01752 364 717

Opening Hours

Monday 9.00am to 8.00pm
Tuesday 9.00am to 6.00pm
Wednesday 9.00am to 6.00pm
Thursday 9.00am to 5.00pm
Friday 9.00am to 1.00pm (admin only)

Opening times may vary due to clinic variation, staff training & holiday


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Dental Services

Glass Fibre Reinforced Bridges

Last Updated on Friday, 03 November 2017 08:32

Your teeth are valuable magda NEW

Magdalena has special interest in everStick glass fibre reinforced restorations.  The technology has been developed in Finland, where Stick Tech Ltd was founded in 1997 and a glass fibre reinforcement technology was developed by Professor Pekka Vallittu, who directs a research group focusing on fibre reinforced biomaterials at the University of Turku Institute of Dentistry.

Magdalena has been using glass fibres in her everyday practice since 2010.

Thanks to everStick glass fibre reinforced restorations your healthy tooth tissue is saved as much as possible, treatment can be provided on one visit, fibre reinforcements are as strong as metal, are aesthetically pleasing and feel natural (we are using your own teeth after all) and are suitable for anyone allergic to metals as Stick Techs fibres are metal free.

Less irreversible actions are performed on the teeth, so that other treatment options remain available.

Missing or loose teeth are a common problem for patients.  Special fibre technology allows Magdalena to save as much healthy tooth tissue as possible, as the fibre reinforcements can often be glued to the surface of the tooth without drilling.  The result is very natural. 

It is a perfect treatment for patients with gum disease.

If you suffer from gum disease, your moving teeth are very difficult to look after which compromises their wellbeing furthermore.  The good news is that they may not need to be removed or replaced with false teeth. Loose teeth can often be stabilized by splinting the teeth together with fibre reinforcement.  If you have already lost your tooth but still have it, it can be used in the restoration.

Prices start from £1500. For more information about Glass Fibre Bridges and to know whether you are suitable, please book a consultation today by calling our reception team on 01752 364717 and book in for a £80 consultation with Magdalana.

GF bridge Pic 1GF bridge Pic 2GF bridge Pic 3

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Dental Hygiene

Last Updated on Thursday, 25 May 2017 08:29

Hygiene Treatment Services

At Plymouth Dental Centre of Excellence, we treat patients individually and tailor our treatments around your needs. We have improved our Hygiene Treatment Services to give you more choice and control over what you would like and require, however if you have an queries, please don’t hesitate to contact our friendly and knowledgeable receptionists.


Classic Scale & Polishhyg 1

Estimated time: 30 minutes

Includes: Soft tissue assessment, screening for gum disease, oral hygiene assessment and advice, ultrasonic and/or handscaling, plaque and calculus removal, standard prophy polish, dietary advice

£60 Private

Inclusive on Practice Plan  


hyg 2

Classic Scale & Air-Flow Polish

Estimated time: 30 minutes   

Includes: Soft tissue assessment, screening for gum disease, oral hygiene assessment and advice, ultrasonic and/or handscaling, plaque and calculus removal, Air-Flow Polish* (if suitable), dietary advice

£75 Private     

£15 on Practice Plan


Intensive Stain Removal

hyg 3

Estimated time: 45 minutes

Includes: Full mouth ultrasonic scaling to remove calculus deposits followed by a comprehensive stain removal with the Air-Flow Polish* (If suitable).

Ideal for people who accumulate staining but don’t necessarily require bleaching treatments for an instant brightening.

£110 Private

£50 on Practice Plan

hyg 4







Advanced Hygiene Maintenance with Air-Flow Polish:hyg 5

Estimated time: 45 minutes

For: Patients who have stable periodontal disease

Includes: Soft tissue assessment, oral hygiene assessment and advice, accessing residual pockets and completing a ‘deep clean’ with the ultrasonic scaler and Air-Flow used in each pocket. This appointment can also include an annual pocket chart to reassess periodontal disease status when required.

