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                                                        DR. DAN PETERSON

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Stress and Your Teeth

Check Your Bite Treatment
Signs    Is Your Bite Incorrect
How it Works
Headache Impact Test
Pain In The Brain

Frequent Headaches? Canít Sleep? Check your Bite  

One in eight Americans suffer from headache.*

     An average person swallows 2,000 times per day, causing the upper and lower teeth to come together and push against the skull.*   People who have a poorly aligned bite or missing teeth can have related health problems, such as frequent headaches or sleep disorders, because their jaw muscles must work harder to bring the teeth together, straining the surrounding jaw muscles.

    This strain, know as orofacial pain is defined as any pain in or around the face.  Some people may experience pain in the ears, eyes, sinuses, cheeks or side of the head, while others experience clicking when moving the jaw.  These symptoms may be your mouth's warning signs for more serious health risks. 

   At the first sign of discomfort, see your dentist.  He knows your mouth best and how you handle day-to-day stress.  Sometimes the pain may be difficult to diagnose if its origin is not localized in one area.

    We will try to diagnose the pain source by conducting test to rule out a cracked tooth, the need for root canal, gum disease, clenching or tooth grinding.  These factors can cause discomfort in the facial region, but can be easily addressed.

    Orofacial pain that lasts longer than 10 days to two weeks or it not related to a specific stressful even, such as a car accident, may signal a more serious problem requiring additional test.

The NTI-tss
(Nociceptive Trigeminal Inhibition - Tension Suppression System) is a Lexan plastic matrix that is customized to comfortably fit over your front teeth. The NTI is worn while you sleep.

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Headache Impact Test-click here to take Headache Impact Test

Find the results to this test at: Headache Test Results

Does your mouth cause you pain?  Look for these signs:

bulletPain behind the eyes
bulletSore jaw muscles
bulletTeeth  grinding
bulletClicking or popping of joints
bulletHead/scalp painful to the touch
bulletEaraches or ringing
bulletNeck, shoulder or back pain

Headaches and toothaches left untreated can interfere with 
eating, talking and swallowing.

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Try This Exercise To Understand How the NTI Works

bulletPlace your fingers on your head where highlighted in the illustration to the right.
bulletFirmly clench your teeth.
bulletYou will feel the temporalis muscle bulging under your fingertips.
bulletThese muscles trigger most migraine and tension-type headache painNTI is headache hope

This simple experiment shows how the NTI works.

Remember how the temporalis muscles bulged when you clenched your teeth?

Now, put a pencil between your upper and lower front teeth and bite down. The temporalis muscles don't bulge.

This simple experiment demonstrates how an NTI (in place of the pencil) prevents migraines and clenching related to head pain.

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This treatment involves NO drugs, surgery, medication, shots or side effects.  It reduces clenching intensity up to 66%. Because the NTI eliminates clenching, it prevents or reduces:

  • Morning headaches, daytime headaches and nighttime headaches
  • Migraines
  • Jaw joint pain and clicking, face and sinus pain
  • Chronic sore neck
  • Tooth wear, teeth cracking, teeth breaking and some types of tooth sensitivity
  • The NTI is therefore also a great diagnostic tool.  If no relief had been gained or things got worse, then there is probably pathology in the joint itself

    NTI Tension Suppression Device

    The NTI device is a pre-fabricated matrix that is retro-fitted and customized to your front teeth.

    The NTI device snaps into place and fits comfortably on either the upper or lower front teeth.  It is worn during sleep and prevents the intensity of muscular parafunction.  For migraine sufferers, there is a more discreet version for daytime use, which is usually required (in addition to the pictured nighttime device) for 6 to 8 weeks for best results. 

    Through using this treatment chronic, intense nighttime muscular parafunction has been shown to be a considerable influence on the triggering of migraine events.  In clinical trials, 82% of medically diagnosed migraine patients had a 77% reduction in migraine episodes within the first eight weeks of use. There is a 10-15% chance it may not work

    *Dentalnotes, pg 4,  Spring 2002 AGD

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    How do I know if my bite is incorrect?

    The human body is an amazing thing.  Our bodies try to tell us when something is wrong.  Sometimes the communication can be immediate and precise.  On other occasions the body tries to tell us that something is out of balance but we canít understand the clues weíre being sent.   

    Bite problems can fall into either category.  An unbalanced bite can cause hard-to-ignore problems like muscle tension headaches.   Some bite problems cause problems that may be just as serious but are not as easy to spot, such as 


    uneven wear of your teeth


    loosening of teeth


    even breakage of teeth or fillings.  

