Jaw tension in migraine and other headache disorders

How is jaw tension implicated in headache and migraine?

If you grind your teeth and clench your jaws together it has been suggested that this can act as a trigger for headaches, particularly tension-type headache and even migraine. You may grind your teeth at night and not even really be aware that you do this. You may clench your jaw together in times of stress during the day and even in your sleep. Equally, if your jaw is in the wrong position the muscles which you use to move your jaw have to work harder and can get tired. This can lead to muscle spasm.

What are dental or occlusal splints?

Some people with headaches and migraine wear occlusal splints to try and reduce their teeth grinding and jaw tension in the hope of reducing their attacks. A dental or occlusal splint is a small plastic covering which fits over either your upper or lower teeth. For people who use these because of headaches or migraine, the splint is made of soft plastic and is usually worn just at night.

The splint separates your teeth which allows your jaw to find the most comfortable position and prevents common night time habits such as grinding your teeth and clenching the jaw.

How do I know if I would benefit from an occlusal splint?

There is no definite method to determine if you will benefit from wearing an occlusal splint. If any of the following apply to you then you may like to consider an occlusal splint:

  • if you know that you grind your teeth at night
  • if you wake up with a tired aching or stiff jaw
  • if you wake up with a headache or migraine
  • if you experience pain behind your eyes
  • if you experience sinus pains
  • if you experience pain in your neck and shoulders

There can of course be other reasons that you experience these symptoms and you should visit your doctor first to rule out other causes.

Where would I get an occlusal splint?

The splint needs to be measured and fitted accurately so that when you bite on it all your teeth meet at exactly the same time in a position where your muscles are relaxed. You will therefore need to visit your dentist who should be able to refer you to a specialist who deals with occlusal splints.

How much do they cost?

Dental charges vary enormously across the UK depending on whether your dentist is private or NHS. The charge for an appointment with your dentist and the splint is likely to be over £150 and may cost significantly more than this depending on the nature of your problem. The charges should be clear before you begin any dental treatment. If not, speak to your dentist or the receptionist.

Can I still take my medication and wear a splint?

There is no reason to stop medication because you are wearing an occlusal splint.

What is the evidence?

There is still relatively little research data available on the benefits or otherwise of wearing an occlusal splint for headaches and migraines.

Research funded by The Migraine Trust in 1989 examined about 40 people who experienced migraine at least twice per month and who reported that at least half of their attacks of head pain started on waking or soon afterwards. Participants recorded the details of each attack for a 10 week period before being fitted with an active occlusal splint or a placebo (which did not cover the teeth). These were worn at night for a further 10 weeks. Again the participants recorded the details of all their attacks. The results showed that the people who gained the most benefit were those who suffered from tension type headaches. For individuals who suffered from both migraine and tension type headaches it was the tension attacks which showed most reduction. For people who had migraine with aura the splints appeared to offer no reduction in attacks and those with migraine without aura there was a small reduction.

Is there anything else I can do about teeth grinding and jaw tension?

Teeth grinding and clenching your teeth in your sleep are often signs that you are feeling extra stress and so identifying and reducing your stress factors can help. Doing something to relax yourself before bedtime can reduce the tension in your muscles.

Paying more attention to your posture can also make a difference in releasing tension from tired muscles in your shoulders, neck and jaw. Try to make sure your jaw and neck are relaxed before you sleep and remember to check your posture during the day. Try to be aware if you find yourself clenching your jaw during stressful times in the day. Double check that there is a gap between your upper and lower jaw when your lips are closed.

Conclusion

Occlusal splints may be of benefit to you if you experience tension type headaches particularly if you wake up with a headache. If you think you do grind your teeth or clench your jaw when you are sleeping it might be worth visiting your dentist to discuss the options of having a splint made for you.

Useful Contacts

  • British Dental Health Foundation, Smile House, 2 East Union Street, Rugby, Warwickshire, CV22 6AJ.¬†Dental Helpline: 0845 063 1188 (local call rate in the UK). Website: www.dentalhealth.org