£110 Private

£50 on Practice Plan


hyg 6Full Periodontal Treatment

Estimated time: 45-60 minutes

Includes: Detailed pocket charting, non-surgical deep ultrasonic cleaning to removed plaque and calculus from the pockets, oral hygiene advice, help stabilise periodontal disease.

Initial assessment required prior to commencing treatment for suitability and treatment planning

£600 Private

£480 on Practice Plan


Non Surgical Periodontal Treatmenthyg 7

Estimated time: 60 minutes per appointment

Includes: Detailed pocket charting, half mouth non-surgical deep ultrasonic cleaning to help stabilise periodontal disease. Usually required periodically after full periodontal treatment.

£120 Private

£96 on Practice Plan 


hyg 8


Advanced Implant Maintenance with Air-Flow

Estimated time: 45 minutes

Includes: Soft tissue assessment, screening for gum disease, oral hygiene assessment and advice, ultrasonic and/or handscaling, plaque and calculus removal, Air-Flow Polish* (If suitable) around each implant. This appointment also includes detailed pocket charting around each implant when required.

Recommended annually for most implant patients

£110 Private

£50 on Practice Plan 


EMS Air-Flow Machinehyg 9

The EMS Air-Flow machine delivers a gentle mixture air, water and micro-fine powder (either erythritol or Sodium Bicarbonate) which disrupts bacterial biofilms, removes plaque and completely removes both old and new stains caused over time by tea, coffee, wine and cigarettes. The effect is instant!

The powders are safe to use on tooth surfaces, dental crowns and bridges and all dental appliances.

It is also safe to use around dental implants and areas of periodontal disease.



*Air-Flow Polish is NOT suitable for patients who have respiratory disorders including asthma and COPD.

 Air-Flow polish Video



Sleep Apnea / Snoring

Last Updated on Tuesday, 20 December 2016 14:22

Snoring and Sleep Apnoea

Sleeping Apnoea

Often jaw problems/ TMD can be part of a more complex problem and secondary to a greater problem affecting the body. In the absence of an acute injury to the head or face, the primary cause of jaw problems is frequently an unidentified sleep breathing issue like Sleep Apnoea.

Snoring is a sound produced when the air passes through relaxed tissue in the back of the throat. Sleep Apnoea is best described as intermittent breathing or stopping breathing during sleep; Apnoea is a Greek word meaning "without breath". Sleep Apnoea is a disorder affecting hundreds of millions worldwide; those affected (adults and children alike) literally stop and start breathing all through the night. This is due to the soft tissue of the airway collapsing so severely that it totally blocks the airway and breathing ceases momentarily. This is termed an Apnoeic event. Apnoea does not allow proper restorative sleep that is essential for individual physical and mental health.

A common reason for this medical condition is poorly positioned jaws or tongue. What we eat and other environmental factors also influence Apnoea. We can have sensitivities to all sorts of different things. This can cause the soft tissues of our airways to swell and occlude the passage of air flowing through.

Dental Sleep Medicine involves the management of Obstructive Sleep Apnoea (OSA) using oral appliance therapy for adults, and orthopedic correction and development for children. This treatment is recognised by the medical community and provided by dentists trained in Dental Sleep Medicine.
The bad news is that most people don’t remember upon awakening that they had the episodes.

Symptoms Commonly Linked to Sleep Apnoea

  • Snoring /frequent night time awakenings
  • Waking up during the night to go to the bathroom
  • Excessive daytime sleepiness
  • Morning headaches
  • Heartburn and GORD (gastro-oesophageal reflux disease)
  • Depression/Anxiety
  • Irritability
  • Difficulty focusing or paying attention
  • Awakening with a jolt, gasp or cough
  • Feeling tired despite a full night of sleep
  • Needing a nap in the day
  • Most people don't notice any symptoms and have become accustomed to a chronic state of dysfunction as being "normal".

