I’m Experiencing Migraines with Dizziness. What is TMJ Therapy? And Other TMJ/TMD Questions

• What is TMJ Therapy? How does Dr. Pilar’s treatment work?
• I have symptoms like migraines and dizziness? Am I a candidate for Dr. Pilar’s treatment?
• Is the Pilar-Type NTI safe?
• Is Dr. Pilar experienced in the fabrication of NTI orthotic device?
• How long does it take to custom make an NTI mouth orthotic?
• What is the Pilar-Type NTI made of?
• Is Dr. Pilar’s treatment covered by Medicare and other medical insurance?
• Will I need pain medication in conjunction with my mouth orthotic?
• Why Haven’t My Previous Migraine/TMJ Treatments Been Successful?
• What is the Trigeminal Nerve?
• What’s Causing My Migraine?
• Migraine Prevention… How?
• Do My Teeth Play a Role in Migraines?
• What is Tinnitus (Ringing in the Ears)?
• What is The Neuromuscular Connection?
• Why doesn't medication help with my difficulty swallowing and sore throats?
• I have severe headaches and suffer from GERD*. Is it possible the two are related?
• My migraine headaches are both chronic and severe. When they do occur, generally on at least on a monthly basis, the pain is debilitating mainly on one side …why?
• Could my frequent sinus infections be somehow related to the trigeminal nerve?
• Could trigeminal nerve issues be responsible for my blurred vision?
• Is the pain and ringing in my ears a result of jaw joint disk dislocation?
• Can a traumatic event like a car accident lead to migraine headaches?
• If TMJ is the root cause of my chronic migraines, why hasn’t anyone diagnosed it?
• Why did why my doctor prescribed mood-altering drugs to help my migraine pain?

What is TMJ Therapy? How does Dr. Pilar’s treatment work?

Dr. Pilar’s treatment involves no pills, no shots, no surgery. Treatment involves effective low frequency electrical stimulation to points along the jaw, and having the patient wear a mouth orthotic to stop painful muscle contractions.

I have symptoms like migraines and dizziness? Am I a candidate for Dr. Pilar’s treatment?

Dr. Pilar likes to speak with potential candidates personally over the phone before scheduling an office visit. This allows Dr. Pilar to ask you an initial set of questions to determine if his treatment can help your condition. If he determines that it could, an office visit is then scheduled.

Is the Pilar-Type NTI safe?

Yes, under the care of a trained practitioner like Dr. Pilar.

Is Dr. Pilar experienced in the fabrication of NTI orthotic device?

Absolutely. In fact, Dr. Pilar has custom-made over 1,000 NTI orthotic devices, with positive results for patients in nearly all cases.

How long does it take to custom make an NTI mouth orthotic?

The Pilar-Type NTI is hand-customized in great detail by Dr. Pilar himself, and usually takes an hour and a half, chairside with the patient.

What is the Pilar-Type NTI made of?

The Pilar-Type NTI is made from a clear thermoplastic material that Dr. Pilar sculpts to each patient’s own mouth. Once formed, it is hardened to provide comfort and no abrasion to teeth.

Is Dr. Pilar’s treatment covered by Medicare and other medical insurance?

Yes, it is covered by Medicare and also, in most cases, by other medical insurance.

Will I need pain medication in conjunction with my mouth orthotic?

On the contrary, the Pilar-Type NTI orthotic may alleviate your reliance on prescription and over-the-counter pain medications entirely.

Why Haven’t My Previous Migraine/TMJ Treatments Been Successful?

We believe that treating migraine/TMJ pain with narcotics or pain medications is generally ineffective and may cause more harm than good. Additionally, many patients come to us because the orthotic device made by their dentist hasn’t achieved the desired results, or the desperate patient bought a do-it-yourself night guard kit at the nearby pharmacy. Many practitioners may not want to admit it, but the truth is that treating headaches medically is often a fruitless effort. Still, many patients find it hard to believe that a dentist may be their best treatment option.

Patients should not hesitate to seek a second opinion if their current treatment, orthotic or otherwise, does not achieve the desired results. Many orthotic devices are inefficient, and some may even make the pain worse. Finding an experienced, first-rate practitioner who is properly equipped to offer both diagnosis and treatment is the most critical step in overcoming your migraine/TMJ pain.

If you are a headache sufferer, there is an overwhelming probability that TMJ or some related joint disorder is responsible for your pain. The simple truth is that most medical doctors lack the necessary dental schooling to diagnose and treat TMJ-related issues. This may explain why so many medical professionals are cynical about dental TMJ treatments. Don’t let this type of unfounded skepticism keep you from finding relief. For years, dental professionals have been treating migraine/TMJ pain with a remarkable level of success; even more so now with the advances made in treatment of TMJ pain in the past ten years, and with a new breed of dentists limiting their practice to the treatment of TMD. The average dentist recognizes no more than four TMD cases a year. A TMJ/TMD specialist like Dr. Mike Pilar sees more than two hundred new cases per year.

