Us for a free initial consultation.

Migraine and Tension Headaches from TMJ

migraine headache
TMJ (temporomandibular joint) problems manifest themselves in a variety of ways. One of the most common symptoms of TMJ are headaches. The most common type of headache is a tension headache. Many people who suffer from this type of headache describe it as a ring of pain around the head. Others will refer to it as a migraine headache. 

TMJ related headaches are caused by a complex mechanism. Essentially, there is a constant contraction of the muscles in the jaw. This creates a tension or pressure in the face, head and neck. The constant tension in the muscles reduces the amount of blood that is able to reach the area. The body responds by sending more blood to the area, which results in an increase in blood pressure to the muscles of the head, thus a headache. When someone is clenching and /or grinding their teeth, which are TMJ symptoms, they are creating a constant contraction of the muscles, which results in pain. By putting the temporomandibular joint back into alignment and placing the jaw into its optimal position, neuromuscular dentistry can alleviate most headache problems related to TMJ, muscle, nerve and joint disorder.
tension headache

28 million Americans suffer from migraine headaches, a type of headache that can often be debilitating. There are 3 times as many women sufferers as men. Although any type of headache can be very uncomfortable, migraine headaches will often cause sufferers to be incapacitated. Sometimes people with migraines will experience some type of warning sign know as an aura. These are usually such sensations as flashing lights, blind spots or tingling in the extremeties. In addition to the pain of a headache, migraine symptoms can also include nausea, vomiting, and extreme sensitivity to sound and light. The only relief many sufferers can find is by locking themselves in a dark quiet room for hours or even days. When left untreated, a typical migraine can last anywhere from 4 to 72 hours depending on the person. All of these symptoms are also symptoms of
TMD, which can be treated using Neuromuscular Dentistry.

There is a lot that is not understood about headaches. Some researchers believe that migraines may be the result of changes in the trigeminal nerve system, which is a major pathway in the cranial nervous system. It is felt that changes in brain chemicals such as serotonin effect the pain messages running along this pathway. When a headache occcurs, the level of serotonin in the brain drops. Scientists believe that this causes the trigeminal nerve to release a protein which travels to the brain's outer covering. This protein causes the blood vessels of the outer covering to become dilated and inflamed. This results in a headache.

The type of migraine varies from person to person. Most people don't experience the aura before their headache. Those that do are experiencing what is known as a Classic Migraine. Whether you experience an aura or not , many people have sensations or premonitions before the headache actually occurs. These symptoms may include: elation or intense levels of energy, craving for sweets, drowsiness, irritability , depressinon or thirst.

Migraine headache triggers

There are a number of things that may trigger a migraine:
• Hormonal changes. The exact mechnism between headaches and hormones is not fully understood. Changes in estorgen and progesterone seem to cause migraine in a number of women. Women who have a history of migraines report there occurence right before or after their periods. Those women who take contraceptives or hormone replacement therapy often report migraines.
• Foods. Many people develop headaches after eating certain food. The most common food causes include: alcohol, especially red wine; aged cheeses; chocolate; fermented, pickled or marinated foods; aspartame; caffeine; monosodium glutamates; certain seasonings; and many canned and processed foods.
• Stress. Stress is often sighted as a major contributor to migraines. Whether it occurs at home or work, the body can react to stress with a headache.
• Sensory stimulus. Bright or flashing lights and glaring sun can causes headache pain. Certain smells such as perfume and flowers, and unpleasant odors, such as paint thinner and cigerette smoke.
• Physical factors. Heavy manual work or exercise can set off a headache. Also, changes in sleep habits including too much or too little sleep can trigger a headache.
• Changes in the environment. Changes in the weather, such as rain storms or changes in altiltude, such as going to the mountains, can result in a headache.A change of weather, season, altitude level, barometric pressure or time zone can prompt a migraine headache.
• Medications. Certain medications can aggravate migraines
All of these factors can contribute to the occurence of a migraine headache. But the biggest factor is a poor bite relationship. When the upper and lower jaw are not aligned properly, it results in the muscles being in a constant state of contraction. These muscles cause the jaws to come together 2000-3000 times every day during chewing and swallowing. After a while, the muscles get tired and go into spasm. There is a build-up of lactic acid and other waste metabolites due to increased blood pressure in the muscles, which prevents normal blood flow. This is the primary cause of migraines.

Current Treatments

It used to be that if you had a headache, the doctor told you to " take two aspirin and call me in the morning." Today, numerous drugs have been designed to treat migraines. These drugs are broken down into two categories:
• Pain-relieving medications. Basically the painkiller for after the headache has started.
• Preventive medications. These reduce the severity or prevent a migraine headache.
The strategy for preventing or relieving your headache will depend on how often they occur and how severe the headaches are. Generally speaking, preventative therapy is used by those who have more than two migraines per month, or do not get relief form the normal pain-relieving headaches.
Pain-relieving medications
Pain-relieving medications work best as soon as the patient start to experience symptoms of the headache.These medications include:
• Nonsteroidal anti-inflammatory drugs (NSAIDs). These are the usual over the counter medications, such as ibuprofen (Advil, Motrin, others) or aspirin. They may help with mild migraines. If taken often, these drugs can lead to ulcers, gastrointestinal bleeding, and other problems.
• Triptans. Sumatriptan (Imitrex) was the first drug developed to treat migraines. Injected sumatriptan is the fasting working migraine medication available.
• There are a number of similar drugs that have become available, including rizatriptan (Maxalt), naratriptan (Amerge), zolmitriptan (Zomig), almotriptan (Axert), frovatriptan (Frova) and eletriptan (Relpax). The triptans have side effects which may include nausea, dizziness, and occassionally stroke or heart attack.
• Ergots. These are drugs like ergotamine (Ergomar) and dihydroergotamine (D.H.E. 45) and dihydroergotamine nasal spray (Migranal) . These drugs may have good pain relieving properties, but they have more serious side effects than the Triptans.
Preventive medications

These medications are designed to reduce the frequency, intensity and duration of the headache. Althouhg they do help with the headaches, they do not eliminate them completely.
• Cardiovascular drugs. Beta blockers which are used to treat high blood pressure and heart disease, can reduce migraines. Calcium channel blockers, another type of cardiovascrugs, especially verapamil may also be helpful.
• Antidepressants. There are a group of anitdepressants that are good at helping to prevent migraines. The Tricyclic anitdepressants seem to be the most effective. This includes like amitriptyline..
• Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs as mentioned above are not only good for pain relieve but when taken regularly may reduce the frequency of headaches.
• Anti-seizure drugs. Some anti-seizure drugs,used to treat epilepsy and bipolar disease, seem to prevent migraines. However, these drugs can have serious side effects such as nausea, vomiting , diarrhea, cramps and dizziness.
Botulinum toxin type A (Botox). Some people receiving Botox injections for their facial wrinkles have noted improvement of their headaches. However, it's unclear what effect Botox actually has on hea
Other options
In addition to medications, the pain from muscle headaches can be reduced by cutting nerves with brain surgery or using biofeeback therapy. The problem with all of the options mentioned is that we are treating the symptoms rather than the actual cause of the symptoms. By using neuromuscular dentistry, ensuring that the muscles are happy, we remove the stress placed on the system. When the bite is correct, the migraines can disappear. Click here for more information on a Neuromuscular Solution.