 Glenn Clark |
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PAINFUL JAW, POUNDING HEAD Many headache sufferers might want to consult their dentist as well as their doctor since headaches and dental pain have a lot in common, says Director of the Orofacial Pain and Oral Medicine Graduate Program at the USC School of Dentistry Glenn Clark. This is especially so if the pain seems centered in the nerves and muscles running throughout the jaw, face and neck region and the patient suspects they have facial tension/clenching habits. In these cases the discomfort may cause and can trap sufferers in a painful feedback loop, with head pain triggering jaw and neck protective muscle guarding and clenching and vice versa. “Headaches and toothaches all transmit through the trigeminal nerve, the largest sensory nerve in the head that supplies the external face, scalp, jaw, teeth and much of the intra-oral structures,” Clark says. “Pain in one branch of the nerve has the potential to activate other branches of the nerve, and when that pain is chronic and sustained, it is more likely to trigger a sequence of events that might trigger a headache. In people who have headaches, a continuous, sustained toothache can easily trigger one of the episodic headaches such as migraines.” Headaches and orofacial pain are in the spotlight this month during National Headache Awareness Week, June 1-7, sponsored by the National Headache Foundation. The foundation estimates that over 45 million Americans suffer from chronic, recurring headaches each year. Besides the close anatomical links between head, face and jaw pain, reflexive behaviors caused by pain and tension such as jaw clenching and muscle tightening can exacerbate and transfer pain. “There is a good deal of interconnectivity between the orofacial and craniocervical systems; for example, when you clench your teeth you contract your neck muscles inadvertently,” Clark says. “When patients have an acute neck injury they often start holding tension in their jaw and TMJ pain and clicking will occur. When you have a chronic toothache or bad temporomandibular joint, this may also cause bracing and guarding in the muscles on the same side of the jaw and in the neck.” When head and face pain spring from tooth or jaw joint injury, such as when a patient unknowingly clenches or grinds his or her teeth for long periods of time and damages tissue inside and below the teeth, it can be difficult for a physician to decipher the cause of the pain, he says. That’s when a referral to a dentist with a trained eye for the medical and behavioral causes of orofacial pain can come in handy. “With some exceptions, headaches don't have physical signs, and diagnosis is all related to the history, pattern and nature of the pain,” Clark says. “If the patient is being treated for the migraines, tension headaches or sinus pains and the medications or other methods of treatment given by the physician are not effective, these patients might want to get a dental consult. At the Orofacial Pain and Oral Medicine Center, we actually receive a number of patients from physicians who want us to check the teeth and the jaw joints for problems.” For more information about National Headache Awareness Week, visit www.headaches.org. For more information about the Orofacial Pain and Oral Medicine Center at the USC School of Dentistry, visit www.usc.edu/hsc/dental/about/orofacial_pain.htm.
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