What is the Trigeminal Nerve?

If you suffer from migraine/TMJ pain, the trigeminal nerve is almost certainly the root cause of your discomfort. In fact, migraine can be defined as a disease of the trigeminal nerve. The trigeminal nerve is a highly complex nerve that is responsible for nearly half of the brain’s processing workload, including facial function and sensation. It is also linked to three nearby nerves (vagus, hypoglossal, and facial) that are responsible for function and sensation in the throat, neck, and head. To make matters worse for migraine/TMJ sufferers, disruption to one of these four nerves often leads to problems with the others.

What’s Causing My Migraine?

Unhealthy jaw function, stemming from abnormal muscular activity and excessive compression, has been widely identified as a potential cause for migraine headaches. The old perception that migraines stem from vascular issues rather than muscular issues no longer holds water. The trigeminal nerve and temporalis muscle are prominent players in this equation, yet despite the implicative indications of neurological research, many doctors and dentists fail to make the connection because they aren’t trained to do so.

The truth is that chronic headaches are muscle-related. Your muscles are constantly contracting, sometimes to the point of dysfunction. This leads to problems in the surrounding joints. Then your joint problems, in turn, lead to more muscle dysfunction as the muscles try to help the ailing joint. When it comes to headaches, the culprit muscles are generally those found in and around the jaw. Excessive contraction of these muscles can cause dysfunction in your nervous system, which leads to more unhealthy muscle contraction. It’s a dangerous cycle that results in the painful and often debilitating symptoms that accompany migraine headaches.

Migraine Prevention… How?

The Pilar-Type NTI is an orthotic device that alleviates migraine pain by cutting down on trigeminally innervated muscle movement. Besides, a NTI-tss type device is the only Food and Drug Administration (FDA) cleared non-drug, non-surgical method of migraine prevention. The familiar horseshoe clear shaped plastic night-guard made by most dentists that attempt to treat TMD with migraines is not the orthotic of choice for migraines, and often can make the condition worse.

Do My Teeth Play a Role in Migraines?

It’s also worth noting that your teeth can play a major role in migraine headaches. What many people don’t know is that your teeth are not supposed to touch with any pressure. Not when you sleep. Not when you eat. Not when you speak. When your teeth touch, your masseter and temporalis muscles contract. Further, even moderate clenching activity in the presence of a “bad bite” can damage the muscles and lead to problems with nervous system function including exhaustion, depression, and migraine headaches.

Orthodontic care (braces) where an incomplete post-orthodontic treatment has left an imbalance in upper and lower tooth contact can lead to temporomadibular joint clicking/dysfunction and muscle hyperactivity leading to migraine.

What is Tinnitus (Ringing in the Ears)?

Tinnitus refers to a condition in which the patient regularly hears a sound, such as a ringing or buzzing in their ears. It is a serious disorder that can lead to mental instability. Tinnitus may be caused by overexertion of the tensor levi-palatini and tensor tympani muscles. These muscles, linked to the trigeminal nerve just like the rest of the mastication muscles, are active when the jaw is clenched. When healthy and functioning properly, they serve to regulate pressure and vibration inside the ears.

Potential signs of tinnitus include muscle sensitivity around the mastication muscles, TMJ pain, noises coming from the jaw, ear pain, jaw pain, neck pain, congestion in the ears, vertigo, worn teeth, and grinding/clenching of the teeth. Tinnitus patients may experience a variety of additional symptoms, including migraines, blurred vision, sore throat, and ear issues including hearing deficiencies. While there are still a lot of unknowns when it comes to tinnitus, it may be a symptom of a variety of serious middle ear diseases, including chronic otitis media and osteosclerosis. In fact, a systematic medical evaluation should be performed before a patient seeks a TMJ/TMD specialist for evaluation.

What is The Neuromuscular Connection?

The Neuromuscular Connection is an improper muscle function throughout the head, face, and neck, can cause a variety of painful symptoms, such as:

• Auto accidents or any other sort of neck trauma can often lead to headaches, ranging from mild to severe. These headaches can stem from disc issues or fractures, but could just as easily result from excessive muscle tension brought on by the traumatic event. It should be noted that these problems don’t always manifest immediately. Rather, they can sometimes take months and even years to make their presence known.
• Excessive jaw compression (clenching) can lead to unhealthy contact of the teeth. This can cause enough strain on the neck muscles that serious headaches may result, running from back of the neck up through the patient’s skull. Exacerbating the problem may be an increase in blood flow to the vessels found in the back of your neck, thanks to a circulation shift in the external carotid.
• Ocular migraines can occur due to excessive stress on the sphenomandibularis, a small muscle that can be found behind the eye. This explains why your eye doctor may have been unable to cure your headaches with glasses or contacts – because the problem may not be the eye, but rather the adjacent muscles, all part of the TMJ/TMD syndrome.
• Sinus headaches are often a direct result of dysfunctional muscles around the jaw, specifically the lateral pterygoid muscle. This muscle connects the nasal passages to the upper part of the jaw. When functioning improperly, the lateral pterygoid causes nasal/sinus pressure and pain. The tricky part for the patient is that a sinus doctor likely won’t know to consider muscle strain as a possible cause for these sinus headaches. Patients are often prescribed drugs that mask the pain at best, and sometimes are ineffective altogether. Again, another sign that health professionals are missing the proper diagnosis of TMD.

