Should Dentists Treat Headaches

Patients go to the dentist with the expectation that our ability is to treat problems in and related to the mouth. This involves more than teeth and gums, as the whole articulating mechanism, including joints, jaw bones and muscles, interrelate and react with the rest of the head and neck region and hence the rest of the body.

Since research shows that most headaches are of musculoskeletal origin, it is clear that the muscles of mastication are frequently the culprits. In this modern age, where there is so much tension and stress, it is a common finding that patients, and many dentists too, indulge in the habit of Bruxism (clenching and grinding). This habit overworks the muscles and restricts the cranial bones to which they are attached. Palpation of the masticatory muscles often elicits tenderness and this is a common finding in Bruxers. These are symptoms that the dentist is best suited to treat and this form of treatment can be more effective than palliative treatment with analgesics.

It is a generally accepted fact that bite appliances can alleviate the symptoms of pain from the masticatory muscles. In simple cases, these appliances need only be worn at night when Bruxing is most prevalent. In more complex cases, where internal derangements of the joints are suspected, appliances are designed to realign the jaws and be worn full time. The more serious problems related to muscle pain secondary to internal derangement of the joints is a more contentious issue. Research by Motegi has shown that more than 70% of children requiring orthodontic treatment already have signs or symptoms of TMD. As the symptoms of pain and dysfunction do not frequently manifest until adulthood, many early signs of dysfunction are missed and orthodontic treatment is carried out in the presence of a misaligned jaw relationship. Thus, the dental occlusion is rearranged to conform to dysfunctional joints and muscles. The signs and symptoms of TMD can then appear later in life.

With modern imaging techniques and knowledge of the underlying structural imbalances, which can lead to pain and dysfunction in the chewing apparatus, our profession is at the forefront in its ability to treat and prevent these most common and troublesome problems. Dental practitioners should practice the full scope of their profession and not be inhibited by artificial barriers separating specialist territories.