An intense migraine headache can interrupt your day, leaving you wondering what to do. While stress, bright lights, and food items are common culprits, it could be the back of your mouth that is causing your severe headache.
Third molars (wisdom teeth) often lack the space to erupt properly. These teeth, if impacted, misaligned, or infected, may irritate surrounding tissues, structures, and the jawbone. This constant irritation can cause referred pain that radiates up to the head and may be mistaken for a migraine or severe headache.
Knowing this hidden connection between teeth and mouth can be very important to obtaining lasting relief. When headache medications fail to work, there may be something amiss with your third molars. Wisdom teeth may contribute to headaches or trigger migraine symptoms in some individuals. Below, we look at the link between wisdom teeth and migraine headaches in detail.
How Wisdom Teeth Can Trigger Head and Facial Pain
If the impacted or infected third molar is causing your discomfort, the pain is not likely to be limited to the back of your mouth. Rather, many people suffer from a puzzling medical condition called referred pain caused by wisdom tooth problems. This occurs when a very painful stimulus is perceived in one spot, and the central nervous system misinterprets it as coming from another location, like the deep root of a wisdom tooth. The brain may interpret pain signals as originating from another area of distress and thus notes the discomfort in another place entirely. As a result, deep dental pressure may be felt as pain in the temples, forehead, or directly behind the eyes.
The trigeminal nerve is the human body's largest cranial nerve, primarily responsible for facial sensation, which is at the heart of this diagnostic dilemma. This essential neurological pathway carries all sensory information from the face, scalp, and teeth and regulates the motor functions needed for biting and chewing. The trigeminal nerve branches into three interconnected divisions, which supply the upper, middle, and lower parts of the face.
If a third molar is developing and it is on the edge of the dental arch, it may irritate tissues located near nerve pathways in the mandible or maxilla. This localized trauma causes dental pain via the trigeminal nerve, which rapidly travels up the nerve pathway. Because these sensory fibers share a common entryway into the brainstem, the incoming signals overwhelm the central nervous system. The pain may be perceived in nearby regions of the face and head, extending up towards the head.
This ongoing bombardment to the brain can cause the headache to feel more like a dull ache than anything else, and for those who already have chronic headaches, it can be a real dental migraine trigger. Constant stimulation of the lower trigeminal branches may result in over-stimulation of the primary headache areas of the brain. This overload of senses signals a cascade of neurochemical changes starting with inflammation of the blood vessels in the head, and may trigger headache symptoms in susceptible individuals. Knowing why pain radiates up the head from the teeth is the first step in recognizing that a debilitating headache may be dental in addition to other neurological causes.
Common Wisdom Tooth Problems That Trigger Headaches
The pain associated with third molar symptoms is a complex combination of structural and biological changes in the rear of the mouth. These oral stimuli account for the rapid transition from dental pain to intense facial and neurological pain. The common triggers include:
Impaction and Mechanical Pressure
The principal cause of dental-induced headaches is an evolutionary mismatch. Human jaw sizes may not always provide enough room for third molars. Despite the smaller jaw sizes, we have retained the same number of teeth. Third molars that are trying to come in may not have enough space, and they often get lodged under the bone or the gum line. This limited space can cause the tooth to erupt at an angle or become impacted against the roots of adjacent molars, resulting in significant discomfort.
These teeth are constantly pressing on the dental arch, which sets a chain reaction in motion that is destructive. This structural force causes the third molars to push teeth out of their normal alignment, significantly altering the bite and placing enormous stress on the jaw joint. The forces through the dental arch cause a deep structural wisdom teeth crowding pain that extends upward, culminating in persistent headache symptoms.
Infection and Pericoronitis
If the wisdom tooth does not fully emerge from the gum, it creates an area prone to bacterial accumulation. This partial eruption leaves a flap of overlapping gum tissue that remains over the tooth's crown. This tissue fold provides a natural pocket for food debris and bacteria, which may increase infection risk, so it is almost impossible to clean it with regular brushing or flossing.
Bacterial buildup can cause a localized infection called pericoronitis. It is characterized by sudden swelling, heat, and severe inflammation of the back of the mouth. As the infection progresses, the surrounding tissues may become inflamed. The body tries to protect itself by having the associated chewing muscles go into a painful, protective spasm, which is felt as sharp pain in the temple area and causes a throbbing headache in the pericoronitis area.