Why doesn't medication help with my difficulty swallowing and sore throats?

These could certainly be TMJ-related issues, stemming from improper function of the facial or trigeminal nerve.

I have severe headaches and suffer from GERD*. Is it possible the two are related?

Absolutely. The aforementioned nerves allow you to chew and swallow properly. If they aren’t functioning correctly, it’s a distinct possibility that your digestive system will not be able to function correctly either.

Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.

My migraine headaches are both chronic and severe. When they do occur, generally on at least on a monthly basis, the pain is debilitating mainly on one side …why?

There’s a pretty strong chance you’ve got TMJ compression and disk dislocation usually more painful on one side. That means your jaw has been functioning improperly for quite a while, and now the disk that is responsible for joint protection has eroded, allowing your jaw joint friction that is dangerously close to your brain. Every time you speak, chew, or undergo any other facial action, it’s like a percussion instrument playing repeatedly on the bottom of your brain.

It’s possible, if not likely, that you’ve already undergone a simple TMJ exam, or it’s possible that you show no TMJ symptoms at all. Patients who suffer from this particular problem have undergone a gradual debilitation, so there probably wasn’t a sudden spike in their pain that would have prompted the body to recognize the problem early on. But if you’re suffering from TMJ compression and disk dislocation, an extensive TMD exam that may include a transcranial x-ray, a 3T MRI or a CT scan, that will show evidence of the joint damage and, if read properly, will uncover a link between that joint damage and your migraine pain. The migraines may well exist concurrently with other TMD symptom complaints like sinus congestion, throat sensitivity, jaw, neck, shoulder pain, and ear problems involving dizziness, imbalance, and lightheadedness.

Could my frequent sinus infections be somehow related to the trigeminal nerve?

In a word, yes. The trigeminal nerve is linked to the sinuses, so trigeminal nerve dysfunction is definitely capable of causing serious sinus problems.

Could trigeminal nerve issues be responsible for my blurred vision?

Yes, but maybe not in the way you’re thinking. It’s possible that your problem is not with your eyes at all, but rather an irritated maxillary/ophthalmic division, likely brought on by trigeminal nerve dysfunction.

Is the pain and ringing in my ears a result of jaw joint disk dislocation?

It’s definitely possible. That jaw joint that rests right next to your brain is also adjacent to your ears. That means that if your protective disk isn’t present and functional, that percussion instrument that’s playing on the bottom of your brain could also be playing on your ears.

Can a traumatic event like a car accident lead to migraine headaches?

Absolutely. And what’s more, migraines stemming from an accident may take years to present themselves, often fooling the patient into thinking the two are unrelated. It all goes back to that protective disk. The degeneration of the disk is often a gradual process, but once it is gone and the brain tissue loses its layer of protection from the jaw joint, it’s certainly possible that the result will be painful migraine headaches.

If TMJ is the root cause of my chronic migraines, why hasn’t anyone diagnosed it?

That’s a very good question, because your physician or dentist certainly should have at least explored the possibility. There is a clear relationship between jaw joint issues and headaches, so if you suffer from chronic migraines and nobody has ever brought up TMJ as a potential explanation, you may want to seek another doctor or dentist. You should never be afraid to seek a second opinion.

Sometimes the symptoms of TMD are not as clear-cut, they may be subtle and escape the eyes of your physicians, sometimes even your general dentist. Experiencing the right questions by the TMD trained dentist with your answers will help stop the run around to all the health professionals you’ve been to.

Good advice would be for the migraine sufferer to seek a dentist in his or her locality who is a member of the Academy of Cranio Facial Pain. You’ll be in good hands.

Why did my doctor prescribed mood-altering drugs to help my migraine pain?

It’s possible you have been misdiagnosed. Migraines and TMJ pain often take an emotional toll on a patient, and for good reason – the pain can be overwhelmingly severe and persistent. Mood-altering drugs, however, will only treat these symptoms. They will not actually address the physical cause of the problem. Imitrex, for example, may temporarily help with a migraine by constricting the blood vessels in the brain, but it doesn’t address the jaw joint disorder that may be responsible for the migraine in the first place.