If someone suffers from migraine headaches, they may look everywhere for a cause . . . and a cure. Migraines are debilitating. They dramatically affect quality of life, daily activities, and overall health. Children and teens miss school due to these severe headaches. In the search for a treatment, some may wonder if an orthodontic treatment like braces can help with migraines.
While braces may have the potential to help a small subset of migraine sufferers, orthodontic procedures, like braces, are not a standard treatment for migraines.
However, if someone has discomfort associated with misaligned teeth, treating dental issues may help someone’s overall pain. This post reviews how dental treatments affect pain overall (including migraines). It also covers some research on when braces may help a small group of migraine sufferers. I’ll also cover a few examples of when braces may actually worsen migraine headaches.
For more information on what migraines are and how we approach them in kids and teens, see this earlier post.
How do dental problems affect pain in other parts of the body?
If someone has pain anywhere in their body (from a sore jaw to a stubbed toe), they may be more sensitive to any additional pain, including pain from a migraine headache or any other kind of headache for that matter. For example, another common type of headache is the tension headache.
Tension headaches are more directly related to muscle pain (or muscle tension). So if someone has pain in their facial muscles or at the sides of the head, then that’s more likely to contribute to these types of frequent headaches. Muscles in the head and jaw joint connect to each other. If jaw muscles are tight, tense, or in pain, it can affect the other muscles. This can certainly lead to minor headaches.
This study from the Journal of the American Dental Association found that people with pain in the mouth or face (called “orofacial pain”) are more likely to have headaches.
Migraine headaches are a bit different.
The underlying cause of migraines is more complex. It’s related both to genetics (migraine headaches run in families) and someone’s environment (what’s going on outside their body). Even though migraines are a common type of headache, they’re still not completely understood. The pain from migraines is related to both the brain and nerves themselves. It’s beyond simple muscle tension.
Usual Treatment for Migraines
Typical treatment for migraines may involve both lifestyle changes and medications. Many of these medications are prescribed by a primary care physician or a neurologist. There are different classes of medications. So, a patient and their doctor will work together to find a good fit. The goal is pain relief while limiting side effects.
Can braces help migraines?
As mentioned, someone may have dental pain, jaw pain, or facial pain due to a misaligned bite. In this case, addressing their dental problems can make them more comfortable at a baseline. Traditional braces can correct a “bad bite,” and therefore alleviate some discomfort. Theoretically, it may allow them to handle headache pain better.
However, orthodontic braces alone rarely treat chronic migraines.
(I write this based on current literature and experience. If you’ve had another experience, please share).
That being said, there are a few studies that show for a very specific subset of migraine sufferers, there may be a stronger connection between dental issues and their bad headaches. See below.
First, though, I want to emphasize the overall lack of research on this topic of dental issues and migraines. Maybe there’s not much research because there really isn’t a huge connection. Or, maybe there’s just not a lot of overlap and communication between the fields of neurology and orthodontics.
What evidence is there on migraines and orthodontics like braces?
Despite a lack of great research (so far), there are a few studies. Many show correlations, but are not definitive enough to recommend braces as a treatment for migraine headaches.
A quick note on correlation:
When we think about correlation, I often think about the example of ash trays and lung cancer. Someone might say that people who have ash trays are more likely to have lung cancer, then incorrectly conclude that ash trays cause cancer. This means we have to be cautious with these studies that showed correlation. However, just as someone noticing a connection with ash trays may investigate more to discover the real culprit, hopefully these studies lead researchers to look further as well.
Migraines and Misaligned Teeth
This study showed that women aged 20-40 who had migraines were also more likely to have a characteristic bite. Yes, it’s on adults, but we can assume that the “bad bite” began at a younger age. It only shows correlation. We cannot say that bite problems are the cause of the pain. However, this information is great first step in planning more research. And, the authors suggested that dental procedures may help with migraine headache symptoms.
Jaw Position and Migraines
This is a small study that showed that improving jaw position (in people who needed it) also improved chronic daily headaches and/or migraines. The paper covers the specific criteria and jaw measurements of people who benefited. If jaw measurements were standard part of an evaluation for headaches, this could also lead to more useful information.
Occlusal Devices and Headaches
Here, they studied the jaw in relation to medication overuse headaches and facial pain. So, while not specifically migraines, it did find a possible connection. Those who needed and used a specific “occlusal device” had improved pain. The device is different than braces or even Invisalign treatment, but it again points us in the direction of a possible relationship.
Orthodontist Perspective on Migraine Headaches
This last study I want to mention is a bit more cautionary. It surveyed a group of orthodontists about migraine headaches. It described a theoretical patient and asked a series of questions. And, it found that most orthodontists (64%) did not suggest adequate therapies to help someone with a migraine without aura.
What does this mean for someone who has migraines and wants their orthodontist to help? I think it emphasizes the point that multiple specialists can be involved in treating head pain or other chronic headaches. This can include a primary physician, a neurologist, and when necessary an orthodontist as well. Based on this small study, it makes sense for people to include a full healthcare team in addition to the orthodontist.
TMJ Issues and Migraines
This is beyond the scope of this article, but I need to mention the temporomandibular joint (TMJ). TMJ pain is often addressed by dentists. And, TMJ problems are associated with migraines in adolescents, according to this study. So, if someone has TMJ symptoms or a TMJ disorder and migraines, then it makes sense to address both issues. In other words, their treatment plan for migraines can include a dentist or other specialist who can also address the TMJ.
Unfortunately, neurologists and dentists often don’t share records (in the United States). So, for patients this may mean that the best way to find relief from both their painful headaches and temporomandibular disorders is to educate their entire healthcare team themselves.
Do braces every make headaches or migraines worse?
Again, if someone has pain, it can make them more sensitive to additional pain. So, if braces are uncomfortable, their migraines may feel exaggerated too. Thankfully, most painful symptoms from orthodontic work and traditional braces are temporary, so this can be addressed or discussed with the orthodontist.
Lifestyle Changes Due to Braces
As discussed in this earlier post, a common trigger for migraines is dehydration or skipping meals. So, if someone changes their eating and drinking habits due to braces, this could certainly be a migraine trigger. It can make the migraine headaches worse. For example, maybe they opt for softer foods without realizing that their overall intake has changed. Or, they may unintentionally lower their water intake leading to mild dehydration.
This underscores the idea that if someone’s migraines get worse (or better for that matter), it’s worth looking at any changes in their life. Their genetics don’t change, but the environment does. Maybe it’s a new schedule. A new activity or diet. Or maybe it’s braces.
Summary: Migraines are complex and the treatment is usually more than orthodontics.
This doesn’t mean braces can never help. It just means there is often more to addressing migraine pain. It also means there’s a lot more to learn about any possible connection. I encourage anyone who feels that their pain is not controlled to seek medical care. There are many evidence-based treatments available.
Maya M. Mahmood, D.O., FAAP is a board-certified pediatrician and mom. She is passionate about parents having evidence-based information to help their families be healthier.
Photo by Aubrey Davis on Unsplash