Untreated Sleep Apnoea Can Contribute to :

  • Hypertension – High blood pressure
  • Diabetes
  • Depression
  • Memory Dysfunction
  • Sexual Dysfunction
  • Cardiovascular conditions
  • Heart Attack and Stroke
  • Weight gain

In summary this is the sequence of events that occur when we stop breathing:

  1. The heart and lungs panic, sending a distress signal to the brain.
  2. The brain, in turn, floods the body with adrenalin and quickens the heartbeat.
  3. The chest heaves as its muscles try to force the body awake in order to restore airway muscle tone and allow air to pass to the lungs again.
  4. The body succeeds and for a moment the airway opens, the individual gasps to breathe, then promptly falls back asleep and repeats this sequence over and over again.
  5. This disturbed sleep does not allow proper restoration of brain and other organ function and prevents the body from eliminating toxic free radicals.

Imagine if this was happening during the years of your development:
Yes! Children suffer with TMD, airway and breathing disorders, and Sleep Apnoea

These conditions have no age boundaries, the good news is when identified and treated in childhood they can be corrected. The earlier the treatment the better the result! For your child's sake, be pro-active; have them evaluated on a regular basis starting at an early age.

mal di gola- tonsils

Tonsils and adenoids are specialized tissues that are part of the lymphatic immune system. They respond to irritants by inflaming and restricting airways. This is most likely to happen during sleep when the soft tissue at the back of the throat is most relaxed. Some studies estimate the incidence of sleep disordered breathing in children as high as 10-12%.

This is what obstructive tonsils look like when a child says ahhh...


Sleeping Apnoea

Studies show that some kids diagnosed with ADHD/ADD actually have attention problems in school because of disrupted sleep patterns that are caused by obstructive Sleep Aponea. Thus what they need is their sleep problem addressed, not stimulant medications like Adderall, Ritalin and anti-depressants.


Determining whether a child has Sleep Apnea

oxygen baby

After a thorough clinical exam and review of the child’s past and current medical history. If we find that there is most likely a breathing disorder we prescribe a sleep test (PSG) to diagnose the sleep disordered breathing. There are two kinds of PSGs: an overnight test at a sleep center that involves monitoring brain waves, muscle tension, eye movement, gasping, snoring and tracking the respiration and oxygen levels in the blood. The other test is one that the patient can take at home which with new technology allows us to monitor over 12 different channels to give us more sleep quality data than has ever been possible for an at home monitor.

  • ADHD (Attention deficit hyperactivity disorder)
  • ADD (Attention deficit disorder)
  • Learning disabilities
  • Bed wetting
  • Teeth Grinding

Boy Apnoea

What to watch for in your child

  • Abnormal sleep position with their head either off the bed or propped up with pillows
  • Loud and frequent snoring
  • Stopping breathing during the night for 10-20 seconds followed by choking, gasping, waking up
  • Sweating heavily during sleep
  • Sleeping restlessly
  • Wetting the bed
  • Having difficulty waking up even though they have slept for a sufficient time
  • Having headaches during the day particularly in the morning
  • Becoming irritable, aggressive or cranky
  • Falling asleep or daydreaming at school or at home
  • Having school related or other behavioural problems
  • Having an Attention Deficit Disorder with Hyperactivity (ADHD)
  • Learning difficulties
  • Teeth grinding

Benefits of early evaluation and treatment of TMD & Breathing Disorders

  • Healthy and functional jaw joints
  • Improved sleep and daytime attentiveness
  • Improved airway for life
  • Reduced incidence of headaches, ear aches and speech impediments
  • Effective chewing and swallowing for nutrition
  • Improved cardiovascular system
  • Pleasing facial profiles
  • Confidence and improved self esteem

Frequently Asked Questions

Last Updated on Thursday, 22 December 2016 08:09

I just have headaches, why was I referred to a TMJ & Sleep Therapy Centre?

