Ramin Mehregan, DMD  
Male, 55
Canton, MA

Interests: neuromuscular dentistry, orthodontics
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Headaches and Dental Health

Mar 26, 2009 - 8 comments









Muscle imblalance


Cranio-mandibular dysfunction






neuromuscular dentistry





Headaches and Dental Health

Is it nerves?     Is it muscles?

One in eight Americans suffer from recurring headaches that are so severe they cannot carry out normal living! An estimated 80% of all headaches occur from muscle tension. Did you know that many tension headaches are related to your bite?  Do you usually blame it on stress? Do you blame it on aging? This article explains how headaches can result from dental stress and how using a neuromuscular approach can help many headache sufferers.

Headaches are our number one pain problem in the United States. Approximately 40% of all “healthy” individuals suffer from chronic headaches. Head pain is not new. Early civilizations relied on magical potions and spells to cure headaches. In severe cases, holes were drilled in the skulls of headache sufferers so that the evil spirits, which were believed to be the cause of the pain, could escape. However, over the years we have learned much about what causes headaches and how to treat them. Today, there is a growing realization that a common cause of tension headaches is a bad bite.

Headaches from Dental Stress
How can your bite cause a headache? Tension headaches result from muscle strain, or contraction. When muscles are held tight for long periods of time they begin to ache. Headaches from dental stress are a type of muscle tension headache. A tension headache may be on one or both sides of your head. Or, it may surround your head as if a steel band were wrapped around it. The pain feels like a dull, non-throbbing ache. Aspirin usually relieves tension headaches. Specific signs, which indicate that the headaches may have a dental origin, include:
• Pain or pressure behind the eyes
• Sinus problems
• Tinnitus (ringing in the ears)
• Clogging or stuffiness of the ears, or subjective hearing loss
• Pain and/or sore jaw muscles
• Stiffness or soreness in the neck, shoulders and back
• Vertigo (dizziness)
• Grinding and clenching of teeth
• Sensitive teeth
• Clicking or popping jaw joints

Tired Bite
The muscles, which control your jaw and hold, your head upright is very complex. Many people do not realize that every time they swallow, their upper and lower teeth must come together in a firm way to brace the jaw against the skull. We swallow over 2000 times each day and night! If your bite is unstable, as from poorly aligned teeth or even a missing tooth, the muscles must work harder to bring the teeth together. Most people take a vacation from work when they tire out-but your jaw muscles never get a break! The overworked muscles become strained. When muscles are under constant strain, they eventually become painful.

Muscle Imbalance
Other muscles may also become involved. Your head is delicately balanced on top of your spinal column by muscles in your jaw, neck, shoulders, and back. Your head weighs approximately 15 pounds the weight of an average bowling ball! Imagine your head as a baseball balanced on top of a pencil by a number of rubber bands. When muscles are tense, they shorten. Now imagine shortening just one of these rubber bands. Some rubber bands would stretch, some would shorten, and the baseball would throw off kilter! Similarly, when even a single jaw, neck, or shoulder muscle becomes shortened, all of the other muscles are forced to overwork to keep the head balanced on top of the spinal column. We see then that dental headaches originate from an unstable bite, which cause the muscles of the jaw, head, and neck to overwork and become painful. Once the muscles become painful, a vicious cycle begins. The pain makes you fell tense and uptight. This worsens the muscle spasm, which in turn increases the pain.

Dental Treatment
Neuromuscular dentistry is nothing new. Actually, it has been around for some 30 years, but is not the traditional approach to patient care in dentistry. Neuromuscular Dentistry (NMD) is a term applied to techniques that expand upon the more traditional approach to dentistry that is more mechanically oriented. NMD places the occlusion where the muscles that control jaw position are at their best for optimal function and comfort.
Additionally, NMD techniques are used to treat patients that suffer from TMJ-like symptoms and to aid in establishing the occlusion for dentures. The relaxed jaw position gives an added insight that may allow for faster completion and improve final treatment results.
So, the next time you reach for the Advil for that afternoon headache, think of what it would be like to be headache free.

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Avatar universal
by BrownEyes44, Mar 26, 2009
Dear Dr. Mehregan,
You are so correct in your description of headaches and the teeth(jaw).   I've just been diagnosed with TMD(temporomandibular disorder) which is a TMJ related disorder.   I have all of the symptoms you mentioned in your article and these are the typical symptoms of TMD.   Thanks to an orthotic or night guard I am able to sleep better at night.   My question is this, is there a type of orthotic that is more wearable for the day?   One that one can use and be able to speak with it on while working?   When I speak with the orthotic I have now, my voice is very muffled and not clear.  

