Managing Head Pain!

Millions of people suffer from headache and migraine pain every day of their existence.

This pain can be debilitating and, basically, wrecks the quality of life.

The good news is that we are starting to have a better understanding of the mechanisms and causes of head pain.  And out of this have come treatments that have spared many sufferers from days of pain and loss of all the enjoyments of life.

While our site doesn't begin to get into all the details, we suggest you visit www.HeadachePrevention.com for detailed background into migraine and headache.

Dentists and medical professionals might want to check out www.MigrainePrevention.com where you can delve into the details of the physiology and biochemistry of head pain.

Our current understanding of the migraine phenomenon tells us that sufferers of this disease have, first of all, an elevated activity of the fight-or-flight part of the nervous system, the sympathetic system.  What's more, their brain responds in strange ways to any inputs coming in from surrounding blood vessels or other nerves.   This is most likely a genetic trait. Yes, migraines DO run in the family.

The critical irritation that sets off the brain response can often come from the muscles that move the jaw. 

If these muscles are over-used, they become hyper and internally bruised.  This sends irritation messages back to the brain.  Then the brain's own wild reaction gets going.

Excess jaw activity leads to muscle damage.

                          Special Dental Appliances

That's why we often make specialized little appliances to relax these muscles and cut down on their bruising. That cuts down the irritating messages that the brain receives.  And THAT cuts down on the cascade leading to migraine headache.  See the Dental Key below.

Forget all the technical terms in the diagram that follows.

What we see hereis a feedback loop.

The brain sends out signals to the blood vessels surrounding the brain.  Then signals come back to the brain from these vessels.

A 'hyper' type brain causes these signals to amplify.  Pretty soon it's like kids at a party.  As one kid starts shouting, pretty soon they all start screaming. 

As the signals grow, all sorts of wild things start happening in the brain, and here comes the headache...

As a migraine attack begins, a wave of lowered activity sweeps over the brain and generates a chemical byproduct called nitric oxide.

These chemicals are passed down the blood vessels of the head and can lead to swelling of the membranes of the sinus, for instance.

Then people start complaining about sinus infection, when, in fact, the sinus is completly healthy.

Medications

There are a number of medications being used to help with migraine attacks.   A common one is Imitrex.

And even muscle-relaxing botox injections seem to be able to reduce some migraines.

But these meds are far from 100% effective.  Most studies show that they work, at best, only half the time.

The Dental Key

But the good news is that we can really boost our ability to control migraine pain by providing the patient a simple dental appliance.

Most often we use a little device called the NTI that fits over just the front teeth.  That interrupts damaging habits and extraneous forces that lead to muscle and joint damage.

As a result, the brain does not receive the same irritating inputs.  So migraine pain can be cut far more than what we are able to accomplish with medications alone .

The key with the little NTI appliance is keeping the heavy clenching teeth from touching.  Once molars get into the act, forces skyrocket!  That's where the damage to teeth, joints, bone and muscle comes from.  And then the resulting headache.

The little NTI device in place

Preventing Headaches

The same is true for many headaches: they start with chronic damage to muscles.  This usually comes from clenching and grinding the teeth, often in the sleep.

The lighter you sleep, the more clenching and grinding you do.

The more stress you have, the more active is your sympathetic fight-or-flight nervous system.  And that leads to lighter sleep.

So, in a way, stress IS related to headaches.

The bottom line?  If we can control the forces that you are able to generate during sleep, we can often lower the noxious input to the brain that acts as a trigger for head pain.

Sleep Apnea and GRD

A surprising number of people stop breathing while they sleep.  this can happen hundreds of times a night.  It interrupts rejuvenating deep sleep and can lead to changes in the blood.

These changes can lead to heart damage or even heart attack.

And, when the victim awakens to the restriction in breathing, it brings them into the lighter levels of sleep where clenching and grinding can go on big time.

And think of what goes on when your throat is closed off and you are trying to suck in air.  That results in a big negative pressure--suction-- in the chest cavity.  This can, in turn, draw the contents of the stomach up into the esophagus and lead to heartburn.

This is often labeled GRD, gastric reflux disease.

Bring up acid into the esophagus long enough and the next thing you know, you have a cancer going there.

What's more, if the acid comes up into the mouth, it can literally MELT the teeth.

And sometimes it all works backwards.  First, someone has acid come up into the esophagus and then into the throat.  Next, their airway closes down in an attempt to protect itself.  And, of course, at this point they're awake enough to do more damage by clenching and grinding.

If you suspect you have either GRD or Sleep Apnea, it is imperative that you contact your physian!  Most responsible docs will then order a sleep study.  We have a great sleep center nearby at the Pomona Valley Hospital.

Disappointing Nightguards

Traditional nightguards look like a horseshoe shape that goes over the teeth.  Some are hard, some soft.

They do help some people with head pain.  Our guess is that they work about a third of the time.  Another third of people will have no effect.  And the last third will even get worse!

Newer technology has made major improvements, though.

This is where the little NTI device can be so helpful.

Thanks to Dr. Jim Boyd for his outstanding research on conntrolling head pain and migraine.

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