Chronic headaches are often a symptom of undiagnosed conditions of sleep-related breathing disorders or a injury to the temporomandibular joint and surrounding structures. The doctors of TMJ & Sleep Therapy Centre’s have been able to find the primary cause and provide treatment for thousands of headache patients.


I’m confused..why is your name TMJ & Sleep Therapy Centre?

First, TMJ is the term patients are most familiar with, and it is the most common component of Craniofacial Pain. Second, both TMJ and Sleep Apnea can be successfully treated non-surgically with oral appliance therapy, and these 2 conditions are often comorbid (interrelated). Our doctors are skilled in identifying and addressing the primary problem for the best treatment direction and successful long term results.


I’ve already tried splints, what’s different about your treatment?

Unlike splints, the orthotics (Orthopaedic appliances) we use are individually designed using a peer reviewed bite registration to provide the best position and fit for healing. They are used short term (approx. 12 weeks) to provide support and protection to the joints during the rehabilitation process.


Why do I have to wear the appliances 24/7?

Rehabilitation is not limited to daytime. During the day we are upright and conscious, during sleep we are prone to unconsciousness. Additionally we have conscious daytime functions and habits, and we have unconscious night time functions and habits ; both must be addressed for optimum healing.


I’m sure I only snore, why cant I just get a appliance for snoring?

If it is truly ‘Just Snoring’ you can! But neither you nor the doctor can be certain snoring is not a symptom of Sleep Apnea without proper diagnosis. Treating a patient for snoring when it is really Sleep Apnea can have life threatening results.


I’ve used a night guard; it really wasn’t that helpful so what’s different about a sleep appliance?

A night guard is typically made to protect teeth that are being worn down due to unconscious behavior during sleep. Often that behaviour is due to a breathing problem that patient is not aware of – it makes them unconsciously move the jaw around all night to get a better airway. A sleep appliance is specifically designed to maintain an open airway.


I thought the only treatment option for sleep apnea was CPAP, can I use the oral appliance instead?

Yes, oral appliance therapy is one of the recommended treatment options for patients with a diagnosis of mild to moderate sleep apnea. The oral appliance is worn in the mouth to keep the airway/throat open during sleep by controlling the position of the tongue and lower jaw. For severe cases, oral appliances can also be used with CPAP to make it more tolerable to wear.


I thought snoring was related to age, size, why do I hear loud, snoring like noises from my little child?

Snoring is a indicator of a possible sleep apnea condition. Sleep Apnea has no boundaries for age or size. In face there is a 70% overlap between snoring and apnea in children. There are staggering number and the reason the American Association of Paediatrics ‘Practice Parameter’ states that all children should be screened for snoring. An affirmative response for snoring should be followed by a more detailed evaluation.


I have been told the only ‘real treatment’ option for a TMJ problem is surgery, is that true?

The standard of care is always to attempt non-surgical rehabilitation before invasive surgical procedures. The percentage of patients who need surgery is extremely low.


My child has started to have night terrors and is very moody, why was I referred to a TMJ & Sleep Therapy Centre?

Night terrors and mood swings in children can indicate a sleep-related breathing disorder due to improper or insufficient skeletal development resulting in insufficient airway. This can create a form of suffocation causing night terrors and moodiness. Insufficient airway and lack of oxygen has also been associated with ADHA (attention deficit hyperactivity disorder). Children with OSA are frequently misdiagnosed as having AHDA and placed on unnecessary medication.



Last Updated on Tuesday, 20 December 2016 14:36


Dentists Examining Jaw Xray 1

MLS® Laser Therapy Laser
The TMJ and Sleep Therapy centre of London promotes the technology available for the relief of pain and quicker healing…

Laser therapy aims to photo-bio-stimulate chemically damaged cells via specific wavelengths of light. When cells are chemically damaged they stimulate the pain cycle. Laser excites the kinetic energy within cells by transmitting healing stimuli known as photons. The skin absorbs these photons via a photo-chemical effect, and photo-thermal—which causes heat damage to the tissues.

