I get three types of headaches: migraines most frequently, sinus headaches, and occasional tension headaches.

A migraine usually comes on in the afternoon and keeps getting worse, but even if I don’t take my prescription medication I can usually sleep it off. Not taking prescription migraine meds is not a good idea though as the pain tends to cause nausea which of course makes me miserable, plus the growing pain and overall heightened sensitivity to light and sound and smell makes me squint and frown and not move as freely which adds tension which may add a tension headache on top of the migraine. Fortunately, by now I don’t get migraines often, and as long as I take medication at the onset of a migraine I am usually ok by the next day.

Sinus headaches feel red-hot behind and around my eye. I am taking two types of prescription medications which cause dry mouth which actually means dry everything: my sinuses feel like they are as dried out as a Southwest desert, so it is not stuffed sinuses which cause my headache which means that typical sinus meds don’t work. Hot and spicy food makes me sweat to the point that I have to pat the running sweat off my face every couple minutes – but I never need to blow my nose. Using a neti pot helps a bit but not enough. The one thing that does help reliably is watching a sentimental sappy movie that makes me cry and consequently blow my nose.

Tension headaches usually start in the neck and work their way around my head, causing every muscle on my head to be sore and painful. These kinds of headaches tend to stick around: where lying down in a dark and quiet (and odor-free) room works wonders for a migraine, a tension headache is not helped by either of these.

Mark’s gentle massage works best, but I feel that while I have very little control over the cause of a migraine (change in the weather, or sensory assault and sleep deprivation such as in trans-Atlantic flight) and sinus headaches, I do have the most control over preventing tension headaches: posture is big, not sitting or standing still for too long, not squinting (sunglasses!) or frowning (which unfortunately I do in order to be facially expressive when teaching – I am working on that one), avoiding general stress etc.

Now it seems I found a new source of tension headaches: dental work. In May of last year I had some crown prep work done which takes an hour and 15 minutes and requires, if it’s the last tooth in the back, a very wide open mouth with lots of force exerted into the jaw for a very long time. I probably unconsciously tried to counter that force by pushing my jaw against it, causing some nastily unhappy muscles, tendons, ligaments – whatever it is that moves the jaw. On top of the lengthy and stressful crown prep, I had a perio maintenance cleaning which also takes about an hour. I wish someone in the office had told me that having a cleaning literally = five minutes after a crown prep might be too stressful for the jaw. Of course, during the cleaning, the temporary crown popped off so there was another 15 minutes in the chair after the cleaning to reattach the temporary crown. It took seven weeks before I didn’t need painkillers anymore: it was not the tooth that was sore but the entire jaw, into the ear, both sides.

The cleaning and exam I had in September didn’t seem to aggravate things, but three weeks ago I had another cleaning and it seemed to set off another round of sore jaw => another week of Mobic, and Neurontin, which keeps the pain under control (and hopefully addresses any inflammatory things going on) and eventually allows it to subside.

Then yesterday, I had an initial consult with an orthodontist. Dr Hayden doesn’t waste time. Putting his fingers on the jaw joint (“everybody has TMJ – the J stands for joint; the disorder is called TMD”) he commanded, “Open. Close. Open. Close. Push left. Open. Close. Push right. More right. As much right as you can. Open. Close. Open as wide as you can. Close.” and so it went on and on and on. Dentists’ chairs are not the most comfortable to begin with, for the head and neck, and doing all kinds of weird things with my jaw, pulling muscles and whatever else is in there into all kinds of unusual directions, was the perfect recipe for a tension headache. It was not terrible, just terribly distracting – like someone pulling on one hair, repeatedly, at random intervals. I spent a puny night, took painkillers with breakfast, took a nap and 20 hours later was ok again.

I am normally very conscious of not clenching my teeth, and my students often hear, “Lips touching, teeth apart” when their intense focus seems to invade their jaw and mouth. For myself, I will have to keep in mind, for future dental work, that I perhaps need more time and/or definitely be very conscious of what I do with my jaw when some dentist or orthodontist has their hands in my mouth.