By Larry Pribyl, D.D.S.
Even for dentists who have extensive training in craniomandibular disorders and jaw dysfunction, intense headaches are often challenging cases to manage. To discover the true cause of the pain, professionals are not unlike detectives looking for clues which can put the pieces of the puzzle together. For instance, among the varying headaches: vascular, sinus congestion, or migraines, the majority of all headaches are muscle-contraction headaches—most often caused by a jaw joint disorder.
In the past, most clinicians had no way of knowing this information since it was not included in their educational programs. Today you will find more and more health care professionals recognizing the symptoms and referring patients to a specialist with training from the American Academy of Craniofacial Pain. Proper screening takes minutes and would allow professionals to use their combined knowledge to unravel the mystery of diagnosis and determine the cause and course of correction.
TM Disorder symptoms
include the following:
• Jaw clicks or pops when opening/closing
• Chronic headaches
• Ears congested, ringing or painful
• Tense or painful neck
• Facial pain
• Unexplained dizziness
• Jaw locks open/closed
• Pain behind the eyes
• Difficulty swallowing
• Clenching and grinding teeth
• Neck, shoulder, back pain/stiffness
• Limited jaw movement
Part of the problem is that TMJ disorder symptoms mimic so many other disorders. It is not uncommon for patients to be treated inappropriately for migraines, anxiety, depression, arthritis, Fibromyalgia, Chronic Fatigue Syndrome or other chronic pain. To add to the confusion, many TM joint disorder patients ALSO suffer with one or more of these additional conditions.
The Tyramine/Headache Connection
Tyramine is a monoamine compound that is produced in foods from the natural breakdown of the amino acid tyrosine. It is not added to foods. Tyramine levels increase in foods when they are aged, fermented, stored for long periods of time, or are not fresh. Certain anti-depression medications in the MAOI classification can interact with even healthy foods. This may cause an increase in blood pressure.
Examples of foods that contain high amounts of tyramine include aged cheese, soy sauce, aged meats, pickled fish, tofu, sauerkraut, red wine, summer sausage, sauces containing fish or shrimp, miso soup, beer on tap and yeast extract.
Lack of serotonin can also cause headaches. Serotonin is a chemical in our bodies that is called a neuro-transmitter. Decreased serotonin also influences estrogen levels. Males will tend to have poor sleep, fatigue, irritability and depression. Females will experience decreased estrogen levels, but they may begin to have irregular periods and hormonal related problems appearing as though they are dealing with hormone issues.
Accurate Diagnosis is Key
Dr. Pribyl is qualified to accurately diagnose your headache to determine if it could be a TMD issue.
A consultation appointment includes a discussion of your symptoms, a clinical exam and a bite analysis. Further x-rays and testing may be in order depending on the results of the first consultation. Treatment may include wearing an acrylic appliance—a mandibular repositioning device—that is custom made for you that fits over your upper and/or lower teeth.
Seeking treatment for TMD is the best step you can take. Without it, the problem can worsen and become debilitating. If left untreated, arthritis can develop in the joint, symptoms can become more severe and pain can worsen. Go to our website www.tmjsleepapnea.com and click on the drop down “Evaluate Your Symptoms” for more information. To schedule an appointment with Dr. Pribyl, please call our office at 816-795-1000.