Once photons reach the cells of the body, they promote a torrent of cellular activities. Laser therapy light floods the tissues with photons, energizing the damaged cells and increasing circulation to the painful area. This increases the body’s production of ATP (Adenosine-triphosphate), speeding up the healing process to reduce inflammation and repair damaged tissue.

Laser light can also elevate collagen formation substances to prevent the formation of scar tissues - a critical step in reducing long term disabling chronic myofacial pain syndromes. Patients get out of pain faster and heal at the same time.

Numerous studies show that the MLS® Laser Therapy can dramatically assist with the following and more:

  • Muscle Strains
  • Repetitive Stress injuries
  • Plantar Fasciitis
  • Rheumatoid Arthritis
  • Osteoarthritis
  • Tendinopathies
  • Carpal Tunnel Syndrome
  • Myofacial Trigger Points
  • Tennis Elbow
  • Ligament Sprains
  • Shoulder, Back & Knee Pain
  • Post-Traumatic Injury
  • Trigeminal Neuralgia
  • Fibromyalgia
  • Diabetic Neuropathy
  • Diabetic Foot Ulcers
  • Burns
  • Deep Edema / Congestion
  • Sports Injuries
  • Auto & Work Related Injuries

Girl Going Through Dental Examination

3D Imaging System and Intelligent software

TMJ & Sleep Therapy Centre of London has coupled with the UME diagnostic imaging group to provide the most state of the art diagnostic imaging. Together with our smart software it has revolutionized the treatment of TMJ and sleep medicine by enabling more accurate and timely results. 3D images of the head and neck allow us to closely analyze each patients’ structural anatomy, which is something that traditional 2D radiography just cannot do.

3-D imaging provides stunning visuals of the bones and soft tissue structures involved with the TMJ that are critical in helping the doctor analyze bone morphology, joint space and function. It also looks at the nose and sinus passages, dimensions of the lower (pharyngeal) airway. There is often congestion or inflammation in these areas, which causes restrictions and is co-incident with TMJ disorders and breathing problems.

Osteoarthritic condyle of the TMJ Healthy condyle of the TMJ Deviated septum
  • Color-coded amounts and areas highlight airway volume for quick reference.
  • Clearly defined true anatomy and treatment simulations that you can see for yourself - in the office
  • We are able to share important information about you with your other treating doctors with diagnostic information they need to consult, treat and even evaluate for surgery in some cases.
  • We are able to reach better diagnoses and treatment plan
  • We can efficiently execute orthodontic treatment planning in 3D in contrast to the limitations of conventional 2D x-rays used by the majority of clinicians

    Zahn-Medizin_Arbeitsumfeld- articulated models

Health & Nutrition

Last Updated on Tuesday, 20 December 2016 14:36

Health and Nutrition

A healthy diet is very important and it is essential to understand that every individual might need different requirements. Foods that aren’t right for you can mean you’re your body carries a lot of inflammation and can suffer the consequences. 

Supplements to consider adding to your diet may be:

  • Vitamin Supplements of B, C and D
  • Probiotics
  • Fatty acids like olive oil, flax oil, chia seed, pumpkin seeds and walnuts
  • Fish oil offers Omega 3s (Aim for a total of at least 1,000 mg of EPA + DHA combined)
  • Curcumin (a powerful natural anti-inflammatory)

Foods and drinks that are “good” for you include:

  • Fresh fruits
  • Fresh vegetable salads
  • Dark chocolate (in moderation)
  • Green tea
  • Fresh juices: carrot, celery and beet juices preferably
  • Fresh/cooked steamed vegetables
  • Meats like lean beef and poultry (white meat only)
  • Fresh fish

Processed food or anything that has been significantly altered are not good for our health. These items include: bread, cereal, instant oatmeal, pasta, crackers, granola bars, pretzels and chips.

