Chronic headaches and migraines are controlled and moderated by the Trigeminal Nerve System. This nerve system has two divisions:
1. Motor Root: Sends nerve impulses to the jaw muscles to make them contract.
2. Sensory Division (divided into three distinct groups):
- Ophthalmic: Receives sensory input from arteries that surround the brain to around and behind the eye.
- Maxillary: Receives sensory input from below the eyes to the upper jaw.
- Mandibular: Receives sensory input for the entire lower jaw.
All three groups feed into the Trigeminal Sensory Nucleus.
The current understanding of the nature of the migraine is that it results from a disorder of “sensory modulation.” This means that information received by the Sensory Nucleus is misinterpreted resulting in a disproportionate or inappropriate response. For example, during a migraine, the pressure change of the fluid that surrounds the brain is perceived as “pounding” due to the beating of the heart.
When the Sensory Nucleus is hypersensitive, it is not unusual for the Motor Division to be also hyperactive. A hyperactive Motor Root results in excessive jaw muscle contraction, resulting in intense jaw clenching and/or grinding during sleep. This is a known cause of TMD (temporomandibular disorders). The combination of hyperactive Sensory Nucleus and Motor Root becomes a self-perpetuation of chronic headache and/or migraine.
The goal in migraine prevention is to limit the amount of migraine triggers and negative input to the Trigeminal Sensory Nucleus so that it is not perceived as pain.
The NTI-tss Dental Device is one method in which Dr. Stender treats headaches and migraines. The NTI-tss Dental Device is the only FDA cleared non-drug, non-surgical method for migraine prevention. This device is a pre-fabricated matrix that that Dr. Stender retro-fits and customizes to your front teeth. The most distinguishing characteristic of the NTI device is that it creates exclusive contact between the incisors (front teeth) only. Preventing any molar or canine contact is a key element to preventing jaw clenching and teeth grinding that can cause intense pain. Dr. Stender dictates the design of the NTI device based on your unique bite presentation. Additionally, Dr. Stender ensures that the device design does not overly “open” your mouth which would result in another negative sensory input. The NTI device fits comfortably on either the upper or lower front teeth. For most patients, it is worn during sleep. For severe migraine sufferers, there is a more discreet version for daytime use, which is usually required in addition to the nighttime device for 6 to 8 weeks for best results.
The second method of treatment is a Maxillary B-Splint. It is a very thin retainer with an anterior stop so back teeth are excluded. This is worn at night only or for 24 hours a day depending on the severity of the case.
The third method of treatment is full mouth occlusal equilibration with the T-Scan III to balance your bite so you bite down evenly throughout your mouth. To learn more about the T-Scan III, click on the term on our home page.
Since each patient’s case in unique, Dr. Stender will prescribe the treatment or combination of treatments most appropriate for you.