Many people have insecurities when it comes to their teeth. Some opt for cosmetic dentistry to get the aesthetics they desire. Others learn to embrace their difference.

In a recent post over at Bustle, one writer told her story of coming to acceptance.

Thanks to my tiny mouth, my teeth had a tendency to crowd and overlap. I also have a crossbite, which causes the right side of my teeth to land in my cheek and create the occasional sore and scar. Two of my adult teeth even started growing in before their respective baby teeth fell out. For a 10-year-old who already had huge body image issues, this only made life more difficult. My aunt’s rude comments about how I should get my snaggle teeth pulled out didn’t do much to better the situation. And my parents, seemingly unaware of the option to help me build a better and more loving relationship with myself, encouraged me to get braces because only then could I feel happy with how I looked.

So she saw an orthodontist. The doctor recommended a two-year course of braces and plastic surgery to even out her jaw. She writes,

The body negativity of the experience, plus the promise of plenty of headaches from the braces (I already had chronic migraines at the time), really made me think twice about my priorities. I was dissatisfied with my teeth, sure, but sealing that feeling with a permanent decision felt harmful to me, and made me begin to consider other ways to go about addressing my feelings.

That kind of process of discovery and movement toward self-acceptance is important. Just as important is weighing any potential treatment against your priorities, values, and goals. And a crooked smile is not necessarily an unhealthy smile.

Yet the mention of a crossbite and migraines raises an issue that the writer seems to overlook. While it’s true that orthodontics can increase the likelihood of headaches, so can a misaligned bite.

Few people have perfectly aligned teeth. Upper and lower jaws might be different sizes, causing distortion in the bite. Some teeth may crowd and overlap. Some may be crooked. Even dental restorations such as crowns and fillings can cause bite problems.

One common problem that can arise is temporomandibular dysfunction (TMD), or dysfunction of the TM joints, a/k/a the “hinge” that lets your mouth open and close. Add habits like clenching and grinding (bruxing), and you have a recipe for more than just headaches. There can be face, neck, shoulder, and back pain. There can be chronic dizziness. Ringing in the ears.

In our office, the doctors use a process called TruDenta to make a holistic assessment, beginning with your migraine and headache history. T-scan technology lets them detect imbalances in the jaw. Range of motion analysis and muscle testing help determine trigger points that may refer pain.

This helps them understand all the factors that may be contributing to your headaches so they can make a proper diagnosis and treatment recommendations. We may use oral appliances to take pressure off the jaw joints, help the jaw line up in a neutral position or reposition the tongue to sit more forward in the mouth. We may recommend herbs, nutritional supplements or homeopathics.

As ever, the best treatment is treatment customized to each patient’s unique oral health situation and needs. Sometimes the best treatment can be no treatment at all.

But if you’re experiencing migraines, chronic headaches, or other head pain, it’s worth consulting with a good dentist well-versed in these issues. Sometimes crooked teeth or a misaligned bite are about far more than just appearance.

Image by Mikal Marquez