782045 tn?1238193325
by Ramin Mehregan, DMDBlank, Mar 27, 2009
Dear BrownEyes44,
Thank you for reading my article. I am glad yo are feeling better. Before I get into your question, may I ask if your orthotic was made after verifying the physiological position of your jaw using Trans Electrical Neural Stimulation (TENS) and jaw tracking?
Unfortunately, well I should say there are some who make day and night splints, but does not cure the problems.....so I do not recommend it. Going back to were I started if your orthotic was fabricated based on neuromuscular science then it should be worn 22/7 (preferably 24/7) Every time you remove it and you bite down on your habitual occlusion it will cause a set back in the healing process. Your orthosis is keeping a physiologic balance and relationship between your lower jaw and your cranium (as your upper jaw is nothing more than an extension of your skull) and therefore stabilizing the associated structures such as muscles, joints and nerves.
Yes, muffled speech and lisping is a problem. I usually tell my patients who have these issues to speak as much as they can or sing when they are alone. The speech problems are overcome by many but I do have couple of lawyers who will remove their orthosis when in court. (unfortunately)
I hope I answered your questions.
In good health, sincerely

Avatar universal
by pieter2009, Mar 28, 2009
Dear Dr.Mehregan I am posting this comment from the UK, it 3.34in the morning and I am looking at why I am in constant pain with a headache? Having recently had a CT scan (my left hand has been numb for 6 weeks, about the same time my headaches started) that came back normal, and my General Practioner giving no other advice than to "improve my lifestyle" I feel I am at my wits end with finding what is wrong, until i read your article.  I suffer from a clicking jaw, very loud when I eat, I have no wisdom teeth and have had both teeth (the ones next to my fangs, going towards the rear of my mouth) removed. I suffer from jaw tension alot, where my jaw muscles stiffen.
Unfortunately our national health service is not the best for dentistry and I have been waiting over 3 years just to be registered with a dentist.  Is their anything you can suggest that would aid me in getting rid of these headaches without having a dentist?
I'd try anything right now!


Avatar universal
by SweetPerl, Feb 02, 2010
Dear Dr. Mehergan,

I have severe headache since last few weeks, i had tooth decay 2 months ago and my teeth has removed now, but the headache is still there specially when on taking cold drinks or icecream, Are my hedche relte with my dental problem please suggest ...


Avatar universal
by vellanki, Feb 17, 2010
Dear Dr. Mehergan,

I have severe headache since last two days, i had body pains too. My teeth have some itch i always gnashing to satisfy myself but it is not polite in corporate field. I'm facing this problem from 1 year. Can you suggest me in this...

Thanks & Regards,
Ravi Vellanki

Avatar universal
by sandra5353, Feb 25, 2012
There is so much here, I amnot sure where I fit in. But, for the last 10 days, my bottom gums tingle, my tongue tip burns, and my lips feel sore. I was taking indomithicine for inflammation and stopped 3 days ago, thinking that it could have this particular side effect. The pain seems to get worse as the day goes on. I fall asleep with pain ( when I can) and wake up during the night almost pain free, upon rising in the morning I hardly feel it, then about 4 or 5 PM, BAM, it starts all over again till I fall asleep ( when I can), I started taking a sleeping pill cause I am depressed and miserable, and can no longer eat dinner. Please give me some insight, as I donnot understand all you comments. thanks, Sandra

Avatar universal
by Maggie5050, Oct 10, 2012
I had a cervical revision surgery in June of this year, and wore a heavy brace for three month. I believe this caused pressure on my jaw, as I heard it popping a lot.  I needed to see my dentist before the surgery but because of the severity of my neck issues ( full cervical fusion  to the whole c spine was done) I did not see him. The past two weeks the headaches have become severe, had MRI,CAT SCAN,AND FINALLY MRA. All appeared normal. Saw ear doctor to rule out ear infection, and today went to see my dentist who said my far back top molar had a deep cavity that went thru the tooth, thus hitting the root. Root canal would not be done and the tooth was pulled. The tooth was pulled in less than two minutes.  I have to assume wearing a hard neck brace for ten weeks, pushed my jaw upwards and just aggravated my bite, which had a silent lurking issue of a cavity gone really bad. My dentist put me on antibiotics after pulling the tooth. I still have a bit of a head ache. Is this normal? I have seen in one week, my neurologist, ENT ,and my orthopedist.and my GP...
  I have never ever had a headache , not ever, until a month ago.
My question, could the tension caused  by the brace, the revision surgery and now the tooth have caused the first time migraine headaches?

Avatar universal
by ashatom1920, Nov 06, 2013
Hello doctor is it safe for my tooth to be extracted whilst am pregnant

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