Migraine and Severe Headaches

Approximately 45 million Americans suffer from chronic headaches, and of them, 28 million suffer from migraines. Of this 28 million, 75% are women. No reliable tests are available to diagnose a migraine. Typically, a diagnosis is made by a medical professional through the patient’s reported subjective symptoms. Prescription medications and life style changes only manage this “incurable” condition. A neuromuscular approach, however, can offer a new solution greatly reducing or eliminating migraines.

Migraines are generally initiated by “triggers” which include stress, foods, medications, hormones, sensory input, and/or genetics. These triggers begin a complex neurological disorder manifesting in the migraine event. The common symptoms are severe headache, nausea, vomiting, dizziness, sensitivity to light, and/or sensitivity to sound. The migraine episode may have up to five phases: prodrome, aura, headache, recovery, and postdrome.

An unusual phenomenon occurred in some women who received cosmetic Botox. Their migraines diminished or ceased after treatment for a short time, but after several months the migraines returned. Some opted for expensive temporary treatment of multiple Botox injections in the scalp.

Botox is a powerful neurotoxin that binds to the nerves which connect to muscle and destroys the ability to cause muscle contraction. When muscle loses nerve connection to the brain, it becomes paralyzed and relaxed. In time, those nerves grow new branches to reconnect with the muscle. Function is gradually restored along with the return of the migraine. Botox therapy usefully demonstrates the link between migraines and tense muscles. In other words, relaxed muscles can mean no more migraines.

Multiple Botox injections in the scalp cause relaxation of the temporalis muscles which are fan-shaped muscles that attach the jaw to skull. Their primary function is to close the jaw and help position it so that all your teeth are in maximum contact. The way your teeth fit together, your bite, is called occlusion. A bad bite or poor fit is known as a malocclusion.

A malocclusion can create continuously tense and strained head and neck muscles. When these muscles become too fatigued, they go into spasm, similar to a “Charlie Horse”, resulting in an additional trigger for a migraine. Over half of patients with migraines have malocclusions. Migraines and tension headaches can be two of the symptoms of temporo-mandibular disorder (TMD). Correcting the malocclusion by creating a new bite so the muscles of the head and neck are relaxed greatly reduces or permanently eliminates migraines.

Technological advances allow us to find the jaw position in which the muscles of the head and neck are in their most relaxed state. With chest pains, a cardiologist will use an electrocardiogram (EKG) to evaluate the heart muscle. Electromyography (EMG) evaluates muscles of the head and neck. High readings mean contracted, tense muscles, while low readings mean they are relaxed. Combining EMG readings with a computerized motion sensor (CMS), which tracks the lower jaw position, can determine where the bite should be when these muscles are relaxed. If the position change is only slight, we can adjust the bite by removing interferences on the tooth structure. We balance your bite, just as you balance the tires on your car so that it operates smoothly. If there is a larger change, we then construct an interim appliance known as an orthotic. This is a plastic retainer-like appliance that usually fits on top of your lower teeth. It repositions your jaw by creating a new bite. The computerized equipment objectively determines where the muscles of the head and neck are most relaxed. The beauty of this system is it is non-invasive. It eliminates the concern for long term side effects from the usage of injections and drugs. This phase of treatment is diagnostic. If the headaches greatly diminish or completely go away after several months of therapy, then we know the primary trigger is tense strained muscles. We can then safely move to a second phase of treatment to correct the bite by either constructing a permanent orthotic, orthodontics (braces), restorations or a combination of the latter two.

Simply stated, imagine you have a cup inside you that receives the triggers: stress, food allergies, medications, hormones, sensory inputs, genetics and/or tense strained muscles. When the cup overfills, the migraine event is initiated. Triggers are variable at any given time. By eliminating one major contributor, the cup will not be so easy to over-fill. This may entirely prevent or greatly reduce the migraine.

Gneuromuscular treatment of malocclusions can eliminate or greatly reduce over half of migraines. Gneuromuscular dentistry has applications in TMD, orthodontics, and cosmetic dentistry as well.