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AVOIDING HEADACHE: Orofacial Pain, Jaw Muscle Pain, Migraines Tension-Type Headaches Closely Related

Study shows majority of TMJ disorder patients and Orofacial Pain patients have Muscle problems in common. 502 TMJ and Orofacial Pain patients were evaluated and 49% had Tension-type Headache, with over 30% having some type of migraine.

PRLog - Nov. 30, 2009 - CHICAGO -- The study in the April 30 Cephalgia was done in Korea.  The study showed " Of the headache patients, 81.1% presented with masseter muscle pain and 47.8% with temporal muscle pain. This finding suggests that pericranial muscle pain may be an inducing factor of primary headache."  

This study supports the view that TMJ disorders (TMD) and MPD, Myofascial Pain and Dysfunction are responsible for the majority of headaches either as a primary cause or an inducing factor.  Headache elimination by eliminating percipitating factors without excessive drug use is ideal.  The common factor in almost all headaches is the Trigeminal Nerve which makes up (directly or indirectly) nearly half of the entire nervous input to the brain and controls blood flow to the anterior 2/3 of the brain through the meninges.  Neuromuscular dentistry is the art and science of eliminating Trigeminal nervous disorders and primary and secondary muscle disorders in the masticatory system.  A new patient oriented website http://www.ihateheadaches.org discusses migraine headache, tension-type headache, sinus headaches, chronic daily headaches as well as other less common headaches and how Neuromuscular Dentistry can frequently give amazing relief to headache sufferers.

A recent article on Neuromuscular Dentistry was published in Sleep and Health Journal at http://www.sleepandhealth.com/neuromuscular-dentistry   The article was originally published by the American Equilibration Society and was reprinted in Sleep and Health.
It is an excellent source to understand the underlying science of Neuromuscular Dentistry. Suffer No More: Dealing with the Great Imposter is another patient oriented article in Sleep and Health Journal and is available at:  http://www.sleepandhealth.com/story/suffer-no-more-dealin... .

A article by Dr Barry Cooper, published in Cranio also discusses the use of neuromuscular dentistry felt that  in treating TMD or Temporomandibular Disorders that  "Evidence for a cause and effect relationship was strong"
PubMED reference:    Cranio. 2009 Apr;27(2):101-8.
Relationship of temporomandibular disorders to muscle tension-type headaches and a neuromuscular orthosis approach to treatment.
Cooper BC, Kleinberg I.

Wikipedia supplies  the following information on Neuromuscular Dentistry:

