Dr. Katz, iHATEheadaches Blog

This blog is now located at http://shapiraheadacheherndon.blogspot.com/.
You will be automatically redirected in 30 seconds, or you may click here.

For feed subscribers, please update your feed subscriptions to
http://shapiraheadacheherndon.blogspot.com/feeds/posts/default.

Everyone once and a while you come across a condition or an anatomical
oddity you learned about years ago but thought you would never see in the everyday population you treat.

Such was the case the other day. I had my hygienist take a panorex x-ray, an x-ray that shows the skeletal structures of the entire mouth, jaws and sinuses, for a new patient in our office. The individual had no symptoms at all. No neck pain, facial pain or headaches. But when I looked closely at the panorex, I saw an unusual sight. The Styloid process, a small bone
on the back of the head, adjacent to the ear lobe running down the side of the neck and which is usually about3/4 of an inch long was about three or more inches long in this case.

I asked again if he had any unusual symptoms like throat pain or facial pain but the patient said that he felt perfectly fine. I showed him the x-ray and told him how amazed I was that he felt perfectly fine. There appeared to be no other pathology. I explained to him that the extended bone might at some point cause him headaches, pain when turning his head, loss of appetite, or even a change in his voice.

I told him that a combination of symptoms such as those could be classified as Eagle Syndrome. I also told him that he was fortunate that he looked well and felt well but be aware that if he began experiencing any symptoms I described, he would be wise to see me so I could refer him to an ear nose and throat specialist.

The causes of headaches, head pain, neck and facial pain are varied. Sometimes a simple dental x-ray and a keen diagnostic eye can make the difference between years of suffering or a very quick and simple remedy.

Stress has been shown to be a major factor in the onset and longevity of tension headaches. We all experience occasional tension headaches. Sometimes they come infrequently but sometimes they can become chronic occurring on a daily basis. Chemical levels in the body such as serotonin and endorphins may be effected by outside stresses on the body and may be the trigger for many headaches.

Frequent episodic tension type headaches can last from hours today. They are bilateral, pressing and frequently coexist with migraines without aura.

Many years ago, I treated a middle aged women who suffered from almost daily headaches. She was also being treated by a neurologist for her headaches and I don't recall any TMJ related
symptoms that might have been contributing to her condition.
She was very high strung, nervous and asked to be sedated for her dental treatment. This occurred over twenty five years ago so I don't have her records available to me any longer but I do remember the following episode very well. I remember that she had a very unusual name with 6 or seven consonants and one vowel. A name I had much trouble pronouncing.

I completed her dental treatment under sedation and she then disappeared from my practice.
I remember that on her last visit I wished her well and hoped that she would eventually find relief from her chronic and debilitating headaches.

A few years later I was introduced to a new patient with the same unusual name as
the woman with the headaches I had seen previously. The patient was a very pleasant, neat
young woman with no dental needs other that a good cleaning.
After my initial examination, I mentioned to her that a few years back I had seen someone
with the same unusual name and out of curiosity asked if there was any relationship.
"Why Yes, she answered me, that was my mother.

I was quite surprised and my immediate question was about her mother's headaches.
"Does she still get them. Are her headaches still as debilitating as they had been."

My Mother , she answered does not get any headaches any more she's doing great and very happy. Astounded, I asked what accounted for the dramatic turn around in her mothers
health. She divorced my father she answered. She just left him.
We both broke out laughing. I was quite amazed and very happy for her mother.
It was a great lesson learned. The mind can definitely effect our bodies and health both in a positive and a negative way. Medication is not always the answer.

True story
So, for your own good health, treat your spouse well

I had not seen Donna, who was now 50 years old, for more than six years. On examination Donna showed evidence of multiple caries and moderate periodontal disease. She had four bicuspids missing,her teeth were crooked and crowded and it was obvious from the four bicuspid extractions that she had had braces at a young age. Her main concern was that she was very dissatisfied with how her teeth looked. She could not open her mouth very wide and made a lot of noise when opening and closing her mouth but was not concerned about it..

"Do you also have shoulder pain", I asked. she told me her shoulders always hurt especially on the left side. "What about your neck?" Her neck had been hurting for as long as she could remember. ' But that's because I sit in front of a computer screen all day. "Well, how about headaches, do you get them often?" I get them a lot especially when I'm tense around my temples and over my eyes. "Do your fingers tingle too." Yes she said, but how did you know that and what does all this have to do with my teeth. "

"Good question", I answered. Maybe your symptoms are all related to your posture, work habits, level of tension and migraines. But you have certain symptoms that can also come form another source, the relationship of your upper to your lower jaw, the relationship of how your teeth come together (occlusion) and the effect the position of your teeth and jaws have on your neck, shoulder and jaw muscles.From the noise your jaws were making it sounds like you jaws (TMJoints)have taken a beating. That popping noise and grinding feeling has to do with your jaw
fitting in the groove of your skull. Like worn shock absorbers or worn brakes , your jaw has become poorly aligned and could just be the cause of your headaches , neck pain and even tingling in your hands. Just like realigning your tires and getting new brakes your car will function better and last longer.

