Dr. Lobo Lobo: You are listening to the dental chat podcast with Dr. Sylvia Lobo Lobo. Dr. Gabriela Garza is an assistant professor at the University of Louisville School of Dentistry in Kentucky. Her main interests are TMD and oral facial pain and she devotes her clinical practice to treat patients in this area. Dr. Garza received her DDS from Universidad Autonoma de Nuevo Leon in Monterey, Mexico and then completed a two-year graduate program of craniomandibular disorders and neurofacial pain at Tufts University School of Dental Medicine in Boston Massachusetts.
Welcome to the podcast Dr. Garza, so great to have you and hear what you have to tell us. Today’s question is whether job problems can cause headaches. How are you today?
Dr. Gabriela Garza: I am very good thank you for the invitation Dr. Lobo Lobo, so let’s start what causes a headache attributed to temporomandibular disorders. Well, first of all a headache attributed to temporomandibular disorders is defined as a headache caused by a disorder involving structures in the temporal modular region. A headache is a very common symptom in TMD patients. Primary headaches are those by which the headache is actually the disorder like a migraine and tension type headache which is very common, but the international headache society has recognized a secondary headache that is related to temporomandibular disorders. With these headaches if we manage the responsible disorder we will help to reduce or eliminate the headache. So some of the causes of these headaches could be displacement osteoarthritis of the temporomandibular joint degenerative disease hypermobility myofascial pain so all of these things can cause a headache related to TMD.
DLL: What are some of the symptoms of a headache attributed to job problems?
DGG: Yes usually the headache develops in the temporal region in the pre-auricular area of the face and in the masseter muscle. So the masseter muscle runs in our in the sides of our face and that’s the that’s one of the muscles of mastication so we use it to speak to swallow to open our mouths so it is a very important muscle in our face.
DLL: What is the difference between a migraine headache and a headache attributed to TMD disorders?
DGG: So in a migraine usually the pain is severe, pulsating, most commonly it’s just in one side of the of the head. It is very high intensity. It’s severe. It’s usually aggravated by physical activity. It can be a debilitating pain.
During the attacks the patients can feel nausea. They can have photophobia and phonophobia. Some patients can experience symptoms hours or a day or two before the actual migraine. These symptoms can be: fatigue, neck stiffness, sensitivity to light and sounds, nausea, and blurry vision.
Usually the migraine has a trigger factor, a trigger or an initiating factor. This could be food, perfumes, cigarettes, some sleep disorders could also be an initiating factor, and emotional stress.
Also, it is important to mention that bruxism or teeth grinding can also be a trigger for migraines so if we treat TMD disorders we can help reduce the number of migraine attacks if that trigger is a parafunctional habit.
The difference between the migraines and the headaches related to TMD is that usually in the TMD headaches the pain is in the temporal region. It’s a dull ache, constant pain. A patient will have it in the morning when they wake up or throughout the day.
DLL: How is this condition treated?
DGG: So there are different ways of treating a headache related to TMD. We can use patient education. We can tell them to avoid certain type of foods. If they are having parafunctional habits like clenching or grinding their teeth, we can tell them to be aware and to try to avoid it. if they are aware of them. Physical therapy can also help.
Sleep therapy makes a big difference if there are parafunctional habits, especially during the night because patients can wear the appliance at night and they cannot control what they are doing and that will help reduce the amount of muscle tension or activation.
Also psychological intervention is important to mention because some of these of TMD patients will have anxiety or depression and that will be managed by a psychological intervention.
Also medications can help with this type of headaches.
DLL: Can you give us some recommendation on lifestyle changes?
DGG: Yes, it is important to evaluate the stress in your life. Consider your daily activities, anything that can put strain on your muscles, your neck, your shoulders, your posture. Check your working area and make sure to have a good posture that will help reduce the amount of this type of headache.
DLL: Any last comments for our listeners Dr. Garza?
DGG: Yes, we as dentists can treat this type of headache. We always have to make sure that there are no underlying conditions when a patient presents with a headache we have to differentiate and diagnose properly a headache that is related to TMD because we can make a big difference for the patients by treating them correctly. We will help reduce the amount of headaches or completely eliminate them but we don’t want to miss anything because something else can be going on as well.
DLL: Thank you Dr. Garza for spending time with us today. I hope that people suffering from jaw-related headaches have found this discussion very helpful.
DGG: Thank you very much.