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Dental causes of Headache SYNOPSIS: Teeth are not the only structures in the stomatognathic system that can give rise to painful conditions. Temporomandibular disorders (TMD) have been identified as a major cause of nonodontogenous pain in the orofacial region and are considered a subclassification of musculoskeletal disorders. In an attempt to conform with the International Headache Society (IHS) "Classification and Diagnostic Criteria for Headache Disorders, Cranial Neuralgias and Facial Pain", the American Academy of Orofacial Pain, has published a classification of TMD expanding the group 11.7 (temporomandibular joint articular disorders) and adding a group 11.8 to cover masticatory muscle disorders. Although many studies have found recurrent headache to occur in as many as 70% of TMD patients, this correlation has been difficult to explain. Recent research has indicated that parafunctional jaw clenching might provide the missing link. The (NTI-tss) dental device has been in use since 1998 for the management of bruxism and TMD. By preventing canine and molar tooth contacts and exploiting the jaw opening reflex, this device has been previously shown to be able to reduce temporalis muscle clenching intensity to one third of maximum. On July 10, 2001, the FDA allowed the NTI-tss to be marketed for the prevention of medically diagnosed migraine and tension-type headache. In a multicenter trial involving 94 patients, 82% of the NTI-tss users had shown a 77% average reduction of migraine events - a figure which compares favourably to popular migraine prophylactic medication, but without the adverse side effects. The results of this and another recent study of 123 migaineurs using periodic injections of Botox as a migraine preventative, provide evidence that migraine without aura (group 1.1) and tension-type headaches (groups 2.1.1, 2.2.1 & 2.3.2) can be positively influenced by pericranial muscular suppression. It also forces us to reexamine current theories of headache pathogenesis. - BACK TO LIBRARY