PLEASE TAKE NOTE: Please mask up when coming to the office; Here is the reason why.
As a reminder: Pennsylvania Dental Association confirmed with the Pennsylvania Department of Health that the CDC's “COVID-19 Community Levels” guidance for masking in public settings does not apply to health care settings (including public areas) and that the DOH Guidance for Dental Health Care Personnel from June 2020, recommending that dentists continue to follow the CDC's recommendations for health care settings, remains in effect.
CDC's most current recommendations for health care settings (Feb. 2, 2022) recommends universal source control. Well-fitting masks are recommended for everyone in a healthcare setting. This includes waiting rooms and other "public" areas. Though CDC recommendations are not enforceable as a regulation or ruling, Pennsylvania State Board of Dentistry regulations consider a failure to follow CDC guidelines unprofessional conduct, subject to disciplinary action.
With the success of the HEADACHE NEWSLETTER’S the question came up about the location of the headache and what does that mean and aids in getting the right treatment
If the pain is around your eye:
According to Johns Hopkins Medicine, head pain in and around your eye can be a classic sign of a cluster headache. Cluster headaches get their name because these headaches tend to occur in groups or clusters, with the pain lasting up to three hours. When these groups of headaches occur, they may happen multiple times a day or days apart. Once the episode is over, you may not experience another cluster headache for weeks or even years.
According to Johns Hopkins Medicine, the pain from a cluster headache is intense and often concentrated behind one eye. It typically peaks within 10-15 minutes, and there may be eyelid drooping or swelling on the side of the eye pain. In addition, restlessness and agitation can develop, as well as sweating. You may also develop a stuffy or runny nose. Cluster headaches are one of the most painful types of headaches but also one of the rarest, with males more commonly affected by them than females.
After a cluster headache has happened, there are treatments that may help, including Sumatriptan, a prescription medication often used for migraines, and oxygen therapy. It's thought that the action Sumatriptan has on constricting blood vessels in the brain helps to alleviate the pain caused by cluster headaches, according to Johns Hopkins Medicine.
Other medications, taken regularly, may help prevent the attacks before they happen. These include corticosteroids such as Prednisone, calcium channel blockers such as Verapamil, and lithium carbonate. Prednisone is thought to help by reducing inflammation, Verapamil relaxes blood vessels, and lithium carbonate helps regulate brain chemistry.
Is the pain is in your neck?
Neck pain may not be the first thing you think about when it comes to migraines, but they are a common feature of the condition. "About 75% of people with migraines get neck pain, which is something many people don't realize," said Dr. Green.
According to Medline Plus, individuals with migraines may experience four phases during their migraine episode, each with different symptoms. The first phase is called the prodrome and can begin a day before the actual headache. Symptoms may vary, including mood swings, fluid retention, extra urination, food cravings, and uncontrollable yawning.
The aura, the headache itself, is the next phase. Not everyone experiences migraines with an aura. But if you do, you may see flashing lights or zig zags. Auras can happen right before or during a migraine headache.
Migraine headaches tend to have a gradual onset, building into severe pain that is typically throbbing on one side of the head. You may experience increased sensory sensitivity, such as increased sensitivity to lights and sounds. You may also experience increased pain with movement, nausea, and vomiting. And as Dr. Green said, you may experience neck pain. It is also possible to have these symptoms without classic head pain.
The last phase is the postdrome, which happens after the pain. A period of exhaustion and it typically lasts a day.
Some people can avoid migraines by staying away from migraine triggers, such as stress, alcohol, and certain foods, according to MedlinePlus. Also, medications such as beta-blockers, antidepressants, and anti-seizure drugs may help prevent migraines before they happen, the American Migraine Foundation advised. One is Aimovig, which the U.S. Food and Drug Administration (FDA) approved in 2018. During an active episode, analgesics such as acetaminophen (Tylenol) or ibuprofen (Motrin) and a class of medications called triptans may lessen symptoms.
If the pain is on your scalp
Most of us expect a headache to affect our scalps, heads, and necks. Unlike migraines and cluster headaches, tension headaches usually cause pain on both sides of your head, mainly your forehead, temples, the back of your head, and sometimes your neck and shoulders. The pain usually feels like pressure, said Dr. Green.
