Migraines are thought of as severe headaches, but they are more than that — they are a common neurological disease. However, the fact that poor oral health can be a cause of frequent migraine attacks is often overlooked. Cavities, pulp infections, bone loss owing to periodontal disease, dental abscesses, impacted teeth, cysts, and tumors can contribute to chronic and recurring migraine episodes.
Oral disease-associated migraine attacks account for a significant proportion of patients visiting neurology clinics worldwide.
Dentists often consider oral diseases as a cause or an exacerbating factor for headaches. For example, a toothache can irritate the trigeminal nerve, resulting in a migraine headache.
Severe and chronic migraine attacks are often related to hidden oral diseases, which can be challenging to identify. Dentists are best equipped to diagnose such cases.
A detailed dental history, plus head, neck, and oral examination, panoramic and/or periapical dental X-rays, and pulp vitality testing, can help determine the contributing factor.
While bad oral health can induce headaches and migraines, prompt measures to correct potential dental problems can help you get rid of the migraine attacks. Read on to learn about the oral causes of migraine and how to manage them.
Can dental problems cause migraines?
Headaches and toothaches are both transmitted through the 5th cranial nerve — the trigeminal nerve. Its principal role is to innervate the face and jaws- split into three major branches.
Oral and dental diseases trigger two branches of the trigeminal nerves — maxillary (V2) and mandibular (V3). In addition, chronic abscesses result in local inflammation, necrotic tissue, the release of pain mediators, and local tissue hypoxia. These inflammatory processes impact the trigeminal and vascular systems — and aggravate an episodic migraine into a chronic migraine.
Once the migraine becomes chronic, the response to medicines becomes less effective. Therefore, the key strategy is to prevent the development of chronic migraine by strictly controlling all potential dental risk factors — such as an infected tooth or a dental abscess.
Oral conditions causing migraines
According to the American Migraine Association, some oral and dental diseases can aggravate migraines:
- Loose, missing, or misplaced teeth. They make jaw muscles work harder to align teeth, swallow, and even keep the mouth closed. This might result in chronic muscular inflammation, which can cause migraines or headaches.
- Bruxism. Teeth grinding and jaw clenching can lead to muscle and gum irritation, producing migraines and headaches. Symptoms include morning headaches, tight jaw muscles, cracked or damaged teeth, severe tooth pain, and migraines.
- Bad bite. While stress is frequently associated with tooth grinding, a bad bite — teeth that are not correctly aligned — can also result in teeth grinding and thus, migraine.
- Damaged wisdom teeth. They are the last and hindmost adult teeth to erupt. Impacted wisdom teeth can cause discomfort, damage to other teeth, and other dental issues resulting in long-term headaches. However, most people find relief from having their wisdom teeth pulled out.
- Temporomandibular disorders (TMDs). It affects jaw joints and muscles, which can produce chronic pain, thus, can induce migraines. Common symptoms include tender jaw muscles, severe migraines, earaches, toothaches, and clicking or popping sounds. Research reveals that addressing such underlying oral health issues helps in relieving migraines. For example, studies show that 35% of migraine sufferers have at least one TMD symptom and simultaneously report having TMD pain and migraines.
- Chronic periodontitis (CP). It is associated with gingival tissue destruction, alveolar bone loss, and even tooth loss, has been linked to a higher risk of migraine.
- Other common dental issues. That includes misaligned teeth, tooth decay, or gum disease, which might cause toothaches. In turn, a severe toothache might set off a migraine or headache. Regular examinations and cleanings, following through on prescribed treatment and practicing excellent oral hygiene help to reduce your risk of toothaches.
Can dentists treat migraines?
Yes, if the cause of a migraine is traced back to a dental cause, dentists are the best professionals to manage the case. Dentists, orofacial specialists, and maxillofacial surgeons are well-equipped to look beyond the mouth for cranial complaints in their patients and refer them to a neurology clinic for further evaluation and care.
Most medical professionals recommend that primary care physicians and dentists work together to determine the source of migraine pain and devise a treatment strategy. If the discomfort is caused by dental health, a dentist who specializes in headaches is the right person for you.
Migraines from oral disease – treatment:
Diagnosing the root cause is the first step to managing a migraine. After identifying the dental cause, treatment focuses on avoiding or managing the issues.
- For people who grind teeth, a mouth guard that goes over your upper or lower teeth and keeps them apart as you sleep;
- If your teeth do not line up correctly, your dentist may recommend dental procedures to fix your bite, including crowns, braces, or oral surgery;
- If you have cavities, the dentist will restore them. For severely infected teeth, root canal therapy is recommended;
- Dental cysts and tumors need aggressive management, such as a curettage (scraping or removal of tissue) and excision;
- TMDs often get corrected with anxiety reduction and muscle relaxants. A dentist can advise you to wear a night guard too.
How to prevent migraine flair-ups
- Regular flossing and brushing. Brush your teeth after lunch with fluoridated toothpaste, if possible. It will help to avoid bacteria-related issues.
- Don't neglect dental cleanings. Regular dental cleanings improve how the mouth feels and helps avoid concerns like plaque buildup, a significant contributor to caries and cavities.
- Overcome teeth grinding habits. Grinding caused by stress can be managed with counseling, relaxation techniques, and, in rare cases, prescription medication. Children usually outgrow tooth grinding.
- Watch what you eat. Reducing the quantity of refined sugar in your diet benefits general health and helps prevent sugar accumulation along the teeth surfaces. Sticky sugars serve as food for caries causing bacteria in the mouth.
- Find the cause. Dental-related migraines are treated by addressing the dental problem — not the migraine. Regular dental examinations can help detect and address issues before they cause pain in your mouth or head.
Maintaining dental health is critical to your overall health. Tooth pain, jaw discomfort, headaches, or any face pain may be the cause or accompany a migraine. Consult your dentist first to rule out any oral issues. Your dentist can treat the pain or refer you to a medical practitioner.
- BMJ Case Reports. Case report: Chronic migraine headache and multiple dental pathologies causing cranial pain for 35 years: the neurodental nexus.
- International Journal of Environmental Research and Public Health. Increased Risk of Migraine in Patients with Chronic Periodontitis: A Population-Based Cohort Study.
- American Migraine Foundation. Pain in your teeth or face may actually originate in other parts of the head—and a form of migraine may be the cause.
- International Journal of Environmental Research and Public Health. Headache Because of Problems with Teeth, Mouth, Jaws, or Dentures in Chronic Temporomandibular Disorder Patients: A Case–Control Study.