Avoid foods that contain sugar (candy, desserts, cookies, donuts, pastries, ice cream, sugary drinks, tea, Gatorade, juice, energy drinks and fried foods. They can cause gases that settle in joints. Beware that sugars can be hidden and although the foods mentioned obviously contain sugar some other foods are not so obvious.

Recommended Reading

Dr. William Davis describes the positive outcomes of thousands of patients that he put on 'wheat free' diets.

Dr.Weston A. Price (1870-1948) embarked on a mission to discover the factors that lead to dental decay and physical degeneration that he observed with patients in his dental practice. To find answers Dr. Price traveled all over the world and studied the teeth and physiques of the isolated "primitive" peoples. Dr. Price found people with the beautiful straight teeth no decay and strong bodies as well as people with strong immune systems were those peoples in isolated groups who maintained a native diet of unprocessed whole foods. Dr. Price studied these foods closely and found them to be rich in minerals and vitamins.

Stress Control

If stress is uncontrolled, it can result in mental breakdown, nervousness, illness, teeth grinding, clenching and other parts of the body to malfunction. Today about 85% of hospitals are filled with stress-related disorders like heart attacks, strokes, stomach disorders, asthma and chronic pain. 

At the TMJ and Sleep Therapy Centre we will give you tips on how to help decrease your stress levels.


Performance Mouthware

Last Updated on Tuesday, 20 December 2016 14:34

Performance/ Power Mouthguards

Gum Guard Perspective

Quality power mouthguards are custom-fit based on the principles of TM Joint stability and neurological balance.

They mouthguards physically place an athlete’s jaw in the most optimal position, helping improve breathing and performance. They enable maximum oxygenation by increasing the size of the airway. They also help the head, neck, and shoulders to achieve a balanced and relaxed position, allowing athletes to increase upper body strength and improve balance and flexibility.

You do not have to be a gymnast or Olympic cyclist to benefit from these appliances. Even if you are an avid gym goer you can benefit from the effects of restored structural balance. 

Runner- performance mouthwearFor information on how members of the New Orleans Saints use power mouthguards to maximize their performance.
The process used to create these mouthguards is more than just a generic boil and bite technique. At the TMJ & Sleep Therapy Centre, we conduct an extensive TMJ evaluation that includes imaging of the jaws, head and neck and models of the teeth. To relax the muscles of the neck and jaw, pulsed low frequency electrical stimulation is administered. The relaxed jaw position is then measured and recorded on a jaw-tracking computer. Results are sent to a laboratory, where the customized mouthguard is created and delivered within two weeks. All our appliances are checked with Dr Patel using motor nerve reflex testing to make sure that they are working optimally before you take them home



Last Updated on Tuesday, 20 December 2016 14:28


Doctor examining girl

Its not just adults that have these issues!! Children clench and grind their teeth 50% more than adults. Baby teeth are much weaker than adult’s teeth and therefore we see faster rates of wear. 
The height of the teeth determines how much we can close our mouths. If our teeth are reduced in height then we can close further. Usually to get the teeth to meet we have to posture our Jaw back to close. When this happens we are reducing the volume of the airway making it more likely to close even further during night-time breathing when our muscles lose their tone. 
As you can imagine if a child has sleep issues and has been grinding their teeth to a point that is causing even more collapse to their airway they will be getting a reduced amount of oxygen. This has terrible effects on a child’s development. Poor concentrations, irritability, ADD/ ADHD, sinus infections, Ear problems are some symptoms these children often present with. 

boy wants to be an orthodontistCurrent treatment of pediatric Sleep Apnoea is using orthodontics to increase the size of the airway, tonsil and adenoid reduction using dietary control or removal and CPAP. One or a combination of these is used depending on the case. Side effects are usually minimal however, CPAP can sometimes flatten the face and surgery may be indicated when they are adults. 




