TMJ / HEADACHE
Dr. Ciuffreda has been awarded the status of Diplomate of the American Academy of Pain Management, and has been accepted into membership of the American Academy of Craniofacial Pain and the National Headache Foundation. He holds certificates for the NYU College of Dentistry Post Graduate Program in Head, Neck & Orofacial Pain as well as the Upledger Institute Programs in Craniosacral therapy (Levels I & II).
The term “TMJ disorders” (also referred to as TMD), as commonly used represents a broad array of jaw joint, occlusal, and musculoskeletal conditions of the head & neck. As the classification encompasses a wide renage of conditions, there naturally are many signs and symptoms of TMD. Some of the more common ones include:
– pain in front of the ear
– tender or painful jaw muscles
– clicking, popping or crunching noises when opening or closing the jaw
– limited opening or locking of the jaw
Headaches or general head / neck pain may also be associated with TMJ disorders. (See the section on headaches below, especially “the migraine myth”.)
Such problems require comprehensive evaluation by a dentist with advanced training in this area. In evaluating a patient with symptoms of a potential TMJ disorder, our office combines the results of an extensive medical history / questionnaire, x-rays, and a detailed examination of the head & neck to arrive at your diagnosis. Referral for imaging such as a CT scan, MRI, or iCAT may be indicated.
Due to the potentially complex nature of such disorders which often involve many contributing factors, our treatment approach is one of the whole person as a system to restore harmony and balance to your TM joint / head & neck functioning. Common therapeutic approaches include the use of an oral appliance, occlusal equlibration (adjusting the “bite”), specific jaw exercises, the use of moist heat, nutritional considerations, muscular stretching and manipulation, CranioSacral Therapy, general exercise, lifestyle and daily living changes, and stress reduction / relaxaion suggestions. We may also work with other medical specialists depending upon your individual needs.
We have had tremendous success with our integrative, conservative, non-surgical approach to the treatment of our TMD patients. In fact, this ability to provide sucj profound relief from chronic debilitating pain is one of the most rewarding aspects of our practice!
Headache is one of the most common medical complaints of the US population today and actually accounts for millions of lost workdays each year. Due to the wide range of apparent symptoms and presentations of head pain, the International Headache Society has developed a comprehensive classification in an attempt to categorize these disorders.
Our experience in treating these disorders has shown that the large majority of patients who complain of unilateral headache (pain on one side) have a muscular / myofacial (MPDS) cause of their discomfort; and a large percentage of the time are a component of a TMJ disorder. Such headaches of muscular origin can be quite successfully treated at our office through a combination of gentle muscular stretching and mobilization. Often these headaches are associated with TMJ disorders and bruxism (tooth grinding) and if so, oral appliances can be utilized. Also, stress reduction seems to play a key role in managing muscular / MPDS headaches.
“THE MIGRAINE MYTH”
There is a growing phenomenon that I like to call “the migraine myth”; quite simply: most people who think or say that they have migraines, or may even have been disgnosed with migraine, actually do not have migraine. This observation is not the current medical consensus, but has developed from my personal clinical experience. This is not to say that I think that actual migraine type headaches actually exist – they most certainly do! Rather, “migraine” is the most popular – that is – the most syudied, discussed, and perhaps more significantly has had the most pharmaceutical attention given to it. Furthermore, headache classifications focus more on the symptoms of a headache, as opposed to its underlying cause.
So if its not a “migraine”, what is it? I have seen numerous patients who provide a history of migraine and upon my examination find that they really have a muscular / myofascial type headache that can usually be alleviated without, or with minimal medications. Frequently these patients have been placed on prescription migraine medication but have had only limited, if any relief. Many of these patients also are found to have an underlying bruxism and / or TNJ component as well.
The most common (although not the only) location for this type of headache is around or above one eye, travelling up from the neck on the same side.
Another very interesting, and even more complex presentation to assess is that a particular patient may have multiple headache syndromes. remember: there is no rule that says you can have only one problem at a time! One of the best ways we can diagnose patients who seem to have a chronic condition of different types of headaches is to have them keep a “pain diary”. This is a daily record of head / neck pain that keeps track of the onset, duration, pain level, and pre-headache foods and conditions. This approach can often take a seemingly random and confusing pattern of pain and differentiate it into two or more obvious headache patterns that can then be properly addressed.
RED FLAGS OF HEADACHE
Not all headaches are “just headaches”. There are certain signs or symptoms that MAY indicate a serious underlying cause for headache symptoms. If you experience any of the following it would be highly advisable for you to seek medical consultation promptly:
– abrupt onset of different or new type of severe headache
– “worst headahe you have ever had”
– new onset of headache if over 50 years old
– worsening of a headache over a period of days or weeks
– headache worsened or precipitated by exertion
– presence of illness, fever, nausea, vomiting, stiff neck
– neurological symptoms (different from classic pre-migraine signs)
Experiencing any of these? Stop waiting to find the right low cost dental care expert. Give us a call now and find out how we can help!
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