Your teeth are not isolated a vacuum that's your mouth. Your teeth are part of a system in your body and changes in that system effects other parts of your body. From your teeth to your neck and shoulders to your ears hands and back.

Your body likes to be in balance and when one of its parts goes out of balance
it lets you know by sending you pain signals. After a while those sharp pains become low grade chronic pain and only become acute if an additional factor suddenly reminds the body that there is still an imbalance and it making you hurt. Worn and broken teeth, shifting teeth, painful jaw joints, bad bite, limit opening and closing are all things that might be causing or contributing to severe head pain.

So when I examined Donna again, I told her I was not only looking at her teeth but that I was observing signs and symptoms that might be telling me that she may have more problems than broken fillings and an unsightly smile that might need addressing.
She was definitely impressed and surprised that I was paying attention to so many thing besides just her teeth. "When I look at you, I told her, I see more than just teeth". I see someone who wants to be as healthy as she can be."

Holistic medicine is defined by the Canadian Holistic Medical Association, as

"A system of health care which fosters a cooperative relationship among all those involved, leading toward optimal attainment of the physical, mental, emotional, social, and spiritual aspects of health."

There are many types of headaches and cause of headaches. There are primary causes and secondary causes, genetic causes, hormonal causes and causes due to chemical imbalance and chemical hypersensitivities. In each of these areas there are specialist who treat headaches based on their specialty. If after seeing a host of practitioners and going through many diagnostic tests and then no cause is found, the sufferer becomes apprehensive, worried, despondent and made to feel that it's all in their head.

Neuromuscular dentist understand that there are other factors that may contribute to head,neck and fascial pain. Headaches of many types are associated with the fifth cranial nerve, the Trigeminal nerve. Migraines, sinus headaches,headaches cause by Temporomandibular dysfunction (TMD) or TMJ are also associated with the same nerve the fifth cranial nerve. Treating, TMJ,the jaw joints, can help relieve or prevent a lot of pain and the associated symptoms linked to the fifth nerve.

Pnupa, a college student over a period of a year, developed symptoms that included headaches,neck, shoulder and facial pain, ringing in the ears and tingling and numbness in her hands. After seeing a host of specialist and months of test, she was told no apparent cause could be found for her symptoms. She had trouble typing and she had to cut the number of classes she could attend at school because of her hand numbness. Carpal tunnel syndrome was ruled out.

She saw a pamphlet I had in my waiting room describing TMD and it's symptoms. "That's me "she said.

Together with her physician, a physical therapist and our treatment of her TMJ with appliance therapy, her symptoms have started to subside. Her hand pain has gone from a Maximum of five out of five to a two in intensity. She is thrilled that she can spend more time typing and working at school. Best of all she happy to know it was not in her head.

Not every headache is due to jaw or bite dysfunction. But being open minded to all the possiblities and working together can make make many chronically unhappy and pain stricken people, pain free and productive again.

How do you deal with stress? Some people get high blood pressure, some people get ulcers. Myself, I tend to clench and grind my teeth. I wasn't always aware of it.
A few years back, I was driving with my wife to a shopping mall. What's the matter she said. "Nothing, I said. Why do you ask." She told me that since we left our drive way my jaw muscles were contracting and expanding as I was grinding and clenching away. I had never realized it. She was right . I was worrying about something and was mulling it over in my mind not realizing that I was transmitting my anxiety and manifesting my tension by grinding and clenching.

Most people clench or grind occasionally but about 10% suffer from TMJ problems and those can set in suddenly. TMJ disorders can mimic migraine headaches, earaches, sinus infection and tooth aches. it can cause dizziness, ringing in the ears, and muscle pain that radiates down the neck and shoulders.

A clenched jaw can exert up to 300 pounds of pressure which can wear and crack teeth. Over time, these excessive and abnormal forces can cause degenerative changes in the jaw joint and muscles of the face, neck and shoulders.

Once Tmj problems set in, treatment can vary depending on the cause and the condition of the jaw muscles, jaw joint, bite, posture and working and sleeping habits. Treatments can include medications, anti-inflammatories, trigger point injections, physical therapy, changing working and sleeping habits, stress management and correction of a misaligned bite.

It's important that when you experience chronic headaches you see your physician to rule out other organic cause that might be causing your headaches. But many times your problem can be of dental origin and a trained dentist in the treatment of TMJ dysfunction and head and neck pain may be your avenue to pain relief.

We know how debilitating headaches can be and our goal is to relieve your pain and give you your life back.