How migraine can be linked to your dental health

Chronic Migraine Awareness Day takes place on 29 June 2024 and shines a spotlight on the debilitating condition that affects one billion people globally, making migraine the third most common disease in the world. While there is no single known cause for migraine, there is a genetic link and some people are aware of the triggers – such as stress, anxiety and tiredness. Migraine can also be linked to two dental conditions: bruxism and temporomandibular disorder (TMD). One of our dentists, Professor Andrew Eder, talks us through both conditions – and how some PortmanDentex practices are able to help.

What is migraine?

Migraine is moderate to severe headaches that can last a few days and are accompanied by symptoms that can include nausea, sensitivity to light, extreme fatigue, problems with sight and stiff necks (including pain before and after the main attack stage). For some, the first symptoms start days before the head pain begins, while around a third of migraine sufferers report going through a stage referred to as an aura. This typically lasts around an hour, when symptoms such as visual disturbances, numbness and dizziness can signal that a migraine is imminent.

Migraine can be highly disabling: with 90% of migraine sufferers saying that it’s not possible to function normally, at work or home, during an attack*. Those diagnosed with chronic migraine are severely affected, having headaches at least eight times a month for three months consecutively. Chronic migraine is much rarer, affecting 2.5 in every 100 people who suffer episodic migraine (those with fewer headache days with migraine symptoms).**

What’s the difference between bruxism and TMD?

Teeth grinding and jaw clenching (bruxism) can cause face and jaw pain, clicking jaw joints and damage to both teeth and enamel. TMD happens when the temporomandibular joints and associated muscles don’t function properly, causing pain and possibly reducing the movement of the jaw. Both conditions can cause headaches and migraine.

The causes of bruxism can vary and it’s not always clear why teeth grinding happens. However, it is commonly considered to be a consequence of stress and anxiety, and is often associated with sleep problems such as snoring and sleep apnoea (as it happens mostly at night). It has also been linked to certain medications (including certain types of antidepressants). TMD can be a result of bruxism, an injury to the head or face, joint damage, and is also often associated with stress.

How do you know if you have bruxism or TMD?

You might now know whether you grind your teeth, but some people will experience symptoms such as face, neck, jaw and shoulder pain, restless sleep and damage to their teeth: ranging from signs of wear to increased sensitivity. If you have TMD, you might have associated pain, your jaw might crack or pop when you open or close your mouth, or you could have difficulty fully opening your mouth.

How can our dentists help?

If your dentist thinks you might have bruxism or TMD, they will examine your mouth for signs of wear and more substantial damage, assess your bite and ask you whether you have any muscle pain. They’ll check to see how you open and close your mouth, plus examine the muscles around your jaw joint.

If you do have bruxism or TMD, some of our dentists may recommend a treatment that will help reduce the intensity of your teeth grinding, including soft or hard mouthguards. These can be worn at night and will protect your teeth from further damage, and could potentially reduce migraine pain. Bruxism can also be linked to stress and anxiety, so our dentists might also recommend or provide stress management advice. Physiotherapy, botox, muscle relaxants and medication are further treatment options, either at a dental practice or in conjunction with other healthcare professionals, with some options often being combined. Most people associate the use of botox with facial aesthetics. Used in the context of headaches and migraines, this is a medical use to relax muscles and alleviate pain, and the injections can be positioned so that there are no cosmetic changes, if this effect is not required or desired.

“In my experience, I have found that one or more of a specific design of hard acrylic mouthguard (such as a Michigan splint), physiotherapy and short-term anti-inflammatory medication can be incredibly helpful to patients who may be stressed, or are grinding or clenching. However, undiagnosed migraine (or headaches) should always be assessed medically without delay.”

Professor Andrew Eder, Specialist in Restorative Dentistry and Prosthodontics.

If you have a misaligned bite, your dentist might also suggest a soft or hard mouthguard, to be worn around the clock or at night only, to see if correcting the bite alleviates your symptoms. If you’re diagnosed with a misaligned bite, you might need further treatment to help correct this.

If your migraine symptoms aren’t caused by bruxism or TMD we recommend you speak to your GP who will be able to offer guidance on how to alleviate symptoms, which can range from medication, to lifestyle changes and management techniques. If you experience any undiagnosed head pains that come on suddenly – you must consult with your GP.

If you think you might have bruxism or TMD, please contact your local PortmanDentex practice to arrange an appointment.

^{*Reuters, Migraine Research Foundation, Harvard Business Review
**Migraine Trust}

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