Headaches and TMJ pain treatment

April 6, 2007 by ·

Headaches and TMJ pain
I would like to discuss an issue that affects over 10,000,000 Americans: Tension and Migraine headaches.  We in the dental profession haven’t been given enough credit or is there an awareness of what we can do to help those who suffer from chronic facial pain.  I have personally helped to treat many of our patients overcome their long term headaches using the methods discribed at the end of this article.  I hope this information is helpful and that you can put it to use.
Tempromandibular Disorder (TMD), a condition that causes pain in the jaw joint, the TMJ (tempromandibular joint), and the muscles that control moving the jaw and chewing, affects an estimated 10 million Americans according to the National Institute of Dental and Craniofacial Research (NIDCR).
 
There are essentially six symptoms caused by TMD:
1) Your dentist notices that your upper and lower teeth fit together differently than they once did.
2) You have pain in your facial muscles or jaw joint when you chew.
3) Your jaw locks when you try to open your mouth, or you have limited side-to-side movement of the lower jaw.
4) The pain radiates from your jaw to you’re the temporal area of your face or neck.  This may include a previous diagnosis of migraines from your physician.
5) Your chewing muscles are stiff especially when waking up in the morning.
6) You hear the telltale snapping, clicking or popping when you chew or close your mouth.
  To be sure those symptoms are TMD and not a result of other causes, we will thoroughly examine your mouth and ask you several questions. TMD symptoms closely resemble the symptoms that cause ear and sinus infections, some headaches and facial nerve pain.  Facial pain can increase to the point of becoming a migraine if left untreated.
What can You do about it?
Treatment options:
Options for the previously mentioned symptoms include bite splint therapy, NTI therapy and/or equilibration.  All of these methods are drug free and therefore treat the causes and not just mask the symptoms.
·        Bite splints are mouthguards that snaps onto your top or bottom teeth.  The other side is completely flat which, when properly adjusted allows you to grind without damaging the teeth.  This also can help take the pressure off of the TMJ.
·        A smaller device is called the NTI.  This FDA approved device is small, but very effective and is fitted to allow only the front teeth to contact.  When only the front teeth contact the bodies ability to forceably clench is eliminated.  When clenching is reduced the muscles become relaxed, allowing the jaw joint to seat into its proper position.  Our patients usually wear the NTI device during sleep when grinding and clenching can be at its highest level.  Typically the tension headaches and migraines start to significantly reduce once the muscles are relaxed.  
Occasionally we need to fabricate a day time device to accompany the evening device for those patients who have severe migraines.  We do find about 90% success rate over 8 weeks of use even for those who have had significant pain.  These success rates are higher than medications designed to treat migraine headaches.
Once headaches are eliminated, we will typically attempt to create long term solutions for these joint and headache patients by slightly reshaping the biting surfaces of the teeth.  If the teeth are misaligned, misshapen, or if the teeth have moved as a result of missing teeth, previously crowned teeth or orthodontics there will be an attempt to bring them into harmony by Equilibration. 
At our office we have treated many patients and successfully eliminated their headaches and noisy jaw joints through this process.  If someone you know suffers from migraine or tension headaches have them contact our office for more information.

 

Filed Under: General Dentistry, Headache treatment, Oral Conditions Tagged With: , , , , , , ,

NTI headache treatment

March 14, 2007 by ·
Question:
In the May issue of the Senior Living I read the article on Chronic headache sufferers not receiving optimal treatment.  I also read your articles in the past on this topic.  You stated in past articles that headaches may be caused by your teeth.  Please explain the differences.  Thank You.     L.G.,Sterling Heights
 