Cyst Formation
The other, although less common, but more severely damaging biological stimulus is an odontogenic cyst.
If the wisdom tooth is surrounded by bone, the dental follicle surrounding the developing tooth can fill with fluid and become enlarged. This growing cyst may place pressure on the surrounding structures and tissues over an extended period.
The cyst enlarges and gradually erodes the healthy jawbone without causing any symptoms, and may affect adjacent teeth and bone. This condition of progressive structural damage imposes significant and direct pressure on the interior alveolar nerve pathways. This is a continual, deep-aching pain that may be a chronic, irritating cause of ongoing facial discomfort and headache symptoms.
How Jaw Dysfunction Contributes to Wisdom Tooth Headaches
Misaligned third molars can seriously upset the balance in your mouth. Patients subconsciously change their chewing and resting patterns, putting painful pressure on the emerging tooth and biting the inside of the cheek. This subconscious compensation results in misalignment of the upper and lower teeth. This imbalance in structure causes the jaw to move down an abnormal path while chewing, talking, and performing other everyday activities, which leads to chronic joint stress.
Unnatural chewing habits can cause a great deal of mechanical stress on the temporomandibular joint (TMJ), which is the complex hinge between your jaw and the skull. The muscles of mastication, especially the strong masseter and temporalis muscles, have to work harder to cope with the imbalance in the bite. These muscle groups are constantly overexerting themselves to hold the jaw in place, which causes significant muscle fatigue, tension, and trigger points. This localized tiredness rapidly escalates to severe, limiting TMJ-related pain that radiates across the side of the face and is accompanied by masseter muscle pain.
The constant structural discomfort of shifting molars frequently follows patients into their sleep cycle. When oral irritation is localized, it may lead to sleep bruxism in some individuals while you sleep. This gnawing wisdom tooth can exert significant biting force on the face for hours at a time.
When the person wakes up, the muscles of the side of the head (temporalis) are fatigued and tender. This sustained nighttime effort results in a severe TMJ headache, which, all the time, feels like a primary headache disorder.
How to Know if Wisdom Teeth Are Causing Your Headaches
To determine if a severe headache is coming from your dental arch or your nervous system, you need to look for specific localized signs and symptoms. If you are wondering how you will know when the wisdom teeth are coming in, you need to consider the health of your gums. The areas of the mouth that are affected by the problem are almost always visible when the radiating head pain is present, and they are the ones that cause the pain. If your consistent migraines are related to dental growth, you are likely to have a unique cluster of visual, physical, and sensory symptoms.
If you are not sure whether you have a headache that is caused by dental pathology versus a regular neurological headache, keep an eye out for these indicators that you have impacted wisdom teeth:
- Visual signs — Swollen gums behind the mouth that may look deep red, inflamed, or bleed easily while you brush and floss
- Physical signs — Stiffness of the jaw or trismus (difficulty opening your mouth comfortably while eating or talking)
- Infection-related signs — Bad breath (halitosis) or the unpleasant sour taste in your mouth, which is due to trapped food debris and the action of the bacteria under the gum flap
- Sensory signs — A deep, continuous, dull structural ache deep in the back of the jaw that worsens with biting down and chewing
These local signs can progress to an acute bacterial infection if left untreated. It is common for several of these items to be present, directly increasing the irritation of the facial nerves, a symptom of an active wisdom tooth infection. If you have these oral symptoms along with pounding temple pain, it is likely that the source of your symptoms is really your third molars.
How to Differentiate Dental Headaches from Migraines
The trigeminal nerve carries information from the jaw to the pain-processing pathways, so a severe toothache can easily appear as a neurological event. However, to distinguish a dental headache from a migraine, it is important to assess the specific systemic symptoms associated with the pain. The symptoms of a true neurological migraine are a cluster of central nervous system disturbances, which, as a single event, a dental problem typically does not produce all migraine-related symptoms.
