Headaches need little introduction. People aged five to people aged 80, headache disorders are one of the three most common neurological conditions.[i] There are many common, well-known causes, such as stress, disrupted sleep patterns, certain foods and, famously, alcohol.
However, many may overlook the importance of the temporomandibular joint (TMJ) as a risk factor for headache disorders. Recent awareness has grown after Zoe Ball, a BBC Radio 2 broadcaster, stepped down because of chronic headaches relating to a temporomandibular disorder (TMD).[ii] This demonstrates how impactful headaches can be to daily life and work, increasing the need to identify and manage at-risk patients before their quality of life is disrupted.
Cause and effect
In a headache, pain occurs when inflammatory substances are released around the nerves and blood vessels of the head, causing that splitting sensation.[iii] Headache disorders affect approximately 40% of people,[iv] whereas TMD symptoms, such as jaw pain and stiffness, can be experienced by 40-70% of the general population.[v] The relationship between TMD and headaches is notable; they are common pain conditions that often co-exist. Both are more common in women.[vi]
The bidirectional connection between TMD and headaches creates a painful cycle: TMD may be the original cause of a headache and may worsen existing ones, whereas a headache may trigger or aggravate TMD. This comorbidity makes the relationship hard to pinpoint – headaches originating from TMD can be caused by pain in the temporalis muscle, the masticatory muscles or in the TMJ.[vii] Another part of the connection between the two can be attributed to the trigeminal pathway, where nerve activation is thought to play a major role in headache and facial pain disorders.[viii] Whilst more research is needed to define the link, there is evidence that it does exist: 82.8% of painful TMD patients reported headaches and 59.3% of headache patients had TMD.[ix]
Managing migraines
Managing migraines One of the most prevalent subtypes of a primary headache is a migraine, often triggered by nausea, increased sensitivity, external stimuli, and TMD. Able to last anywhere between 4-72 hours, migraines are considered the second most debilitating diseases in the world.[x] A migraine can impair function in both work and home life, as well as disrupting family and leisure activities, with 71% feeling that migraines affect their mental health and 60% finding that their relationships are impacted by them.[xi]
Impairment from work is damaging to the economy: 43 million days of work are lost each year due to migraines.[xii] However, it can have a great toll on a person’s physical and mental health. Repeated time off work can cause a build-up of tasks, causing employees to lag behind their workload when they return. This can increase stress, aggravating further migraines. Furthermore, 52.7% of migraine sufferers have disrupted sleep patterns.[xiii] Between sick leave and insufficient sleep, migraines can impact workplace productivity, leading to higher levels of stress that can exacerbate the migraines further. Whilst time off work is unavoidable, this vicious cycle from TMD-induced migraines can be managed with support from dental practitioners.
At-home remedies
At-home remediesAs awareness of the relationship between TMD and headaches grows, patient education is essential to eliminate concerns and reduce symptoms. At-risk patients, such as women aged 20-50 or patients who are in stressful jobs,[xiv] should be encouraged to avoid hard or chewy foods, as well as finding ways to stop parafunctional habits like clenching or grinding. As excessive function can cause symptoms to appear, resting the masticatory system can reduce the risk of headaches or facial pain.[xv]
To alleviate pain, applying heat or ice to sensitive areas is recommended. For a lasting change, physical therapy is crucial for chronic TMD patients. Motion exercises decrease pain and improve function, assisting patients in their journey to restore quality of life.
A great device for at-home therapy is the OraStretch® Press Jaw Rehab System from Total TMJ. A simple yet reliable user-operated system, it stretches the mouth open to mobilise the jaw. As well as enhancing function, the system treats pain and swelling, limiting the prevalence of headaches. Patients can follow the recommended daily exercises to rehabilitate their TMJ, improving quality of life and containing regular migraines to a one-off occurrence.
Headaches are so common many may think they are a normal part of life. By aiding patients at-risk of TMDs, dental practitioners can help reduce their prevalence, ensuring work days aren’t missed, sleep is undisturbed, and life is happier and healthier.
