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April 30, 2019

Dr. Riosexplains in this post how a bad dental occlusion can be the cause of a constantheadache.

“Every dayI see patients who present this alteration. Many are referred from otherspecialists because they began their journey in the family doctor who referredthem to the neurologist, who in turn referred them to the neurophysiologist,from here they went to the otolaryngologist and even to the cardiologist ortraumatologist, until someone diagnosed them with Orofacial Pain Syndrome, aCosten Syndrome, a Temporomandibular Dysfunction Syndrome, a TMJ Pathology orany of the other different collars for the same dog…”.

Without gettinginto further discussions, I’ll stick with Orofacial Pain Syndrome (ODS). It isnothing more than arthritis or osteoarthritis (depending on the degree) that iscomplicated by myofascial (muscular) pain. Let’s take an easy example: if I injuremy knee, I won’t be able to walk well. In fact, I will probably overload theother leg more so as not to force my damaged joint. It also seems logical that,if I don’t walk well, my hip can suffer some displacement to adapt to my newposition, and with it also my back. In the end I will suffer contractures andpains in the back, waist and the other leg if I do not remedy the injured knee.This is something that any physiotherapist or osteopath will be able to talk tous about for a long time… And all this because of having broken the posturalbalance due to not walking properly!

Well, now it’stime to explain how the mouth joint, called the temporomandibular joint (TMJ),works. Imagine a door with its frame and two hinges.

The door, whenit closes, must fit perfectly into its frame. If it doesn’t, it can happen thatit crashes and doesn’t close, dislodging the hinges if we force it, or that itdoes the forced closing rubbing the frame and wearing it out.

So basically,this is how the ATM works, as a door with two hinges (which would be the jaw),and if closing does not fit well with its frame (the upper jaw) will cause wearon the teeth and crowding or will dislodge the joint.

Faced with thesedisorders, the joint is not completely defenseless, but has mechanisms toprotect itself. These mechanisms are diverse, but the main one is based onmuscular protection. The musculature will change and adapt to the new situationtrying to keep the joint in place, which causes an overwork muscle, responsiblefor fatigue and muscle contractures that are those that hurt. This is known asmyofascial pain.

And this iswhere the dentist comes in, who treats this problem by rehabilitating theocclusion (the fitting of the door into the frame). This can be done through orthodontics,prosthetics, selective carving or by making a discharge splint.

 As a final note, I must say that all this ismuch more complex and often requires the collaboration of other specialtiessuch as maxillofacial surgery, physiotherapy, psychiatry, speech therapy …The truth is that in the end the success of this treatment is in the teamwork.