Important neurological migraine symptoms include:
- Seeing flashing lights, zig-zag lines or short, temporary visual disturbances before the pain
- Hypersensitivity to light and sound often causes a person to seek a dark, quiet room
- Severe, debilitating nausea or vomiting during the peak of the headache cycle
Identifying dental pain, on the other hand, requires the monitoring of specific dental mechanical triggers and physical patterns. Impaction or misaligned teeth can cause a tension headache that typically does not have neurological symptoms or nausea. Rather, the pain is similar to that of a structural musculoskeletal problem and typically begins as a deep, dull ache in the lower jaw or neck, and may radiate toward the temples.
Furthermore, oral physical activity is a significant factor in dental headaches. Chewing hard foods, clenching the teeth, or moving the jaw from side to side can cause severe pain. This type of headache is on one specific side of the face. It is localized in the quadrant in which the problematic tooth is located.
Sometimes patients also mistake sinus headache symptoms for toothache symptoms, especially with regard to upper wisdom teeth. The upper third molars may be located near the maxillary sinus. These teeth can become impacted or inflamed and cause pain that may feel like sinus pain, which may worsen when bending forward. When it comes to a sinus headache, however, the other symptoms are nearly always present: nasal congestion, fever, and thick nasal discharge, while a dental headache is firmly associated with movement of the jaw and localized tenderness or pain in the mouth.
Will Removing Wisdom Teeth Cure the Migraines?
Before scheduling any surgical intervention, it is necessary to undergo a detailed clinical assessment to confirm that your third molars are indeed causing your headaches. To determine whether wisdom tooth extraction for a headache will be effective, the oral tissues and impacted teeth should be evaluated. An oral surgery consultation will start with your dentist or oral surgeon using sophisticated imaging technology, like a digital panoramic X-ray or a Cone Beam Computed Tomography (CBCT) scan.
These high-resolution 3D images enable the dentist to create a detailed map of your dental anatomy. They can visualize exactly where the roots of your third molars are located in relation to the inferior alveolar nerve canal and the maxillary sinuses.
If the imaging shows that an impacted root is indeed being compressed on a nerve pathway, which compresses the adjoining bone, or if it is affecting your jaw joint, it may support a possible connection between your dental health and your head pain.
If the dental headache is due to dental pressure, overcrowding, or active infection, removal of the source of the trauma often helps relieve headache symptoms when the teeth are the source of pain. The oral surgeon removes the difficult wisdom teeth right away, allowing the underlying source of irritation that is stressing the teeth to be removed and relieving the chronic pressure from the branches of the mandibular nerve.
Furthermore, the extraction of a partially erupted tooth will prevent the presence of bacteria that cause chronic pericoronitis and the inflammation of the surrounding tissue that can trigger facial muscle spasms.
After the initial recovery period from the wisdom tooth extraction (post-surgery) period, which is about 1 to 2 weeks, the deep strain on the temporomandibular joint and the masseter muscle decreases. Without the constant sensory overload traveling up the trigeminal pathway, the frequent muscle contractions and radiating temple aches go away, and many patients experience significant improvement during recovery.
The oral surgery can be life-changing for structural pain, but it is important to have realistic expectations for the procedure. A question that is often asked is whether pulling out wisdom teeth will eliminate migraine symptoms permanently. The answer is directly related to your medical history. If your headaches are only due to referred pain from your teeth or joint strain, then the extraction will likely be enough to stop them.
However, if you have been suffering from primary chronic neurological migraines for some time and you have a genetic predisposition, this will not cure the primary or neurological migraine. What extraction does is remove a huge and increasing physical spark. You greatly reduce the burden of chronic dental inflammation and jaw tension on your trigeminal nerve in this way. This reduction in irritating stimuli can be a significant difference in the frequency, duration, and severity of your neurological migraine headaches.
Find a Dentist Near Me
A common migraine is a complex neurological issue, but an underlying dental cause could actually cause your constant headache. When impacted, misaligned, or infected, wisdom teeth exert sustained pressure on the jawbone and irritate the intricate network of the trigeminal nerves, leading to referred pain felt directly in the temples. If this is a serious structural stress, you can improve your quality of life by having it professionally removed.
If you have tried all the other medical options to alleviate chronic head pain and they have not worked, a dental evaluation may help identify the cause. Call Beach Dental Care Anaheim today at 714-995-4000 to schedule an appointment for a thorough oral examination. Contact our dental team and let us help address your pain.
