When children get headaches regularly it can affect their progress at school, their overall health and wellbeing, and their social development. Unfortunately, it can be difficult to figure out the cause of headaches in an active teenager who may be going through an uncommunicative stage. With pain medications often contraindicated in children, it’s even more important to find out what’s going on rather than just doling out NSAIDs day after day.
Headaches in children and teenagers can have a range of causes, some easier to spot than others. These are just a few of the things you might want to consider if your kid is missing school, practice, or social occasions with chronic headaches:
- stress, anxiety and/or depression
- hormone fluctuations
- frequent travel
- sleep disturbances
- perfume or cologne
- video games and lots of screentime
- environmental noise
- smoke exposure
- reading in dim light or excessively
- vision problems
- concussion or other head injury
- neurotransmitter imbalance
- nutritional deficiencies
- blood sugar problems
- consumption of cheese, chocolate or alcohol
- temporomandibular joint syndrome (TMJ).
Headaches and Jaw Pain in Kids
When headaches and jaw pain occur together this can offer additional clues as to the source of the problem. Clenching of the jaw at night or during the day can be triggered by stress, muscular issues, or nerve problems. There may be a dental issue such as an impacted tooth, wisdom tooth, or an infection that is causing inflammation and pain referred up into the head. Some kids have abnormal jaw development that leads to asymmetry and pressure on the discs in the jaw joint, or ligament strain and inflammation.
Kids may grind their teeth at night and while for some this can mean that a mouthguard is helpful such devices may actually make jaw pain worse in others so it’s essential to consult a dentist rather than buying a mouthguard from the store. These mouthguards can put extra strain on the joints in the jaw, as can excess gum-chewing.
Excess Strain on the TMJ
This latest study, carried out at the Child Neurology Unit and Child Development Center, Meir Medical Center, Tel Aviv University, Israel, noted that headaches in children linked to gum chewing were not a result of aspartame ingestion as previously thought, but a result of undue exertion on the temporomandibular joint (TMJ). The headaches have a mechanical cause in these cases, and so the researchers recommend that physicians ask about gum chewing in adolescents reporting daily or frequent headaches but for whom neurological exams are normal.
Quitting chewing gum could be an easy answer for pain relief for teens with headaches, but it should be noted that some teens simply switch their gum chewing to another oral fixation such as chewing pens, fingernails, or even smoking. These can all contribute to further pain and abnormal bone development and poor ligament and cartilage health so any gum cessation advice should be followed with clear information on the reasons for such guidance.
Headache Relief by Quitting Gum
The researchers in this study noted that some kids have suffered chronic headaches for years, and undergone expensive and invasive diagnostic tests to rule out a variety of causes before the realisation of the link to their gum chewing. In this study, 30 participants aged 6-19 years were assessed for gum-chewing habits and headache characteristics, along with medical and neurological history, family history of headaches, and known headache triggers.
The participants were asked to stop chewing gum for a month and 26/30 patients had at least some improvement in symptoms, with 19 no longer suffering from headaches at all. All participants were then asked to resume gum-chewing to the same degree as prior to the study. Of thoe 26 that had their headaches relieved when not chewing gum, 20 began suffering headaches again within a week of reintroducing the habit.
Even an Hour of Gum-Chewing Linked to Headaches in Children
The interesting thing about the results of this study is that the time spent chewing gum did not significantly influence the frequency of headaches. Some of the children had severe tension headaches when chewing gum for just an hour a day, while others chewed gum for more than six hours a day. Such excessive gum chewing may, however, lead to anatomical disturbances that could predispose a person to temporomandibular joint disorder, headaches, and neck pain later in life.
The recommendation from this study then, is to discontinue gum-chewing for several weeks if headaches are experienced regularly and to see if symptoms are resolved fully or partially. Reintroducing the gum after this time may prompt a return of headaches and help isolate the cause of the condition.
Nathan Watemberg, MDemail address, Manar Matar, MD, Miki Har-Gil, MD, Muhammad Mahajnah, MD., The Influence of Excessive Chewing Gum Use on Headache Frequency and Severity Among Adolescents, Pediatr Neurol. 2013;50:69-72. Abstract