Help Keep Your Patients Mindful of What They are Eating During the Holidays

This holiday season is all about having fun and spending time with your friends and family. However, it is important that our patients be mindful of what they eat so as to not worsen their TMD pain or sleep apnea condition.

Overeating often happens during the holidays, which can lead to weight gain and worsening of sleep apnea symptoms. And, depending on what they eat, it could exasperate the pain felt in the jaw.

What is the issue?

Immediately after overeating, patients might feel abdominal discomfort, but won’t think much about it. And while they might not immediately gain 10 pounds, it can lead to the development of weight gain if patients continue to eat like that. The repeated episodes of overeating result in health consequences such as obesity, high cholesterol, joint problems and sleep apnea. Excess weight can even lead to psychosocial and emotional problems.

It is completely fine to eat those holiday foods available once a year, so don’t encourage self-deprivation. However, overdoing it should definitely be avoided. Try to inform your patients on what to eat, how to pace themselves and what to do to make up for heavier eating during the holiday season such as exercising or going on a walk.

One way of doing this is to tell your patients to put a positive spin on not eating certain foods. This might include, “I can eat that, but I choose not to because I want to eat healthfully.” This helps to minimize the feeling of being deprived of food. Some other tips include planning ahead, setting priorities for the foods patients want to eat, staying hydrated and eating mindfully. Very few bites get that maximum pleasure for people.

Whatever our patients eat this holiday season, make sure you emphasize enjoyment, moderation and perspective. And after all is said and done, recommend a nice walk or hitting up the gym in the days following.

What are some tips you can share with us for keeping our patients’ eating patterns in check this holiday season?

Chronic Migraines Worsen Jaw Pain

Headaches and migraines are bad enough, but add jaw pain on top of that and our patients are bound to be miserable. To make matters worse, frequent migraines can actually increase a patient’s risk for developing temporomandibular disorder (TMD), according to a recent study published in the Journal of Manipulative and Physiological Therapeutics. As a result, patients will not only experience migraines, but jaw pain, clicking and even difficulty with chewing.

The connection between migraines and jaw pain

In the study, researchers found that people who experience migraines on 15 or more days of the month were three times more likely to exhibit severe symptoms of TMD. Previous studies suggested there was a link between migraines and TMD, but this current study is actually the first of its kind to study migraine frequency and jaw pain severity.

Of the 84 women in their early mid-thirties that were observed, 32 had episodic migraines and 32 had no history of migraines. TMD symptoms were observed in 54 percent of the women with no history of migraines, 80 of those with episodic migraines and all of the women with chronic migraines.

This is an interesting study because we might not place enough emphasis on this link between migraines and TMD. As dentists, we need to look at all aspects of conditions. If your patients suffer from migraines, it is important to also determine if they have TMD for the best treatment options.

There’s a Deeper Connection between Migraines and Sleep Apnea

I recently received a notification about a new study published in Medscape. This new study targeted a connection between migraines and sleep apnea, which I found to be very interesting. It suggests that patients with migraines, especially chronic, are at an increased risk for sleep disturbances.

There were about 37 percent of patients with migraines that responded to the survey and were deemed “high risk” for sleep apnea. And with over 75 percent of migraine respondents with sleep apnea diagnosed by a physician, it was worthwhile to being talking to patients about this connection.

Migraines and Sleep Apnea, a Link

Dawn Buse, PhD, a director of behavioral medicine for the Montefiore Headache Center in New York City, presented new results from the Chronic Migraine Epidemiology and Outcomes (CaMEO) study at the Congress of the European Academy of Neurology (EAN) this year. Both depression and anxiety have a bidirectional relationship with migraines.  This relationship exists in sleep disorders because they can aggravate migraines, just as migraines can worsen sleep disorders.

This study had 16,763 respondents, with 12,810 providing valid data. The participants were divided into those with episodic migraines (EM) and those with chronic migraines (CM). Respondents with CM had a headache on 15 or more days in a month. There were 11,699 participants with EM and 1,111 with CM.

Chronic and Episodic Migraines

The differences between EM and CM groups were clear, though. In the CM group, it contained more women, while the EM group was significantly more likely to be employed. What was also not surprising to Dr. Buse was that the CM group was more likely to have a higher body mass index (BMI).

In followups, the risk for sleep apnea was assessed as high or low by using the Berlin Scale for Sleep Apnea. From this, 37 percent of respondents were at a high risk for sleep apnea. The risk then changes across BMI categories. For men with EM, the rates skyrocket from 11 percent those those who are underweight to 18 percent for those who are normal weight and then to 35 percent for overweight individuals and 79 percent for those that are obese.

To contrast that information, rates for women followed the same pattern, but their risks were consistently lower than those among men. In addition, sleep apnea risk for patients with CM also rose with increasing BMI. Their risk was even higher in the obese category which had 92 percent of men and 84 percent of women at higher risk for sleep apnea.

Knowing this extra information is important for the care of our patients. By understanding the connection between migraines and sleep apnea, we can continue to treat both conditions successfully.

Managing Headaches in Patients with Sleep Apnea

Have your patients ever complained about headaches? Do they suffer from sleep apnea AND experience headaches? Many times, patients with headaches will have a hard time sleeping, or attempt to go to a quiet space to sleep in order to relieve their throbbing pain. One common indicator of sleep apnea is waking up with headaches. In fact, at least 50% of people who wake up with headaches might have sleep apnea. Another common problem that can cause headaches upon waking is bruxism, or teeth grinding. So, when your patients experience headaches, what do you do?

Providing Treatment

Sleep-related headaches are a throbbing pain, which can include nausea and vomiting. As a dentist, you can help provide relief through the availability of an oral appliance. Many times, bite guards or oral appliances can help relieve aching jaw muscles caused by bruxism or misaligned jaws that might be leading to sleep apnea.

Through treatment of sleep apnea with oral appliance therapy, your patients can experience improved sleep while also resolving any pain they might be experiencing from headaches. In addition to oral appliance therapy, it is also important for patients to maintain a regular sleep schedule as well.

Let’s take charge of our patients’ health by providing proper treatment of sleep apnea and headaches. Visit my lecture page for ways to learn more.