MIGRAINE: The TMJ Connection
Patients with severe or extreme headaches are often diagnosed with a migraine. Migraine headaches are caused by a disturbance of the trigeminal and vascular system to the head. Much about the causes of migraines are not fully understood and genetics and environmental factors may play a role. A migraine may be caused by chemical changes and imbalances within the brain and the trigeminal system. Common triggers of a migraine headache have been reported to be:
- Foods as in aged cheese, chocolate, MSG, and sulfites contained in red wine and alcohol
- Sensory Changes certain smells from perfume/cologne, smoking and bright light including the sun
- Stress physical activity and emotional stress
- Hormonal Changes in females with change of estrogen levels
Migraines are considered as a diagnosis if patients complain of deep throbbing or pulsating pain in a local part of the head (usually on one side of the head). Also associated with these headaches are:
- Nausea
- Vomiting
- Light sensitivity
Patients with a TMJ (Temporomandibular Joint) disorder also present with severe head pain in the temple region.
Many patients with a TMJ problem are misdiagnosed by their physician with having migraine pain. In turn, some dentists diagnosis a true migraine as a TMJ problem.
There is an anatomical link between TMJ disorder and migraine headaches. The disc within the TMJ can displace in a forward and inside direction. That disc can press against a major artery and therefore a vascular type headache can develop. Therefore the symptoms between a true migraine and one from a TMJ source are the same. There are a certain percentage of patients that can have headache from both a migraine source and from a TMJ/Neck structural dysfunction source. Typically though, a true migraine will attack infrequently, occurring only 2-3 times per year. In those patients that suffer with headaches that occur on a weekly or daily basis, a true migraine cannot be considered a primary source without ruling out other factors.
In our practice, a diagnosis of migraine is only offered when all structural factors have been eliminated. Some factors to be considered include TMJ, neck, anatomical, postural and hormonal influences.