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Orthodontic Treatment Failures: Migraine Headache Pain

Correction of Occlusal Damage caused by braces

Orthodontic dentistry has long been known to be the treatment of choice for correcting any number of dental issues involving tooth alignment, tooth rotations, bite alignment and slow erupting tooth structures.

In many instances, treatment plans may be developed and initiated during late childhood that can take excellent advantage of continuing developmental events until a person's adult tooth structures complete their final form.

Adults, both young and old, choose to be treated with braces to correct certain alignment problems that didn't self correct or other types of issues that arise from continually shifting teeth. Orthodontic re-treatment is a common experience with those individuals who fail to use retainers that are often recommended to thwart potential shifting.

For some patients however, orthodontic treatment can cause unexpected problems that can lead to distortions accruing to excessive adjustment.

One such patient, a young adult male who had undergone ortho treatment and the use of metal braces for 4 years, acquired an unusual distortion to the occlusal plane. Soon after the start of treatment, the patient reported having migraine headaches.

Orthodontic Treatment Gone Bad The headaches continued throughout the 4 years of orthodontist recommended treatment. Consults with his orthodontist and his physician were uneventful. Based on appearances, both the orthodontist and the patient felt treatment was progressing smoothly, in terms of aesthetics.

As in most orthodontic treatment plans, the braces and wires were adjusted as needed to assure healthy tooth movement into whatever optimal positions that were defined as being functionally correct or balanced.

During tooth movement, physical forces operate on the posterior tooth structures as upper and lower arches are slowly influenced to move into predefined positions determined by the treating doctor.

Posterior Bite Occlusal Plane Distortion At the recommendation of the patient's family physician who was treating the migraine pain, the patient was evaluated from a TMJ Pain diagnostic perspective.

Surprisingly, technical data acquired from studies of jaw movements, resting jaw positions and articulation data revealed gross distortion of the patient's posterior teeth and occlusal plane, attributed to the extended use of orthodontic braces.

The adjacent photo of one of the diagnostic models shows the unusual alignment of the posterior teeth. It is apparent these posterior teeth cannot attain normal resting nor biting and chewing relationships with the lower arch.

This type of relationship causes undue strain on the tmjoints which typically leads to excessive strain and the eventual perception of generalized headaches and migraine pain.

Migraine Headache Pain Resolution: Occlusion Adjustment

Correcting the distortions of an occlusal plane can be achieved through the use of different types of dental components ranging from new posterior crowns, gold onlays and porcelain onlays. For some patients, orthotic devices can be used.

A correction process for this type of anomoly occurs over an extended time period. Adjustments are incremental, which allow the jaw structures to achieve healthier repositioning through a natural process.

As treatment progresses, articulation data acquired after each completed step becomes factored into the amount of subsequent adjustments, until the jaw structures and tmjoints have achieved optimal resting and biting relationships. Attempts to readjust an occlusal relationship in one reconstructive treatment typically result in failure.

Editorial Staff

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