Local Inflammation as a Mediator of Migraine and Tension-Type Headache

Objective.—To demonstrate the relationship of migraine and tension‐type headache to a localized maxillary gingival inflammation. Background.—Intraoral tenderness has been observed consistently in the most common types of primary headache disorders. The laterality and degree of tenderness is related to laterality and severity of reported symptoms, both during headache and in the interictal state. Methods.—Bilateral posterior maxillary palpation and local temperature recordings were performed during unilateral migraine and tension‐type headache. Local anti‐inflammatory techniques, ie, local chilling and a topical anti‐inflammatory gel, were used in these tender areas in episodic migraine and tension‐type headache patients. Results.—Ipsilateral intraoral tenderness and increased local temperature were consistently observed during unilateral migraine and tension‐type headache, suggesting local inflammation. Intraoral chilling and topical application of a nonsteroidal anti‐inflammatory drug were highly effective for the treatment of migraine and tension‐type headache, both in the acute phase and for headache prevention. Conclusion.—These results suggest that a local intraoral inflammation may be associated with the pathogenesis of these common headaches.