For more details about Total TMJ and the products available, please email info@totaltmj.co.uk
Author Bi0:
Phillip Silver
Founded in 2018, Total TMJ was created by Phil Silver, after a long career in medical devices, which gave him the knowledge to set up in his own right. The Dorset company is a specialist provider of medical devices. It distributes innovative technologies from leading healthcare manufacturers to dentists and clinicians around the UK. Their vision is to combine a portfolio of complimentary medical devices that both help the clinician and improve the outcome for their patients.
The privately-owned family business Total TMJ in Bournemouth fully supports the clinicians it works with through educational support by offering local and international surgeon peer to peer led courses. If you would like to find out more about their courses, please click here.
Total TMJ also supplies innovative medical devices offering solutions for temporomandibular joint disorders (TMD) & trismus within the healthcare sector.
[i] World Health Organization: WHO (2024). Headache disorders. [online] Who.int. Available at: https://www.who.int/news-room/fact-sheets/detail/headache-disorders.
[ii] Glynn, P. (2024). Zoe Ball left with ‘awful headaches’ by jaw condition. BBC News. [online] 28 Nov. Available at: https://www.bbc.co.uk/news/articles/c9wr95njpzpo.
[iii] World Health Organization: WHO (2024). Headache disorders. [online] Who.int. Available at: https://www.who.int/news-room/fact-sheets/detail/headache-disorders.
[iv] World Health Organization: WHO (2024). Headache disorders. [online] Who.int. Available at: https://www.who.int/news-room/fact-sheets/detail/headache-disorders.
[v] Pankaew Yakkaphan, Elias, L.-A., Priya Thimma Ravindranath and Renton, T. (2024). Is painful temporomandibular disorder a real headache for many patients? British dental journal, 236(6), pp.475–482. doi:https://doi.org/10.1038/s41415-024-7178-1.
[vi] Pankaew Yakkaphan, Elias, L.-A., Priya Thimma Ravindranath and Renton, T. (2024). Is painful temporomandibular disorder a real headache for many patients? British dental journal, 236(6), pp.475–482. doi:https://doi.org/10.1038/s41415-024-7178-1.
[vii] Pankaew Yakkaphan, Elias, L.-A., Priya Thimma Ravindranath and Renton, T. (2024). Is painful temporomandibular disorder a real headache for many patients? British dental journal, 236(6), pp.475–482. doi:https://doi.org/10.1038/s41415-024-7178-1.
[viii] Yakkaphan, P., Smith, J.G., Chana, P., Renton, T. and Lambru, G. (2022). Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis. Cephalalgia Reports, 5, p.251581632210973. doi:https://doi.org/10.1177/25158163221097352.
[ix] Yakkaphan, P., Smith, J.G., Chana, P., Renton, T. and Lambru, G. (2022). Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis. Cephalalgia Reports, 5, p.251581632210973. doi:https://doi.org/10.1177/25158163221097352.
[x] Pankaew Yakkaphan, Elias, L.-A., Priya Thimma Ravindranath and Renton, T. (2024). Is painful temporomandibular disorder a real headache for many patients? British dental journal, 236(6), pp.475–482. doi:https://doi.org/10.1038/s41415-024-7178-1.
[xi] The Migraine Trust (2021). Impact of migraine. [online] The Migraine Trust. Available at: https://migrainetrust.org/understand-migraine/impact-of-migraine/.
[xii] The Migraine Trust (2021). Impact of migraine. [online] The Migraine Trust. Available at: https://migrainetrust.org/understand-migraine/impact-of-migraine/.
[xiii] Awaki, E., Takao Takeshima, Yasuhiko Matsumori, Hirata, K., Miyazaki, N., Takemura, R., Satoshi Osaga, Yoshinori Tanizawa and Komori, M. (2024). Impact of Migraine on Daily Life: Results of the Observational survey of the Epidemiology, Treatment, and Care of Migraine (OVERCOME [Japan]) Study. Neurology and Therapy. doi:https://doi.org/10.1007/s40120-023-00569-3.
[xiv] Yakkaphan, P., Smith, J.G., Chana, P., Renton, T. and Lambru, G. (2022). Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis. Cephalalgia Reports, 5, p.251581632210973. doi:https://doi.org/10.1177/25158163221097352.
[xv] Oral Health Foundation. (n.d.). Jaw problems and headaches. [online] Available at: https://www.dentalhealth.org/jaw-problems-and-headaches.
