Aims: To evaluate the influence of an oral appliance on morning headache and orofacial pain in subjects without reported sleep-disordered breathing (SDB).

Methods: Twelve subjects aged 27.6 ± 2.1 (mean ± SE) years and suffering from frequent morning headache participated in this study. Each subject was individually fitted with a mandibular advancement appliance (MAA). The first two sleep laboratory polygraphic recording (SLPR) nights were for habituation (N1) and baseline (N2). Subjects then slept five nights without the MAA (period 1: P1), followed by eight nights with the MAA in neutral position (P2), ending with SLPR night 3 (N3). Subjects then slept five nights without the MAA (P3), followed by eight nights with the MAA in 50% advanced position (P4), ending with SLPR night 4 (N4). Finally, subjects slept 5 nights without the MAA (P5). Morning headache and orofacial pain intensity were assessed each morning with a 100-mm visual analog scale. Repeated measures ANOVAs and Friedman tests were used to evaluate treatment effects.

Results: Compared to the baseline period (P1), the use of an MAA in both neutral and advanced position was associated with a ≥ 70% reduction in morning headache and ≥ 42% reduction in orofacial pain intensity (P ≤ .001). During the washout periods (P3 and P5), morning headache and orofacial pain intensity returned to close to baseline levels. Compared to N2, both MAA positions significantly reduced (P < .05) rhythmic masticatory muscle activity (RMMA).

Conclusion: Short-term use of an MAA is associated with a significant reduction in morning headache and orofacial pain intensity. Part of this reduction may be linked to the concomitant reduction in RMMA.

J OROFAC PAIN 2011;25:240–249

AZ TMJ’S Dr. Stan Farrell is considered a top authority in the Phoenix metropolitan area for the treatment of TMJ and headache disorders. AZ TMJ focuses on non-surgical treatment options for those who suffer from morning headaches with the use of numerous custom oral appliances. As the research indicated, there was greater than 70% reduction in morning headaches and greater than 42% reduction in orofacial pain intensity with the use of an oral appliance. Dr. Farrell is Board Certified in Orofacial Pain, making him one of the best options for your care. Schedule a consultation with Dr. Farrell and get control of your morning headaches, call 480-945-3629. www.headpaininstitute.com