The Possible Link Between Your Headache and Your Toothache

If you are suffering from both a headache and a toothache, it's natural to wonder if the two symptoms are related. Perhaps your toothache is triggering your headache, or perhaps the combination of your headache and toothache indicates an underlying health problem like a sinus infection or temporomandibular joint dysfunction.

Let's dive deeper into some possible headache and toothaches connections, and what this may mean for your care.

There are many culprits behind an aching tooth such as cavities, cracked teeth, or impacted wisdom teeth, to name a few. If these conditions are left untreated, a person may also develop a migraine— a throbbing, often one-sided headache that can be associated with nausea, vomiting, and/or sensitivity to light or sound.

The trigeminal nerve provides sensation to most of your face, including your upper and lower lip, teeth, and gums.

Since the trigeminal nerve is believed to play a significant role in migraine pathogenesis, it makes sense that an underlying dental condition could irritate the supplying trigeminal nerve branch and thus, trigger a migraine.

In addition to a toothache "triggering" a migraine, tooth decay or advanced gum disease can "refer" pain to the head. Referred pain means that you feel a painful sensation in a separate area of your body from the body part actually causing the pain. Again, this is due to the many nerve connections (via the trigeminal nerve) that connect the teeth and other facial structures to the brain.

It's not uncommon for a person to go see their doctor for tension-type headaches or migraines when they really are experiencing a dental problem.

One classic example of referred pain to the head (from the teeth) is bruxism, whereby people clench or grind their teeth. This often occurs at night. The headache resulting from bruxism is generally reported as a dull pain that wraps around the head or occurs behind the eyes. Sore teeth and jaw muscles, as well as clicking in the jaw joint or trouble opening and closing the mouth, is also common with this condition.

Very rarely, an untreated dental condition may cause a serious, life-threatening infection called cavernous sinus thrombosis, which causes a severe headache, often felt behind the eye or on the forehead.

In addition to a severe headache, other symptoms of cavernous sinus thrombosis include:

• High fever
• A weakness of the eye movement (from third, fourth, and/or sixth cranial nerve involvement)
• Eyelid swelling
• Eyeball protrusion (called proptosis)

There are some conditions that may cause both a headache and toothache, but are not actually related to a dental or primary headache disorder (such as migraine or tension-type headache).

A sinus infection may cause discomfort from one or several teeth, especially your upper teeth since they are located right below the maxillary sinus (located behind your cheekbones).

Other signs and symptoms of sinus infection include:

• Fever
• Fatigue
• Nasal congestion and purulent (pus-containing) discharge
• Ear pressure or fullness
• Bad breath

Temporomandibular joint (TMJ or TMD) disorder, which refers to a problem within the jaw joint (located in front of your ear) and the muscles surrounding it, is another condition that dentists commonly see, as it often cause toothaches.

Besides toothaches, TMJ often causes headaches, usually described as an aching pain that starts near the ear and moves towards the jaw, temple, or neck. These headaches are usually triggered by jaw motions, like chewing or opening and closing the mouth.

Trigeminal neuralgia is a pain disorder characterized by irritation of the trigeminal nerve. This disorder causes excruciating stabbing or shock-like facial pain that is nearly always one-sided. In many cases, the pain is felt along the upper or lower jaw, which is why people sometimes see their dentist first, believing they are suffering from an abscessed tooth.

In fact, it's not uncommon for a person to undergo one or more unnecessary root canals or tooth extractions before receiving the diagnosis of trigeminal neuralgia.

If you are suffering from a new toothache and/or headache, be sure to see your doctor. Sorting out the underlying diagnosis can be a tricky process, even for healthcare providers, so remain persistent.

For instance, if you have undergone dental procedures for toothaches and not obtained relief, it's reasonable to talk to your primary care doctor about seeing a specialist, such as a headache specialist, neurologist, or ear, nose, and throat doctor.

In the end, getting to the bottom of your tooth and/or head pain can be a tedious, challenging process. Be reassured though—once diagnosed, you can move forward with a treatment plan. That plan may be as simple as getting a cavity filled or taking an antibiotic for a sinus infection or more complex (but doable), as wearing a nightguard and practicing trigger avoidance for bruxism.