This 63 year old patient came to my office for regular dental care. Her
main complaint was the fact that she had some old dental work that was
breaking down and she had some missing teeth that required replacement.
During our comprehensive dental examination we learned that she was
suffering with migraine headaches since she was 15 years old. The
frequency of her migraines were at least twice per month, with episodes
of debilitation lasting 2-3 days. She was consuming approximately 2
bottles of narcotics per month in a useless effort to combat her head
pain. She had seen countless physicians, neurologists, chiropractors,
and physical therapists. No treatments were successful.
We introduced her to our headache treatment program, and although
skeptical at first, she was excited to try anything that could help.
Her full face photos above reflect her condition before treatment.
Her diagnostic x-rays revealed serious jaw joint compression, “canted”
skull bones, calcified styloid process, and unbalanced bony
relationships. The patient did not exhibit any noises or pain in the
TMJ area. Some patients with TMJ problems elicit popping or clicking of
the jaw joint, and some related pain. Chronic head pain patients
(especially migraine sufferers) usually don’t exhibit pain or noises in
the jaw joint area, although the cause of these pain issues is always
related to a damaged joint. Only proper x-rays can show this damage, in
these cases.
Her muscles were functioning properly and she had no apparent pain in
the jaw or neck area. The only area that was sensitive and painful was
the tissues and muscles in the back of the lower jaw. This is often
seen in patients who suffer from a condition known as Eagle’s Syndrome, a deposition of calcium on the styloid process caused by overactive jaw muscles.
The styloid process is a small bony protuberance that ties the styloid
muscle to the skull bone. As the styloid muscle overworks, especially
in patients with poor jaw to jaw relationships, it can cause this bone
to elongate through extra calcium deposits, making it a “sitting
knife”. It’s as though the patient has a knife in their neck, causing
stabbing pain that is uncontrollable.
Many migraine sufferers have this process. Only proper x-rays can
detect this condition. This is what we see in many of our migraine
patients. It is a “silent” problem, related to improper jaw function,
that masks itself deep into the skull and neck area with no apparent
signs of dysfunction.
The skull bone relationship in this patient was also abnormal, and most
likely caused by a difficult birthing process. The delivery process is
very traumatic to some babies, often causing skull deformities. If
these abnormalities are not corrected early in life, they can lead to
head pain problems later.
Missing Teeth and TMJ Headaches
The adjacent pre-treatment photographs show some of the problems this
patient had to start with. Years of dental neglect caused her to lose
tooth support, subsequently affecting her jaw joints. The missing teeth
also caused further jaw joint compression, since her left side had no
support.
Many patients who lack back teeth end up with headaches and other
facial pain issues. The muscles continue to contract without tooth
support, which places hundreds of pounds of pressure on the joints
eventually fatiguing and injuring them.
The brain is so intimate to the jaw joint (being separated by only 1/16
of an inch of bone in some patients) that it senses this problem in
many different ways. In some patients, we see migraines, in other
patients we see neck or ear pain. The symptoms vary, but the body will
manifest the dysfunction in one way or another.
The treatment for this patient began with “composite mock-ups.” Bonding
was placed on the appropriate teeth in order to help decompress the
joints and align the jaw to jaw relationship. It gives us an indication
of how the patient responds to early treatment before we began the
major work.
After two months, the patient showed only 2 episodes of headaches,
which were controlled by Advil. She no longer required narcotics and
the headaches were minor, lasting only 1 day. She was still skeptical
about her future prognosis.
We nonetheless assured her that we would achieve at least a 90%
reduction in her migraines. This was unbelievable to her, considering
the many years of suffering she had endured.
Relief begins during first month of TMJ Treatment
The photo at the left shows how well the patient was able to open her
mouth, without feeling any jaw joint strain, after only one month of
treatment.
The next phase of treatment consisted of placing implants in her lower jaw to allow us to gain support and proper alignment.
After six months, we finished restoring the implants and replaced all
of her old dental work. A new jaw to jaw relationship was achieved, and
final x-rays confirmed that her jaw joints were healing.
48 Year TMJ Headache Misery Successfully Resolved
This final photo clearly shows the end result after about a year of
treatment. Her life has changed considerably since her treatment.
This patient’s energy level, attitude, and personality have improved for the best. Years later, she is no longer skeptical.
TMJ Treatment Outcome
In the patient's words:
"I
am a different human being. I have an extra 6 days a month that I can
do other things besides lay in bed with a migraine! Not to mention that
I can eat properly now and my new teeth look like a move star’s! I just
can’t believe that a dentist could make such a huge difference in my
life."
The adjacent photo was taken 3 years post operatively. Migraine headache pain no longer exists for the patient.
Have questions about certain physical relationships or properties
operating within your jaw structures that could be the cause of
craniofacial or tmj-tmd pain?.
Contact our office to arrange a private consultation or use our on-line Ask The Doctor form to contact Dr. Halmaghi directly with your questions.
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