Hello Everyone,

I occasionally get the typical migraine headache but things have gotten much worse after a recent visit to my dentist.

A recent visit to a dentist to have a crown re-bonded seems to have triggered my episodes. My crown came off during the Christmas holiday. I tried using a temp bonding agent but it came off again after 4 days. I left it off and finally went back to the dentist on 1/20 to have it re-bonded. During this visit the dentist rechecked my bite and decided it needed to be adjusted. A quick procedure ended up lasting 45 minutes.

My gums around the crown were sore for the next 3-4 days and I was experiencing pain whenever I chewed on the crown. The headaches started on 1/21. I thought this was just a regular migraine so I took some excedrin. The pain lasted for about 2hours. I didn't think anything of it until the same headache was triggered by a single glass of alcohol on 1/23, 1/24 and 1/25. I finally wised up and laid off the booze thinking i was in the clear. I have been awoken by a CH every morning around 4:30am pacific since 1/26. I can feel a throbbing sensation in my gums around the crown during each episode. Last night I had another glass of alcohol and experienced another episode an hour later. Went to sleep around 11pm due to the pain and woke up around 2:30am feeling better. I stayed up until around 4:30am this morning at which I experienced another episode.

At this point I'm thinking there might be too much pressure on the crown and my gums but I am not entirely sure why alcohol would trigger the headache every single time??? some of the research I have done online indicates that the trigeminal nerve is very close to the area where my crown is (bottom right).

I am going to a new dentist on Friday for a second opinion. Not sure what to think about all of this...

Welcome to the board, do continue to explore the dental options, but start thinking about the possibility it might be the beginnings of a headache disorder. Many a CH'er had teeth pulled, extensive dental work done, all while actually dealing with cluster headaches! The fact that alcohol triggers an attack means CH is a possibility. If the dentist can't get a handle on it, even after all the tooth work is done, it'd be worth while to get in to see a headache specialist neurologist. Any kind of sudden head pain is worth seeing a qualified doc for, if only for your peace of mind! Hoping this is all dental related and you're near the end.

Joe

Since you have migraine and not Cluster headaches it may be the dynamics are somewhat different resulting in your response to the dental work.

While the facial nerve you noted often leads to feeling tooth pain when someone has Cluster, there is geneal agreement that tooth problems are NOT the cause of Cluster headache.

So, the your issue is out of our range of experience, I fear.

Seyi,
I can give you a professional opinion on your issue.
When crowns come off, we look at 3 main reasons-
1. The occlusion, or bite, is off causing too much pressure for the cement to hold the crown on
2. The cement fails due to technique error; ie the tooth was not dry when the crown was put on
3. The tooth is decayed to the point that the crown has nothing to hold on to

When I see patients who have symptoms such as yours, my number one suspect is your overall bite. Sounds like you may have an "alignment" issue. This is something that is very often overlooked. Nearly everyone has some sort of a bite instability, but we are able to compensate for it over time. However, when people start wearing teeth flat, breaking teeth, and even breaking crowns off, the overall system needs to be evaluated. I have several patients who are heavy clinchers and grinders who have migraine like symptoms due to over compression of their teeth. Problems go away 90% of the time when we get them in a splint to prevent the strain on the teeth. This also allows the muscles to relax and release tension from the jaws and temporal area.
Then the bite can be evaluated properly. Hope this helps