When the jaw causes a headache: the link between tension-type headache and the jaw joint
With temporomandibular disorder (TMD), it is not only the jaw that hurts; a headache that squeezes the temples and the sides of the head can come along with it. In Korea, the National Health Information Portal includes headaches, including tension-type headache, among the symptoms of TMD, and Seoul National University Hospital's medical information also treats recurrent headache linked to muscle pain in the jaw, neck and shoulders as a main symptom. However, headaches have many causes, so a headache with warning signs must be checked before the jaw.
Key facts
| Headache in TMD | Headaches, including tension-type headache, are included among the symptoms (source: KDCA National Health Information Portal) |
|---|---|
| Pattern of jaw-related headache | Recurrent headache linked to muscle pain in the jaw, head, neck and shoulders (muscle tension headache) (source: Seoul National University Hospital) |
| Features of tension-type headache | A squeezing feeling on both sides of the head, with milder pain than migraine or cluster headache (source: KDCA National Health Information Portal) |
| Exam for tension-type headache | Feeling whether the forehead, jaw, head and neck muscles are hardened helps diagnosis (source: KDCA National Health Information Portal) |
| Headaches needing an exam right away | The worst headache ever, a headache that starts after age 50, a headache with fever or neck stiffness, a headache after head trauma (source: KDCA National Health Information Portal) |
| Dental exam item | Checking for tenderness in the chewing muscles and the temple muscle (temporalis) (source: KDCA National Health Information Portal) |
How are the jaw and headaches connected?
Among the muscles used for chewing, the temporalis covers the temple in a fan shape. When this muscle stays tense for a long time from clenching or grinding, pain develops in the temple and the side of the head, and many people feel it as a headache rather than a jaw problem.
The National Health Information Portal explains that TMD consists of problems of the jaw joint itself and problems of the head and neck muscles, and that tension-type headache is included here. Seoul National University Hospital's medical information advises that the cheek or the muscles at the side of the head may ache with a tight feeling, and that neck and shoulder pain may also appear.
What are the features of a headache caused by the jaw?
Headaches related to the jaw often start at the temples or the side of the head and are felt as a squeezing sensation on both sides. The headache information on the National Health Information Portal describes tension-type headache as a headache that squeezes both sides of the head, with milder pain than migraine or cluster headache. The same material explains that in diagnosing tension-type headache, it helps to feel whether the forehead, jaw, head and neck muscles have hardened.
If the features below are present together, a link between the jaw and the headache can be suspected. The more of them overlap, the stronger the reason to have a dentist check the jaw muscles and jaw joint.
- The headache gets worse after chewing tough food or talking for a long time
- The temples feel heavy in the morning and the jaw muscles are stiff too
- Pressing the temple produces pain similar to your usual headache
- Jaw sounds or limited mouth opening come with the headache
Which headaches need care right away?
Assuming a headache is from the jaw ahead of time can cause you to miss other important causes. The National Health Information Portal advises getting an exam right away if you have headaches like those below.
If paralysis of an arm and leg on one side, slurred speech, vision changes or dizziness suddenly appear with a headache, suspect a stroke and call 119. In such cases emergency care comes before dental care. The same material stresses that even for people who usually have headaches, they should go to a hospital right away if the headache pattern changes or other symptoms suddenly appear.
- The worst headache you have ever had
- A headache that began for the first time after age 50 or that differs from your usual pattern
- A headache with fever, a stiff neck or a skin rash
- A headache that began after a head injury
- A headache that suddenly reaches its worst within 5 minutes
How is a jaw-related headache diagnosed and treated?
At the dentist, the jaw joint, the chewing muscles and the temple muscle are pressed to check whether the sore spot matches the usual headache area. The simple jaw joint exam introduced by the National Health Information Portal also includes checking for tenderness in the chewing muscles and the temporalis. If needed, signs of teeth grinding and the range of mouth opening are also looked at. Even when tenderness of the jaw muscles is confirmed, the cause of the headache is not pinned on one thing, and the possibility that another type of headache is also present is taken into account.
Treatment follows the same principles as TMD treatment. Behavioral therapy to correct habits, exercise therapy for the jaw and neck, physical therapy such as heat or electrical stimulation, and an occlusal splint worn at night come first, and if needed a muscle relaxant or painkiller is used briefly after the exam. If the headache does not decrease or its pattern changes, it is good to see a neurologist as well.
What daily habits reduce jaw-related headaches?
Check often during the day whether you are clenching your teeth, and if your teeth are touching, relax and leave a slight gap between them. If your head juts forward when looking at a computer screen for a long time, the neck and shoulder muscles tense too, so stand up now and then and correct your posture.
The National Health Information Portal lists excessive screen use and a forward head posture as contributing factors to TMD. Hard, tough foods and long gum chewing also keep the temple muscle working, so try cutting back during periods when headaches are frequent. Writing down the days you had headaches along with that day's food, sleep and stress will help find the cause at the exam.
Common myths and facts
Myth: Headaches are all a problem of the head or nerves and have nothing to do with the dentist.
The National Health Information Portal lists headaches, including tension-type headache, as a symptom of TMD and explains that tenderness of the temple muscle is checked at the exam.
Myth: Taking painkillers steadily will also solve a headache caused by the jaw.
The National Health Information Portal explains that medication for TMD is usually given together with other treatment and prescribed after an accurate diagnosis. Treatment that reduces causal habits such as clenching is also needed.
Frequently asked questions
Can I tell by myself whether a headache is caused by the jaw?
If the temple headache gets worse after chewing or clenching, and pressing the jaw muscles produces pain similar to your usual headache, it may be related to the jaw. But it is hard to judge on your own, so if the headaches keep recurring, have the cause confirmed at an exam.
If I have a headache, should I go to the dentist or the neurologist first?
For a headache with warning signs, the emergency room or a neurologist comes first. If the headache appears together with jaw pain, jaw sounds or limited mouth opening, have the jaw joint checked at the dentist, and if needed visit both departments to narrow down the cause. In either department, telling them your headache diary and the type of painkillers you take helps with the diagnosis.
Why do my headaches continue even though my brain MRI is normal?
The National Health Information Portal explains that common tension-type headache and migraine are headaches without abnormalities in brain structure. Even when brain imaging is normal, headaches from muscle tension can continue, so it is worth looking at the state of the jaw and neck muscles as well.
Will wearing an occlusal splint also reduce headaches?
An occlusal splint is a device that reduces muscle strain from grinding and clenching, so it may help if the headache comes from jaw muscle tension. The effect differs from person to person, so the dentist checks the course while looking at your headache diary.
Is it okay to massage for a headache caused by the jaw muscles?
Seoul National University Hospital's medical information advises that when the jaw muscles hurt, rest them fully and promote good circulation. You can do a light massage or a warm compress, but pressing hard may increase the pain, so it is good to be shown the intensity and method at the exam.