Headaches

The American Headache Society has classified headaches into three main groups. These groups are:

1. Primary headaches (the vast majority of headaches)
   1. Tension Types: a mild to moderate headache throughout the head that happens without warning
   2. Migraine Types: a stronger headache that throbs on one side and causes nausea, usually accompanied by some sort of warning sign 
   3. Cluster Types: a series of short but intensely painful headaches, especially around a single eye
2. Secondary headaches (less than 10% of cases, no further discussion)
   1. Bleeding in the brain
   2. Tumors
   3. Meningitis/Enchephalitis/Inflammation
3. Facial pain, cranial neuralgias, or other headaches

Dr. Issa's Dental Office has helped many patients with headaches and TMJ disorder for years. Some common symptoms shared by many of our patients include:

• Headaches lasted longer than an hour
• Fatigue, disorientation, loss of concentration, and anxiety
• Neck and back pain
• Limited mouth opening (less than 5cm)
• Pain/jaw locks while chewing food
• Unexplained earaches, increased ear pressure, loss of hearing in an ear for few days 
• Strange toothaches
• Worn down/chipped teeth (bruxing)
• Popping sounds or noises from the TMJ (around the top of the jaw)
• Jaw shifting to one side when you open/close your mouth 
• Blurry vision, seeing things, and discomfort in the sun/bright lights
• Depression

IF YOU HAVE ONE OR MORE OF THESE SYMPTOMS we can help you, call us at (905) 318-4724 to discuss your case

What can cause it?

Because of the nature of the joint (which include muscles, ligaments, vascular, cross nerval supply, bone, cartilages, and capsules) many varied factors can affect it. A problem can start at an early age and will continue to get worse until it becomes a disorder-- some of the office's most common cases. It can be caused by:

1. A class II malocclusion with overbite
2. Motor vehicle accident
3. Bruxism
4. Sport injuries
5. An unbalanced bite 
6. Arthritis 



The TMJ: A Unique Joint

The temporomandibular joint (TMJ) is the most unique joint in the whole body, as it is two joints in one. The two joints, one on each side of the head, are connected by the jawbone. One joint may influence the function of the other joint. Because they are fused in the midline, this means that you cannot move one joint without moving the other. The two temporomandibular joints can differ in size, shape, and even in function. It is possible to have a problem in one joint, but have the symptoms expressed in the other joint. You could also have pain that starts on one side of the head and migrates to the other side simply because of the relationship of these joints one to the other.

The second factor making this joint unique is that another structure dictates its function. This other structure is the teeth. The teeth are passive members of the upper and lower jaw, but they have a specific way they must fit together and interrelate. As far as the brain is concerned, tooth position has priority over joint position. This means that the TM joint is forced by the muscles to move so that the teeth will fit together properly. This can potentially cause a mal-alignment within the joint capsule. If this happens, the muscles are put in a compromising situation, causing them to spasm and resulting in pain. Many of the problems you may be experiencing are the result of muscle spasm, but the cause is not a muscle problem. The muscles are simply caught between two positions: the tooth position and the jaw position.

The third factor making this joint unique is that is has an articular disc located between the ball (condyle) and the socket (glenoid fossa). This disc has a muscle attached to the front of it that pulls the disc forward as the condyle moves forward in the glenoid fossa. The disc is also attached in the back by elastic connective tissue that is much like a rubber band and pulls the disc back as the condyle moves backward in the glenoid fossa. In other words, this attachment can stretch and recoil as the jaw opens and closes. Since the disc is a separate structure and may move independently of the condyle, it can be displaced, causing many issues. We call this disorder an internal derangement of the TM joint. Internal derangement of the TM joint can be a distressing syndrome of pain, limited jaw movement, clicking, popping and crepitus (a grating sound like the crumpling sound of parchment paper) in the joint.