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Living with Migraine

Oral Pain and Migraine?

  • By kstout135

    Hi Everyone,

    I’m curious does anyone have migraines that they think are oral pains? I have lots of jaw and gum pain. Here’s an article I found:

    When a ‘Toothache’ is Really a Migraine
    Rutgers strives to raise global awareness of dentists trained in orofacial pain to diagnose elusive pain syndromes
    Wednesday, November 20, 2013By Jeff Tolvin
    Benoliel (right), Heir examine patient
    Photo: Jeff Tolvin
    Rafael Benoliel, right, and Gary Heir demonstrate to students how to search for a patient’s source of pain.
    When Maria, then 22, began experiencing pain, she felt it intermittently, mostly in the left upper jaw area. Thinking she had sinusitis, she visited an ear, nose and throat specialist. The ENT found no explanation for the pain. With the pain intensifying and lasting hours and sometimes days at a time, she also consulted her dentist, who suspected that faulty restorations were to blame.

    Maria, not her real name, eventually underwent four root canals, an extraction and multiple sinus explorations, and yet nearly eight years after it began, the pain had become excruciating and constant. Finally, her ENT referred her to specially trained dentists whom he had heard lecture about orofacial pain.

    “When we took her medical history, we learned that her mother and grandmother suffered from migraine headaches,” Rafael Benoliel, a professor at Rutgers School of Dental Medicine (RSDM) where he is director of the Center for Orofacial Pain and Temporomandibular Disorders. “Migraines are genetic in nature but I still wasn’t certain until we looked at the whole picture and considered everything we had observed.”

    Maria’s pain stemmed from an atypical migraine, “atypical” because of its mid-face location, rather than in the forehead region where most migraines occur. The technical diagnosis: “neurovascular orofacial pain,” generally treatable with medication. Maria was prescribed Depakote, an anti-convulsant medication often used for such pain, and remains pain-free as long as she sticks to the regimen.

    Her case is used at the dental school to explain “atypical” mid-face migraines but also to illustrate the value of interdisciplinary care, particularly when the evidence for a diagnosis and treatment plan is not clear.

    Rutgers School of Dental Medicine, which has taught orofacial pain management for 25 years, is one of only 10 dental schools in the nation with a post-graduate pain management program approved by the American Dental Association’s Commission of Dental Accreditation. It is also one of the few dental schools with an extensive undergraduate pain management program. Though not recognized as a specialty by the American Dental Association, orofacial pain management is a specialty area in several countries and emerging as one in others.

    Led by Benoliel and Gary Heir, a professor who directs the center’s division of orofacial pain, Rutgers has a central role in the global orofacial pain community’s efforts to raise awareness – among dentists, physicians and other health care providers – of the value of a multidisciplinary approach to patient care to prevent cases such as Maria’s from lingering.

    “A misdiagnosis not only may lead to inappropriate treatment and expense, it can delay reaching an accurate, timely diagnosis of conditions with potentially severe consequences,” Heir said.

    Orofacial pain is defined generally as pain felt in the face or mouth caused by disease or by various problems in the nervous system. In a report on oral health in 2000, the U.S. Surgeon General cited facial pain as a major component of trigeminal neuralgia, facial shingles, temporomandibular disorders and fibromyalgia. The report said 22 percent of U.S. adults reported some form of oral or facial pain in the previous six months.

    In a notable development, the International Headache Society last month accepted orofacial pain specialists’ recommended criteria which define certain pain caused by nerve injury in the facial area – technically referred to as painful traumatic trigeminal neuropathy.

    Benoliel, lead author of the paper outlining the recommendations, said it is valuable to provide internationally accepted terms and criteria to enhance understanding among a variety of professionals encountering similar symptoms.

    Acceptance of the recommendations is seen as another step toward increasing collaboration in health care. “Pain caused by nerve injury in the facial area might require treatment by a pain specialist, by a dentist trained in orofacial pain or by a neurologist trained in headache,” Benoliel said.

    Separately, Benoliel and Heir are serving on a task force of the International Association for the Study of Pain, which has declared October 2013-October 2014 the “Global Year Against Orofacial Pain” to expand the knowledge of orofacial pain. The association has more than 12,000 members in 94 countries.

    For the yearlong campaign, Benoliel and Heir developed background materials explaining the criteria and recommendations for treating various types of orofacial pain and pain disorders.

    Benoliel and Heir will also continue awareness-raising in a series of lectures, including at the American Academy of Orofacial Pain’s 2014 meeting where both will make presentations. Heir is an academy past president and scientific chair of the meeting. Benoliel co-edited the award-winning textbook Orofacial Pain and Headache, published in 2008, which is used extensively. He is working on a second edition.

    So, do you think this could be a migraine? I have an Emergency appointment at my Dentist on Tuesday.

    Thanks!
    Kstout135

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  • By Nancy Harris Bonk Moderator

    HI Kstout135,

    It’s entirely possible to have jaw, gum, cheek and even tooth pain during a migraine attack. We have a few articles on symptoms you wouldn’t think were associated with migraine, but are; https://migraine.com/blog/i-had-no-idea-that-was-a-symptom/.

    Or it could be something completely different. Good to hear you are going to the doctor. I hope this reaches you in time; https://migraine.com/blog/a-one-sided-headache/.

    Do let us know how you are doing,
    Nancy

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    • By Cpfarrington

      TMJ and other jaw pain can be related to migraines. I am actually in the process myself. I saw my regular dentist who did just a couple of things and disgnosed me with TMJ. I have seen her for over 20 years now so she has an extensive history for me already. She is referring me to a dentist that specializes in oral pain and Craniofacial issues. It takes a while to get into see her so I’m not sure what she will do. The first visit is also expensive, around $500. She advised me to check my medical insurance about coverage because that is what the treatment will be billed under not dental insurance.

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  • By kstout135

    Hi Nancy,

    Thank you!! I hope you are doing well. My pain was actually from using too much Optic White Whitening Products.

    Thanks!
    kstout135

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