"Neuromuscular dentistry is a medical paradigm in which temporomandibular joints, masticatory muscles and central nervous system mechanisms follow generic physiologic and anatomic laws applicable to all musculoskeletal systems. It is a treatment modality of dentistry that objectively focuses on correcting misalignment of the jaw at the temporomandibular joint (TMJ). Neuromuscular dentistry acknowledges the multi-facted musculoskeletal occlusal signs and symptoms as they relate to postural problems involving the lower jaw and cervical region. Neuromuscular dentistry recognizes the need to solve the root of the misalignment problem(s) by understanding the relationships of the tissues involved, which include muscles, teeth, temporomandibular joints, and nerves. In short, neuromuscular dentistry and technology add objective data and understanding to previous mechanical models of occlusion.
Symptoms of temporomandibular joint disorder (TMD) are claimed to include:
Headaches / migraines
Facial pain
Back, neck and shoulder pain
Tinnitus (ringing in the ears)
Vertigo (dizziness)
Trigeminal neuralgia (tic douloureux), a neuropathic pain disorder unrelated to TMD
Bell's Palsy, a nerve disorder unrelated to TMD
Sensitive and sore teeth
Jaw pain
Limited jaw movement or locking jaw
Numbness in the fingers and arms (related to the cervical musculature and nerves, not to TMD)
Worn or cracked teeth
Clicking or popping in the jaw joints
Jaw joint pain
Tender sensitive teeth
A limited opening or inability to open the mouth comfortably
Deviation of the jaw to one side
The jaw locking open or closed
Postural problems (forward head posture)
Pain in the joint(s) or face when opening or closing the mouth, yawning, or chewing
Pain in the muscles surrounding the temporomandibular joints
Pain in the occipital (back), temporal (side), frontal (front), or infra-orbital (below the eyes) portions of the head
Pain behind the eyes
Swelling on the side of the face and/or mouth
A bite that feels uncomfortable, "off," or as if it is continually changing
Older Bells palsy
Neuromuscular dentistry uses computerized instrumentation to measure the patient's jaw movements via Computerized Mandibular Scanning (CMS) or Jaw Motion Analysis (JMA), muscle activity via electromyography (EMG) and temporomandibular joint sounds via Electro-Sonography (ESG) or Joint Vibration Analysis (JVA) to assist in identifying joint derangements. Surface EMG's are used to verify pre-, mid- and post-treatment conditions before and after ultra-low frequency Transcutaneous Electrical Nerve Stimulator (TENS). By combining both computerized mandibular scanning (CMS) or jaw motion analysis (JMA) with ultra-low frequency TENS, the dentist is able to locate a "physiological rest" position as a starting reference position to find a relationship between the upper and lower jaw along an isotonic path of closure up from the physiologic rest position in order to establish a bite position. Electromyography can be used to confirm rested/homeostatic muscle activity of the jaw prior to taking a bite recording.[citation needed]
Once a physiologic rest position is found, the doctor can determine the optimal positioning of the lower jaw to the upper jaw. An orthotic is commonly worn for 3-6 months (24 hours per day) to realign the jaw, at which point orthodontic treatment, use of the orthotic as a "orthopedical realigning appliance", overlay partial, or orthodontic treatment and/or rehabilitation of the teeth is recommended to correct teeth and jaw position."


The PubMed reference for the above study is reprinted below:

Cephalalgia. 2009 Apr 30. [Epub ahead of print]
Application of ICHD-II criteria for headaches in a TMJ and orofacial pain clinic.
Kang JK, Ryu JW, Choi JH, Merrill RL, Kim ST.

Department of Oral Medicine and Orofacial Pain, College of Dentistry, Wonkwang University, Iksan, Korea.
Kang J-K, Ryu J-W, Choi J-H, Merrill RL & Kim ST. Application of ICHD-II criteria for headaches in a TMJ and orofacial pain clinic. Cephalalgia 2009. London. ISSN 0333-1024The aim of this study was to identify and diagnose headache in a temporomandibular joint and orofacial pain clinic population using the second edition of The International Classification of Headache Disorder criteria. In 502 temporomandibular disorder and orofacial pain patients, 246 patients (49%) were diagnosed with tension-type headache (TTH), followed by migraine without aura (14.5%), probable migraine (12.9%), migraine with aura (7%), probable TTH (4.8%) and cluster headache (0.2%). The prevalence of headaches was compared between male and female patients, and the prevalence of migraine was found to be higher in women than in men. In evaluating by age, the prevalence of migraine was highest in patients in their 20s and 30s and declined as age increased above 40. TTH showed the highest rate throughout all age groups, but it also decreased as age increased. In this study, the prevalence of migraine was lower than that reported in Dr Kim et al.'s study, and the prevalence of TTH much higher than that reported in the previous study. Of the headache patients, 81.1% presented with masseter muscle pain and 47.8% with temporal muscle pain. This finding suggests that pericranial muscle pain may be an inducing factor of primary headache.

Cranio. 2009 Apr;27(2):101-8.
Relationship of temporomandibular disorders to muscle tension-type headaches and a neuromuscular orthosis approach to treatment.
Cooper BC, Kleinberg I.

# # #

I HATE HEADACHES LLC has created http://www.ihateheadaches.org to provide vital information on utilizing Neuromuscular Dentistry to avoid and treat headaches of all types.

Information on sleep apnea, sleep apnea treatment and cpap alternatives are available at www.ihatecpap.com This is the premiere site for the promotion of Dental Sleep Medicine and Sleep Apnea Dentists.

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