Treating some headaches in children may be a simple matter of getting them to stop chewing gum!
A new study suggests that excessive gum chewing may be an important but under-recognised trigger for headaches in older children.
Researchers believe that excessive gum chewing causes headache not through the ingestion of aspartame from the gum, as has been previously suggested, but by putting undue exertion on the temporomandibular joint (TMJ).
For this study, 30 youngsters (25 girls)were recruited, ranging in age from 6 to 19 years, who had recurrent episodes or chronic headache and were daily gum chewers. Their headaches were classified as migrainous (60%) or tension-type (40%).
Patients filled out a questionnaire that included information on medical and neurologic history, headache characteristics, family history of headaches, and known headache triggers. Researchers divided the participants into 4 groups according to gum chewing duration: up to 1 hour a day, 1 to 3 hours a day, 3 to 6 hours a day, and more than 6 hours a day.
Study participants were asked to stop gum chewing for a month. After this discontinuation, 26 patients responded (19 had complete resolution of headaches and 7 had some improvement in headache frequency and intensity). No improvement occurred in 4 patients.
The duration of symptoms before stopping gum chewing did not play a role in the clinical response. Some children who reported full or significant improvement had experienced chronic headaches for up to 6 years.
Patients were then asked to renew their gum chewing habit to the same extent as before discontinuation. All 20 of the 26 patients who first reported complete or partial headache relief and who reintroduced gum chewing reported relapse, within a week, of headaches of similar intensity as before they discontinued the chewing habit.
Research shows common headache triggers include weather, stress, menstruation, frequent travel, sleep disturbances, perfume, and lights. Triggers in children appear similar to those in adults, although they may also be vulnerable to video games, environmental noise, exposure to smoke, and school book reading. Specific foods, such as chocolate, alcoholic drinks, and cheese, are also associated with headaches.
Headache has been shown to be associated with and be provoked by TMJ dysfunction. Chewing gum, as well as other oral habits (such as excessive nail biting and teeth grinding), imposes a mechanical burden on the joint.