Answer:
 It sounds to me like you have read these articles with keen interest and I would venture to guess that you are a chronic headache sufferer.  If you are then you are one of the millions out there looking for answers.
The article you are referring to is sponsored by the national headache foundation.  If you go their website you will notice it has links to all of the pharmaceutical companies who manufacture drugs to treat the headache, without any other treatment options listed.  Often there is a dental component responsible for headaches and this is what I want to let the public know about.   As you can see, the topic of headache management is controversial and I will be giving you my opinion and experience on how we, as dentists, successfully treat headaches.   This is quite different from what the pharmaceutical companies want you to hear.
Drugs that are developed and promoted to physicians for headache treatment are a multi-billion dollar industry.  The medications that are prescribed are basically used to treat the symptoms of the headache after the pain is experienced. Medications such as imitrex have been used to help, but only in about 50% of the cases is there resolution of the pain. I believe, and have many patients who will agree with me, that there is a better treatment available.   Typically the physicians are uninformed about the dental components to headaches.  In fact, I contacted 20 local medical offices and offered to give a lunch seminar on the dental option for treatment to migraines and none of them had an interest.  If you are sick and tired of using drugs to cover the symptoms of your headache then this treatment may be a successful option for you!
I would like to mention that migraines should be diagnosed medically.  CT scans and other tests must be performed to rule out tumors or other systemic diseases.
                Tension and migraine headaches often start by the constant clenching of the jaws, especially at night.  In fact, the tension-type headache patients without jaw disorders clench their jaws 14 times more intensely while sleeping than control subjects.  This constant clenching and grinding overworks the jaw muscles and leads to tension, sinus and ultimately migraine headaches.   Dentists who are well trained to look at the way the teeth come together can make a connection between clenching, the bite and its relationship to headaches.
 
                In my practice we use the small FDA approved dental device called the NTI to allow only contact on the front teeth during its use. This type of bite splint is different form other bite splints as it prevents the back teeth from touching and grinding.  It is by blocking the back teeth form clenching and grinding that allows the jaw muscle and joint to begin to relax.  By allowing the chewing muscles to relax the tightness in the temple area goes away which ultimately resolves the headache.
 
This treatment has been shown to be more effective than medications.
In using this device I have been able to help many patients who were having this type of chronic pain.  They inform me that their headaches have been reduced by 90%.  After the patient has been pain and headache free for a couple of weeks, we will typically adjust the bite to directly treat the problem.  A well adjusted and harmonious bite usually eliminates the desire to clench and grind.  So wearing this device isn’t usually something that is needed for a life time.
                A recent patient, who is a nurse, and has suffered with migraines, told me she hasn’t taken a pain pill since we treated her for her headache.  She had been taking multiple pain pills throughout the day over the past 10 years for the headache.  She is very happy to no longer need to rely on medications to get her through the day.   We are so sure of the positive results that we provide a money back guarantee if you aren’t completely satisfied with the results.
                For more information go to the www.HeadachePrevention.com website or call the office at (586)247-1212.  You can e-mail me directly at  DrAntolak@TheGentleDentist.com 

Filed Under: General Dentistry, Headache treatment, Mouth pain Tagged With: , , , , , ,

Sleeping Disorders and Snoring

March 12, 2007 by ·

Question: I know that as I age along with other seniors it seems as if I am more tired. My wife says I snore and have been for years. Am I tired because of the snoring or do you think because of my age?

Answer: Over 70 million Americans snore or have a sleeping disorder. It affects the energy level, memory and concentration of those who have these problems. It also affects the spouses who have to sleep with the snorer.

Snoring is caused by a partial obstruction of the windpipe by the tongue during sleep. When the tongue fully covers the windpipe during sleep the person can’t get air in their lungs and stops breathing. This is called sleep apnea and is a momentary event, but can occur throughout the night. Both of these are constant disturbances during sleep as if someone was nudging you throughout the night preventing restful sleep. About 17% of those who snore have apnea.

When there is a constant interruption in sleep and a reduction in oxygen takes place mental awareness is reduced. We can now treat these problems by using a small mouth guard type of device that is worn at night. It can be adjusted by the patient for maximum comfort. They can also remove it whenever they want. It works by keeping the lower jaw forward and therefore opens the airway during sleep. The result is the elimination of snoring and apnea. There is greater than a 90% success rate in this treatment and can be done in less than 30 minutes and in one visit to our office. 

I am certain that if you are having these snoring or even apnea problems you will have success and have a more restful night and a much happier wife. Contact us for more information at (586) 247-3500 or visit The Gentle Dentist.

Filed Under: General Dentistry, Sleeping Disorders Tagged With: , , ,