Last Updated on Tuesday, 20 December 2016 14:24


One of the most frequently reported symptoms associated with TMJ disorders is headaches. Secondary headaches, especially tension-type headaches and migraines, are common in these people.

Research indicates that the association between headaches and TMJ disorders goes both ways. People with TMJ disorders often report having headaches and people with chronic headaches are more likely to have TMJ disorders. In several clinical studies, as many as 55% of people who sought treatment for chronic headaches had additional symptoms of a TMJ disorder.

There are many different types of headaches. They can be split into 3 classifications (The American Headache Society 2007):

  • Primary Headaches (the vast majority of headaches: Tension Type, Migraine Type, and Cluster Type headaches)
  • Secondary Headaches- Caused by symptoms of an underlying illness or disease: bleeding in the brain, a tumors, meningitis and/or encephalitis (inflammation of the tissues that surround the brain, increasing cranial pressure). These only account for less than 10% of all headaches and will not be discussed here.
  • Facial Pain, Cranial Neuralgias and other headaches.

Within these 2 classifications we can further distinguish 14 distinct categories of headache (The International Headache Society). We will discuss the types that we are most concerned with and are able to help with at the TMJ and Sleep Therapy Centre of London.

Facial Pain

Frasier and Russell first introduced facial pain also known as atypical facial pain in 1924. Nowadays it is known as Persistent Idiopathic Facial Pain (PIFP). This is pain along the Trigeminal nerve and does not fit the presentation of other cranial neuralgias. The duration of pain is usually long, lasting most of the day. The area is usually localized to one side of the face and has a deep ache. Both sexes are affected roughly equally.

Tension-type headaches (TTH)

These are the most common types of headaches and they affect around 30 to 78% of the general population at least once in their lifetime and are not gender or age specific.

Characteristically they are infrequent episodes of headache that last from 30 minutes to 7 days with pain that is "located bilaterally, characterized by a feeling of pressing or tightening, and of mild to moderate intensity." The headache may be accompanied by sensitivity to light or sound, but is not usually worsened by physical activity

They are seen in our patients that clench their teeth and present with clicking/popping, and jaw pain. Some do not notice any other symptoms than the headache itself.

Jaw issues, airway issues, or other orthopedic imbalance(s) often result in forward head posture (FHP). This puts extreme pressure on the neck itself; for every inch of FHP, the neck must carry an extra 15 lbs. This weight on the neck can cause pain and/or numbness up to the head and down the arms to the fingertips.

At the upper neck level there is an important nervous structure called the Subnucleus Caudalis which is essentially an extension of the Trigeminal Nucleus, the source of all Migraines. 
It has been documented that chronic tension type headaches can eventually lead to Migraine headaches.


Dysfunction in the structure or function of a nerve can cause pain in known as a neuralgia. There are many types and causes of neuralgia, and these influence the intensity of pain.

Cranial nerve neuralgias

cranial nerves

Cranial neuralgias cause recurrent pain in the same localized area of the head, face, or scalp. The pain may vary between episodes. Severity of pain can vary greatly. The pain may fade, but is likely to return and it often occurs along the length of the affected cranial nerve. Dr Patel is one of a small group of dentists that treat Craniofacial pain and can help with cranial nerve neuralgias.

Patients can experience the following symptoms:

  • Sharp
  • Itchy
  • Numbness
  • Muscles feel weaker
  • Excruciating pain
  • Burning
  • Shock-like
  • Triggered by light touch

The most common of all the neuralgias are the Trigeminal Neuralgias (these include Facial Neuralgias). The symptoms can be along any of the 3 branches of the Trigeminal nerve.

Other neuralgias are associated with rest of the 12 cranial nerves.


Migraine is considered a vascular headache because it is associated with changes in the size of the arteries in and outside of the brain. These vascular changes are ultimately caused by the Trigeminal Nerve/Ganglion. Migraine headaches typically last from 4-72 hours and vary in frequency. Migraine affects 3 times as many women as men. They are usually made worse by physical activity. The headache is often accompanied by vomiting or feelings of nausea and a heightened sensitivity to both light and sound.

