Head and neck pain and discomfort can run a wide range, being a simple nag to severe radiating pain. These pains can be different from day to day, side to side, or up and down. These variations can cause much confusion for all as to where they stem from and how to fix them.
In my practice I see many head and neck and myofacial pain patients who had thought that the pain might have been migraines; sinus and or tension headaches and so on. Most of these sufferers have been seeking medical advice for many years, actually decades in most cases. Most often for a large number of them x-rays, MRI’s and CAT Scans report nothing wrong. Since there is no definitive diagnosis, there is no treatment other than medications. As a matter of fact, there is a whole industry banking and betting on these patients accepting that they are going to be miserable all their life and continue to take these meds as their only relief. It is also my observation in meeting with these patients that they feel they are not being listened to or believed by their families, friends and doctors.
Now here comes the jaw. The jaw is attached to our head by a set of intricate and complex muscles. Under certain conditions, these muscles can cause all the symptoms mentioned earlier. However a properly trained dentist can recognize this and help relieve and dissolve these pains.
To better explain the above, I will use an analogy once used by one of my mentors to describe the action:
The closing of the jaw is much like landing an airplane. When landing a plane, the pilot must control three movements, the angle or the steepness of the approach, the straightness of the approach and the evenness of right to left. So basically if the angle is too steep, the nose will damage, or if it’s too high the tail can drag and break. If the approach is not straight, meaning it’s sideways and the head is one direction and the tail is another, who knows what happens. Finally, if one side hits before another it can also cause much damage and destroy the plane. In pilot lingo these movements are called Pitch, Roll, and Yaw. Luckily there are sophisticated electronic instruments that handle all these today.
The Jaw can also have Pitch, Roll, and Yaw. As the lower jaw moves towards the upper and the teeth proximate for “landing”, the same rules apply. If the brain perceives that there are inaccuracies in the way teeth will come together, it will activate certain muscles to pull the jaw in any which way required to bring the teeth together or “land” them just perfectly. Most of us can accommodate these movements and lord knows we need to. Orthodontic research has shown us that for the past 250-300 years our teeth have not exactly come out in the correct position. Current estimates tell us that less than only 3% of us have our teeth naturally in the correct place. Our muscles and jaw joints have had to make the accommodation for our teeth to come together. Multiply this oral gymnastic by many years and you will have some very over worked and unhappy muscles. Muscles that can go into spasm and cause many of the symptoms mentioned before.
With the use of specialized technology and proper training, some dentists can accurately measure good or bad activity of major muscles that open and close the mouth. This computerized technology tracks your jaw and muscle activity at the same time. The dentist looks for a jaw position where the muscles are happiest. We can then record and capture the position using specialized materials, and from that fabricate an appliance that fits over the lower teeth. This appliance, or as we call it “orthotic”, will mimic a good bite or if you want to call it a “good landing”. This will allow muscles to stay happy and as we all know happy muscles don’t cause headaches and neck pains.
The modality of treatment described above is called “Neuromuscular Dentistry” and it is fascinating to watch and experience as it helps people have healthier lives and their well-being improve.
Hamid Nassery, DMD, FICOI, FAGD
