It is estimated that 15%  of  Canadians suffer from recurring  headaches. Some patients experience recurring headaches once a month, other individuals experience  headaches from 1 to 4  times a week. These headaches can be mild and of short duration or they can be severe and last a day or two.  Sometimes recurrent headaches can be very severe to the point of causing sensations of nausea and can even cause vomiting.  Some patients have to lie down in a dark room as their best treatment to resolve their headaches.

If you have recurring headaches you  should consult  a physician.   If the physician cannot find a cause or explain the headaches he / she will likely prescribe strong pain relievers.  The Physician will not want the patient to depend on the pain relievers for too long.  But many patients, have no other way of controlling the pain and so often will stay on pain relievers for years.  Continued use of pain relievers can be damaging to the liver and kidneys as is explained on all packages of pain relievers. Therefore it is important for patients with headaches to try this dental treatment to see if it helps their headaches so they can substantially reduce or even eliminate the need for pain relievers.

The diagram below shows a skull and the  bone of the  lower jaw called the mandible.

At the back of the lower jaw there is a vertical extension called the condyle.  On the top of the condyle is a ball or a rounded portion.  This rounded portion is the ball portion of the ball and socket area of the joint.  There is a square drawn in the middle of the sketch of the skull that is expanded into two different diagrams of the jaw joint, one on the right and one on the left.  In these 2  diagrams in the square boxes  the ear canal is to the left, then immediately to the right there is a deep depression in the base of the skull providing a socket.  The ball portion on the top of the head of the condyle fits into this socket in the base of the skull.

The square diagram on the left shows a healthy temporomandibular joint (TMJ) when the teeth are closed.   The square  diagram on the right shows a deranged temporomandibular joint when the teeth are closed.. There is an articular disk within the joint.  In the healthy joint on the left when the teeth are closed  the head of the condyle  sits on this disk.  The disk acts as a cushion between the head of the condyle of the lower jaw and the socket bone in the  base of the skull.

In the unhealthy joint on the right when the teeth are closed,  the condyle is not sitting on the disk but instead the condyle rests on the ligaments and the bone at the back and the superior aspect of the socket.

When a person opens their mouth, the condyle moves downwards and forwards. When a person with a deranged joint opens their mouth, as the condyle moves downwards and forwards, the round head of the condyle may slide or pop onto the disk.  Also ,when the patient with a deranged joint closes their teeth, at a certain point in the closure, the disk may abruptly slip off the condyle and  pop forward again.  If the round head of the condyle  pops on and off  the disk during opening and closing  it can  causes a popping or clicking noise in the jaw joint.

There are many studies in the dental literature that claim that 50% and possibly as much as 60%-70% of the population  have partially or completely deranged  joints.  Many persons with deranged joints do not suffer from any symptoms or headaches and live normal lives.

Most patients are totally unaware that they have deranged temporomandibular joints ( TMJ). Most patients are also completely unaware that they may be grinding their teeth at night when they sleep. The night time grinding, that is very common with many patients, may only occur for a short duration such as 10 minutes during their sleep. The muscle forces during grinding, squeeze the teeth together, but at the same time they squeeze  the condyle upwards in the joint.  If the joint is deranged, then the condyle does not have the cushioning effect of the disk, but rather the condyle will apply the forces of grinding and clenching onto the ligaments and  bone at the back of the socket.  This squeezing or trauma to the joint areas can cause swelling of the TMJ.

Many patients who have recurring headaches during the day, very commonly  grind and clench their teeth at night. Sometimes patients who grind their teeth at night wake up with stiff jaw muscles or possibly some tenderness in the joint or ear area.  Some patients on occasion, will also wake up with headaches.

In the vast majority of cases of night grinding or night clenching, the patient wakes up in the morning not knowing that they were clenching or grinding during the night.  However the forces applied during the clenching and grinding episode are so extreme that unknown to the patient, there is a lingering strain to the muscles as well as inflammation of the jaw joint.  Later on in the day, if the patient experiences stress or tension,  the patient’s jaw muscles may tense up slightly.  If the jaw joint and the muscles and ligaments  were traumatized  the night before by a significant episode of grinding or clenching, then the slight increases in muscle tension from stress during the day can cause pressures on the jaw joint and  the muscles, which can trigger a headache.

Night grinding is extremely common. And yet most patients are totally unaware that they occasionally or frequently night grind their teeth .  Due to this relationship of night grinding and daytime headaches, a very successful and simple  treatment for recurring headaches is to make a night guard  that is specifically designed to protect the jaw joint while sleeping.

Night Guard a very successful treatment for recurring headaches

The night guard Dr Morris uses for  patients with headaches,  is made of  a layer of clear hard denture  material,  usually 2 to 4 mm thick,  that fits over the top of the teeth of  the lower jaw.   The material spreads the upper  and lower teeth apart slightly (2-4 mm) and therefore also spreads apart the head of the condyle from  the ligaments and bone in the socket by 2 to 4 mm. The night  guard is also designed so that it brings the mandible and therefore the head of the condyle forward about 2 to 3 mm. . When the patient wears this type of  night guard,  the condyle cannot press onto the ligament and bone of the socket even if the patient  clenches or grinds  their teeth.

Use of this  night guard will eliminate or significantly reduce the muscle strains and  trauma to the jaw joint that occurs during any clenching or grinding episodes during sleep.  Patients with recurring headaches who wear this type of  night guard every night, commonly report a significant reduction in the frequency and the intensity of their headaches.  And some  patients report complete elimination of their headaches as long as they continue to wear their night guard at night.

Some patients who grind their teeth at night, find that they also clench their teeth together during the day. Although the  night guard will protect the teeth and joint at night, to attain relief of headaches , patients  must not clench their teeth during the day.  Night guards are also needed to protect the teeth and the fillings and other dental work from damage from grinding  pressures  applied during sleep.

The 2017 Fee for a night guard including the dentists fee and the laboratory fee is $460.00

Most dental insurances include night guards in their list of treatments benefits.

The night guard on the lower jaw is  comfortable to wear while sleeping.      Dr Morris will be glad to provide you with a free consultation regarding potential derangement of the TMJ and the benefits of this kind of night guard.

To my colleagues who find this page on the web The night guard appliance I am  using is a Gelb appliance invented by Dr Harold Gelb, a TMJ specialist in New York dedicated to treating headaches.  For my patients I do not remove the occlusion in the appliance and therefore it is only for night time use.