When tension headaches occur, there is often muscle tightness in these areas, which can cause discomfort, according to Medline Plus. Also, stress, depression, anxiety, and head injury may lead to tension headaches. Other common triggers include eye strain, dental issues, and sinus infections. You may try over-the-counter pain relievers for everyday tension headaches, but be sure to talk with your healthcare provider if they become chronic.
If the pain is in your sinuses
Many "sinus headaches" are actually tension headaches or migraines, the first and second most common types of headaches, respectively. In fact, a true "sinus headache" probably doesn't really exist, said Dr. Green. "Most headaches are referred to the sinus region."
Sinus infections and colds can trigger tension headaches. And tension headaches can occur with migraines, according to Medline Plus.
Also, acute sinus disease can cause headaches, said Dr. Green, often with accompanying fever and pussy discharge from your nose.
Whichever kind of headache you experience, it is important to talk with your healthcare provider if your pain becomes chronic or disabling, if headaches feel different from how they used to feel, if they come on suddenly, or if they're accompanied by a fever, confusion, stiff neck, double vision, or seizures.
As in any medical situation, if the problems persists or is constant seek the help of a medical professional.
What Exactly Is Brain Freeze and How Do I Make It Stop? The science behind brain freeze—also known as ice cream headache—and why the sudden pain can almost make you regret that triple scoop of mint chocolate chip.
Brain freeze is one of the downsides of summer. Also known as ice cream headache, cold stimulus headache, or by its hard-to-pronounce scientific name, sphenopalatine ganglion neuralgia, it's a sudden and intense kind of pain that can catch you off guard, even when you've experienced it many times before.
And while it's hardly the hours-long skull throbber a migraine or sinus headache can be, brain freeze is officially categorized as a type of headache as well, and it's listed in the International Classifications of Headache Disorders.
Brain freeze happens when a cold substance, like ice cream, is introduced behind the nose and palate," says Lauren Natbony, MD, a neurologist at the Mount Sinai Hospital in New York City. When the bundle of nerves in this part of the mouth senses something cold, they send an instant message to the brain, causing arteries and blood vessels to react. As a result, your head starts to throb.
"The pain comes on soon after something cold has touched the palate and is typically 'referred' to the forehead," says Anne MacGregor, MD, a headache specialist at the Barts and The London School of Medicine and Dentistry in the UK. The ache comes on fast, just as the cold temperature of your ice cream or drink hits those nerves. "It lasts just a few seconds but sometimes minutes," before fading away, says Dr. MacGregor.
By itself, brain freeze is harmless, and the phenomenon isn't associated with any worrisome neurological conditions. However, it is linked to migraines. "People who suffer from migraines tend to be more prone to brain freeze," says Dr. Natbony, because the same nerves in the palate are responsible for triggering both types of head pain.
How Can I Get Rid of It? Brain freeze is temporary and not exactly something serious enough to take a sick day for, so it's perfectly okay to just wait it out. But if it's super intense, or you just don't want to deal with the buzzkill, there are solutions. Dr. MacGregor suggests drinking warm (but not hot) water slowly as you sense brain freeze coming on; the warm water will mitigate the cold sensation in your palate, and your head shouldn't throb as intensely or for quite as long.
Another quick brain freeze fix is to press your tongue or the tip of your finger against the roof of your palate, which will warm up the nerves there similar to the way warm water can.
Prevent Brain Freeze Next Time You Eat or Drink:
"Of course, the easiest way to keep brain freeze from striking is to avoid consuming ice-cold food and beverages," says Dr. MacGregor. But in the summer, or on a sunny warm vacation, that's not all that realistic—or fun.
So to prevent brain freeze from happening, in the first place, eat your ice cream very slowly, especially during that initial bite or lick, so the nerves in your palate aren't overwhelmed with the cold sensation. Or try eating cold food toward the front of your mouth, which helps you avoid the sensitive nerve endings toward the back that trigger brain freeze, suggests Dr. Natbony.
If none of these solutions help, Dr. Natbony also advises that you heat your cold food to a warmer temperature before putting it in your mouth. So if you can handle a soupy, warm pint of Rocky Road ice cream, stick your bowl in the microwave for a couple of seconds before devouring it.
Until Next Time: Stay Safe, Stay Healthy and be careful out there
James A Vito, D.M.D