Tell us about your headaches...: I have suffered from migraines w/and w/o aura since I was 10. I got a brain tear frontal lobe in the third grade. It's only been about the last several years that I got diagnosed with tmj. In the last 6 months it has got unbearable. I've got a permanent mouth guard for night grinding,but I still have pain and migraines help!
First Name: Lorin
Last Name: M.....
First Name: Lorin
Last Name: M.....
DR Shapira's response:
Lorin in Boston, Your e-mail was rejected, I hope you find this response helpful
Night Guards work great if you only have pain at night or on awakening. If you have day and night pain it is usually necessary to utilize a 24/7 appliance. TMJ is not a diagnosis but a Joint, the TemporoMandibular Joint. TMD is a more correct description because it includes the Myofascial and neurogenic aspects of migraine and chronic daily headaches. I suggest a neuromuscular diagnostic orthotic as it allows an ongoing healing process as you adjust it for postural changes. Spenopalatine ganglion blocks can serve to prevent migraines and you can learn to do them easily at home. Trigger point injections or spray and stretch techniques are useful for eliminating trigger points.
It is a process to correct a lifetime problem and I like the analogy of ealing an onion, you remove one set of problems to get to the next level.
I would like to tell you that everyone who practices Neuromuscular Dentistry (NMD) can help you but NMD is only one part of a larger puzzle. It is extremely important component of treatment because it addresses nociceptive input to the Trigeminal Nervous system that is primary in all migraine and non-migraine headaches. Unlike drug treatment that affect the CNS like a shotgun blast NMD particularly is designed to focus on I/O errors or input/output erros into the Trigemininal nervous system. In computer lingo the expression GARBAGE IN....GARBAGE OUT describes the effect of unfiltered nociceptive input into the central nervous system. 100% of all physicians, neurologists and pain specialists understand that all headaches and migraines are Trigeminally nerve related.
Neuromuscular Dentistry addresses this input output error of the human computer...ie the brain.
Physicians often consider TMJ and TMD problems a subset of headaches due to their ignorance of the massive input to the CNS (central nervous system) from the Trigeminal Nervous System)
Te use of Botox to treat headaches and Migraines is directly due to effects on the masticatory system of the trigeminal nervous system... ie a TMD or TMJ problem addressing not the entire scope of the problem but just the myofascial pain aspects. Botox is a crutch that can be used while correcting the underlying problems. Unfortunately there is money to be made in injecting dangerous neurotoxins and where there is money there are always willing participants. The problem is not the use of Botox but the substitution of Botox for correction of the underlying problems.
Read: http://www.sleepandhealth.com/neuromuscular-dentistry for more info on neuromuscular dentistry.
I do see up to two long diatance patients month in my Gurnee office, the first week I see you twice a day on Monday and Tuesday and half a day wednesday.
Ira L Shapira DDS, D,AAPM, D,ABDSM, FICCMO
