TMJ MIGRAINE TREATMENT…. The PILAR-TYPE NTI Tension Suppression System (NTI-tss)
For TMJ migraine prevention, there is only one FDA-cleared, non-drug, non-surgical method: the NTI-tss device. This device is approved for the prophylactic treatment of medically diagnosed migraine pain and migraine associated tension headaches and for the prevention of bruxism and TMJ syndrome by reducing trigeminally innervated muscular activity.
The Pilar-type NTI orthotic is a deprogrammer stabilizing refinement of the NTI orthotic. It is a customized version of the NTI and the perfect one takes one and a half hours to fabricate chair-side. A laboratory processed NTI will not have all the critical refinements necessary for TMJ treatment success. For a dentist to refine an NTI laboratory processed orthotic is akin to you starting from scratch with border limitations that might not apply… it doesn’t work.
The one-time belief that migraines are a primarily a vascular phenomenon is no longer viable. Today, most theories on the causes of migraines now include a trigeminal pathway, and cite the common pericranial muscular tenderness in migraine sufferers. There still exists a lack of objective evidence for a causative element for migraine pain, keeping the healthcare industry from isolating an acceptable means of prevention.
TOO BAD… THEY SHOULD ALL KNOW ABOUT THE PILAR-TYPE NTI.
What You May Not Know about Migraines…
Migraine is a disease of the trigeminal nerve and approximately 75% of migraine patients have pain in neck and shoulders. Why? Because the trigeminal nerve also feeds back into the brain stem where it connects to the neck and shoulder nerve branches coming from the cervical spine, thus causing neck and shoulder pain to accompany the migraine.
Migraines can often mimic the symptoms of sinusitis. The thin sinus bone walls become inflamed in the presence of constricted spastic connecting muscles inherent in TMD conditions. These are all reversible physiologic conditions, not medical conditions treated with drugs.
The trigeminal nerve is a cranial nerve with three major branches in the head: the ophthalmic nerve around the eye, the maxillary nerve in the area around the cheek, maxilla, upper teeth and nasal passages, and the mandibular nerve with nerve endings to the jaw, lower teeth and ear region.
The trigeminal nerve endings are supersensitive and supply blood vessels on the surface of the brain and nasal cavity. These nerve endings can cause blood vessels to become dilated and produce a throbbing sensation, swelling and neuropeptide fluid secretions that may inflame neighboring arteries and mucosa.
Internal changes in hormone levels, usually a falling estrogen level, along with stress and sleep deprivation, weather changes, and alcohol will trigger the trigeminal nerves to start firing off, resulting in this painful condition.
Further, even minor clenching of the teeth and jaw in the presence of a “bad bite” can hyperactivate the protective activity of the lateral ptergoid muscle (situated next to the TMJ). The lateral ptergoid muscle must protect the jaw joint and improperly positioned teeth during upper and lower tooth contact, further stimulating the brain’s sensory nucleus, adding to its sensitization. This sensitized sensory nucleus becomes “triggerable,” responding to otherwise harmless noxious stimulations (i.e., odors, glare, food additives, etc.).
The trigeminal nerve also feeds back into the brain stem where it connects to the neck and shoulder nerve branches coming from the cervical spine, thus causing neck and shoulder pain to accompany the migraine.
The ophthalmic nerve endings supply the blood vessels on the surface of the brain and the firing of these nerve endings causes the release of chemicals to the blood vessels, dilating them. This inflammation causes the throbbing pain of the migraine with body movement.
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 TMJ treatment option.
Patients should not hesitate to seek a second opinion if their current TMJ 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’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.