Migraines are a common and often debilitating neurological condition, recognized by severe headaches, light sensitivity, and nausea. Tooth pain is a less common, but distressing, symptom that can accompany these attacks. Despite seeming unusual, there is a physiological basis for this discomfort. Understanding this connection helps differentiate it from other dental issues and manage it effectively.
The Neurological Link
Migraines can cause tooth pain due to the trigeminal nerve, the largest cranial nerve, which is central to migraine pathways and facial sensation. This nerve has three main branches, providing sensory input to various parts of the face, including the eyes, forehead, cheeks, upper teeth, and lower teeth. When a migraine attack occurs, abnormal brain activity can activate or irritate pain-sensitive nerve endings associated with the trigeminal nerve.
This activation can lead to “referred pain,” where pain from one area is perceived in another. During migraines, irritation of trigeminal nerve branches in the head can cause pain signals to be misinterpreted by the brain as originating from the teeth or jaw. The second branch of the trigeminal nerve, known as the maxillary branch, provides sensation to the upper teeth and gums, making these areas susceptible to referred pain during a migraine.
Differentiating Migraine-Related Tooth Pain
Distinguishing migraine-related tooth pain from dental problems is important for appropriate treatment. Migraine-related tooth pain often presents with specific characteristics that help differentiate it. This pain is typically experienced as a throbbing sensation, often affecting the upper teeth and usually localized to one side of the face, mirroring the migraine headache. It does not usually worsen with chewing, biting, or exposure to hot or cold temperatures, common triggers for dental issues like cavities or exposed tooth roots.
In contrast, tooth pain from dental problems (such as decay, gum disease, or a cracked tooth) tends to be more localized to the affected tooth. This pain often intensifies with chewing or when consuming hot or cold foods and drinks. Dental issues may also present with additional symptoms like swelling, tenderness in the gums, or a persistent bad taste, which are not typically associated with migraine-related tooth pain.
When to Consult a Professional
Consult a dentist or doctor for persistent tooth pain, especially if its origin is unclear. If the pain is severe, makes daily activities difficult, or is accompanied by signs of dental infection (e.g., swelling, fever), seek immediate dental attention. These symptoms suggest an underlying dental issue requiring prompt attention.
If a dentist finds no obvious dental problems, but tooth pain persists with headache symptoms, consult a primary care doctor or neurologist. They can determine if the pain is migraine-related and establish a diagnosis by identifying a pattern of migraine attacks and associated symptoms. Self-diagnosis can be risky, as serious conditions like tooth infections or other neurological issues can mimic migraine-related tooth pain.
Coping with Tooth Pain During a Migraine
When tooth pain is clearly linked to a migraine, managing the migraine itself is the primary approach to alleviating the dental discomfort. Resting in a dark, quiet room can reduce overall migraine symptoms, including the referred tooth pain. Applying a cold compress to the face or jaw can also help numb the pain and reduce sensitivity in the affected area.
Over-the-counter pain relievers, such as ibuprofen or aspirin, taken at the first signs of a migraine attack, can reduce both the headache and the associated tooth pain. For some individuals, avoiding specific triggers that worsen facial pain, such as certain foods or stress, may also provide relief. Maintaining good oral hygiene with a soft-bristled toothbrush and avoiding acidic or cold foods during a migraine can also minimize irritation to sensitive teeth.