Tooth or jaw pain may be symptoms of a headache, according to new research from the journal Neurology. Up to 10% of people with headaches also experience orofacial pain, and tooth or jaw pain may be the only headache symptom for some people.
The study included thousands of people who visited a clinic specifically for headache problems. Facial pain was associated with all types of headaches, but it was much more likely to be a symptom of rarer, severe headaches (Neurology, August 21, 2019).
"Facial pain has not been well recognized as a symptom of headache, and some people end up waiting a long time for a proper diagnosis and treatment," stated study author Arne May, MD, PhD, a professor of neurology and head of the headache clinic at the University Medical Center Hamburg-Eppendorf in Hamburg, Germany, in a press release.
Dr. May and a colleague studied almost 3,000 patients visiting the medical center with headaches not attributed to another medical condition or dental problems. In fact, many of the patients had been referred to the clinic by dentists.
About 10% of clinic patients experienced orofacial pain, the researchers found. While a percentage of people with all types of headaches experienced orofacial pain, it was far more common for some types of headaches.
Almost half of patients with paroxysmal hemicrania (PH) headaches experienced orofacial pain, and one patient had pain exclusively located in the mandible. Orofacial pain was also relatively common among patients with hemicrania continua (HC) and short-lasting unilateral neuralgiform (SUNCT) headaches.
Facial pain was less common among people with cluster headaches or migraines. Among the 2% of people with migraines who also experienced orofacial pain, many reported pain in the maxilla and teeth.
For those with cluster headaches, about half reported pain in the upper teeth, jaw, and cheek. Another one-third reported pain in the lower teeth. While pain presenting solely in the maxilla or mandible was uncommon, the beginning of a cluster headache can feel like a toothache, the authors noted.
"This study shows that facial pain is not uncommon, and for many people, their pain occurs mainly in the face, not the head," Dr. May stated. "For a better understanding of these types of facial pain and ultimately for the development of treatments, it's crucial that we understand more about facial pain and whether it is the same disease as the headache, but showing up in a different place, or whether they are two different symptoms."