Hello,

Thanks for writing your query to us.

The trigeminal nerve innervates a portion of the scalp, the face, nose, inside the nose, lips, inside the mouth, part of the tongue, and every tooth in the mouth.

Headaches and toothaches all transmit through the trigeminal nerve, the largest sensory nerve in the head that supplies the external face, scalp, jaw, teeth and much of the intra-oral structures. Pain in one branch of the nerve has the potential to activate other branches of the nerve, and when that pain is chronic and sustained, it is more likely to trigger a sequence of events that might lead to a headache. Therefore in people who have headaches, a continuous and sustained toothache can easily trigger one of the episodic headaches such as migraine. It can also give rise to burning sensation of the nose.

Besides the close anatomical links between head, face and jaw pain, reflexive behaviours caused by pain and tension such as jaw clenching and muscle tightening can exacerbate and transfer pain.

I would advise you to consult a neurologist so that he can examine you clinically & decide regarding further course of treatment.

Also keep your blood sugar levels under control since neuropathy is more common in diabetics.

I hope I have answered your query. If you have any further query I will be happy to help you.

Take care.

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Hello,

Thanks again for writing back.

'Over the counter' medicine such as Ibuprofen (Advil) can be taken once in a while- when the pain is severe and not every day. However since you are diabetic, painkiller medicines taken for pain relief can have effect on kidney function. So be very cautious before having any pain medicines and avoid frequent use.

Moreover, I believe we need to be addressing the root cause. As you had mentioned that the dentist, ENT & neurologist could not find any cause for your pain & your CT scan was also normal, I would suggest you to visit an ophthalmologist. Diabetes can affect your eyes in various ways. An Eye problem can also associated with headache. Moreover people with diabetes are at increased risk of having an eye problem.

If all the work up comes normal and if these headaches are very frequent and bothering you, your doctor can prescribe prophylactic medications (used for chronic headaches). Those should be helpful.

Also try to find out if some activities that triggers this headache like for example a strong perfume, exposure to sunlight can trigger headache is some people. So avoiding this trigger factors can also help to decrease the frequency of headache. Keep a watch on what are the trigger factors that causes headache & avoid this trigger factors.

Your treating doctor is right, so I would advise you to keep your blood sugar levels within normal range. A high blood sugar can worsen your problem. Have strict diabetic diet & regular exercise. This will help to keep sugars within control.

I hope I have answered your query. Wish you good health.

Regards

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Hello,

Thanks for the query.

Though headache seems to be a simple problem, many a times it is one of the toughest symptoms to treat and I do understand the stress of going through test multiple times & visiting so many doctor without any relief. Let me provide you with some measures which I think should help you.

1. Managing stress is the most important as it's been the most important cause (the number one) of headache in my patients and all patients across the globe. I would suggest that you join a yoga class. This will help to decrease the intensity & frequency of headache. Yoga can decrease the stress in your life & make you feel relaxed.

2. Lack of sleep is also a cause for headache. If sleep is affected, try some breathing exercise before going to sleep. This will help you to get a peaceful undisturbed sleep.

3. If milk is a trigger factor, then stop drinking milk for few days & see if you get headache. If still you continue to get headache then milk is not responsible for your headache.

4. Strong and aromatic smell can also be one of the trigger factors. Though you did not mention it, please avoid it.

5. Check with your dentist if the new dentures are fitting well or not.

6. If you still have nasal congestion then only continue Rhinocort. Long term use of Rhinocort is not good for health. It would also be good if you can rule out sinus problems especially maxillary sinusitis. They have been well known cause of headache.
If you cannot afford another visit to a specialist, I suggest you to try steam inhalations - it helps every time!!!

7. If none of the above measures provide good relief, a brief use of small dose antidepressants can be considered. It will benefit you.

Hope this recommendations works for you too just like most of my patients. Let me know if you have other concerns.
If all your queries are answered to your satisfaction, please close this discussion and rate this service.

Regards

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