Migraines may be experienced with or without an aura. Auras are sensory disturbances that are experienced as symptoms of a migraine before, during, or after an episode. These warning symptoms may occur anywhere from a few minutes to 24 hours before the migraine. Migraines that do not include auras are termed common migraines, and account for 70 to 80% of all migraines. 

Classic Migraines, accounting for the rest, are associated with aura. The visual changes are common in one or both eyes. 

They may occur in any combination of the following:

  • Seeing zigzag lines
  • Seeing flashing lights
  • Sensitivity to bright light
  • Blurred vision
  • Eye pain
  • Other visual hallucinations
  • Temporary blind spots

Other symptoms that may precede or accompany the migraine include:

  • Increased sweating
  • Loss of appetite
  • Nausea
  • Irritability
  • Fatigue
  • Vomiting
  • Chills
  • Increased urination
  • Swelling of the face

Cluster Headaches:

Cluster headaches occur in about 1% of the population. Cluster Headaches are characterized by severe, unilateral pain that is around the eye or along the side of the head. It typically affects males between the age of 20-40 yrs. Cluster Headache attacks last from 5 to 180 minutes and occur once every other day to up to 8 times daily.

Cluster headaches are described by the International Headache Society as "attacks" of "severe and sometimes excruciating pain around the eye or along the side of the head". These headaches are associated with nasal congestion, sweating of the face and forehead and tearing or swelling of the eye on the affected side of the head.

Most people get their first cluster headache at age 25 years, although they may experience their first attacks in their teens to early 50's, where they typically will begin to automatically reduce.

There are 2 types of cluster headache:

  • Episodic: This type is more common. There may be 2 or 3 headaches a day for about 2 months and not another headache for a year. The pattern then will repeat itself.
  • Chronic: Behaves similarly but it occurs long term.

Typically Cluster headaches occur between 9pm and 9am, and are worse during REM sleep, where Sleep Aponea is at its worst.

Furthermore, the most commonly accepted treatment for onset of cluster headaches is inhalation of medical Oxygen. It is successful treatment in over 70% of cluster headaches.

What to note about your headaches to help us diagnose. 
As we are all aware, headaches may be indicative of many different ailments. We recommend keeping a headache diary to record the following:

  • Time
  • Duration
  • Triggers

Other headaches

Although a cold is most often the culprit, sinusitis can be caused by anything that prevents the sinuses from draining. Sinus Headaches can be caused by inflammation in the mucosal linings. The inflammation is typically due to a viral, bacterial, or fungal infection or allergies. Healthy sinuses allow mucus to drain and air to circulate throughout the nasal passages. When sinuses become inflamed, these areas get blocked and mucus cannot drain. When sinuses become blocked, they provide a place for bacteria, viruses, and fungus to live and grow rapidly. 

Pain can often be caused from an area that's not where the pain is felt, called referred pain. There can be facial, eye and top of the head pain referred from the SCM (sterno-cleido mastoid muscle). Or even jaw and side of head pain referred from the Trapezius muscle.


About us

Last Updated on Thursday, 22 December 2016 08:13

The TMJ & Sleep Therapy Service is led by Dr Karina Patel BDS (Plymouth & Totnes)

Dentists Examining Jaw Xray 1
Karina graduated from Kings College London and spent 4 years in private practice in Australia focusing her special interests in Neuromuscular and Advanced cosmetic dentistry. During this spell of advanced education Karina also completed two years of intensive study with international lecturer and orthodontist Dr Derek Mahony.

Dr Patel undertook further training in the USA with TMJ & Sleep Therapy Centre International Group founder Dr Steven Olmos, to provide the latest and most successful techniques for TMJ Disorders.

Karina is the only American Trained and Accredited Dental Sleep Medicine Specialist and Craniofacial Pain Specialist in the United Kingdom.


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