    Hereís a good analogy;  you could have a fine car with  top-quality tires.  If the wheels are out of alignment you might not be aware of the problem until your mechanic shows you that the tires have severely uneven wear.  The problem is something you canít feel, but it affects your car in a way that can be damaging or even dangerous. 


    How can you tell if your bite is unbalanced if you may not be able to feel that anything is wrong?  A thorough dental exam can spot uneven tooth wear,  sore head and neck muscles,  broken teeth or cracked fillings before such problems become catastrophic.    


    How is an unbalanced bite corrected?  Severe abnormalities may require orthodontic treatment with braces or, in extreme cases, surgical repositioning of the jaws.  Fortunately, many bite-related problems can be corrected by  subtly reshaping the teeth so they mesh in a more balanced fashion.  This type of treatment is called an equilibration which may result in reduction in tension headaches or in teeth clenching or grinding. 

    If you have an unbalanced bite it is important to correct the underlying problem  before the damage is severe.  The enamel coating on your teeth is the hardest substance in the human body;  it is even harder than bone.  Once you wear through your tooth enamel, the underlying layer (called dentin) is seven times less resistant to wear.  If you habitually grind or clench your teeth you may wear them down so rapidly that many crowns are required to replace the tooth structure youíve worn away on your back teeth.  A complete equilibration is generally a completely painless procedure. 

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    Headache Hope

    Migraine Prevention

    Here is an interactive program on migraine prevention.

    At the heart of migraine disease is are two main components:
    -an elevated sympathetic tone,
    -a hyper-sensitive sensory ganglion of the V.

    Either or both of those are either genetically programmed that way, or are a result of environmental influence.

    Chronic sub-clinical conditions (oh, like a hole in your heart) serve to increase an already elevated sympathetic tone.  That elevated tone  can increase the sensitivity of the V sensory ganglion. One result of an increased sympathetic tone causes excessive  nocturnal jaw-clenching, which results in a bombardment of the  sensory ganglion of the V.  (the crushing PDLs for years is a noxious afferent stimulation).

    When the noxious V stimulation hits a certain threshold, it in turn causes a secretion of Calcitonin Gene Related Peptide (CGRP). It can also be initiated following a wave of cortical depression... which is an actual turing-off, and then turning-on of brain cells.  Nitric Oxide is released as a result, thereby causing the  intracranial surface arteries to enlarge.  V1 neurons that wrap  around those arteries send noxious afferent messages back to the
    sensory ganglion of V.

    Now, if the sensory ganglion of the V weren't so hyper-sensitive, the next part may not occur...Upon receiving the noxious stimulation, the sensory ganglion triggers the V1 nerve endings that wrap around the surface intracranial  arteries to secret CGRP, thereby causing a frank inflamation of those  arteries.  Meanwhile, a parasympathetic response produces acetylcholine, which causes nasal passage swelling, adds to the already inflamed cerebral arteries, produces hyper-tensing of the  intrafusal fibers spindles of the temporalis (the tension-type part),  and through V3, causes inflammation of the extracranial temporal
    artery. Migraine pain.

    The Holy Grail of migraine prevention is to convince the V sensoryganglion to not be so hyper-sensitive.
    Dentistry is fantastic at reducing chronic noxious V sensory stimulation.

    Mild clenching may not be such a big deal, but mild clenching on an  interference every night is a considerable noxious stimulation.

    Normal chewing:

    Mild clenching on an interference:

    Other times, following the perfecting of the occlusal scheme, the  intensity of the clenching can increase (due to an elevated  sympathetic tone).  Now the noxious stimulation *increases*.

    The goal is to considerably reduce the chronic noxious stimulation of the V sensory ganglion:

    This chart:
    IDF Jim Boyd Migraines and Wholes in Heart 2/05

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    Temporal Arteritis: Don't Let This Disease Fool You

     Could your reoccurring headache be a sign of a much more severe disease? Older individuals who experience variable signs, symptoms, and pain in the head and jaw could be suffering from temporal arteritis, a disease characterized by inflammation in and damage to the walls of various blood vessels. Headaches typically are the characteristic feature in 60 percent of temporal arteritis cases.
    Though the cause is unknown, dentists who encounter patients with puzzling complaints that are not explained by oral and physical findings may encourage their patients to take additional steps in order to properly diagnose this disease. Patients with temporal arteritis should be referred for medical evaluation and treatment before serious complications occur such as sudden blindness.Temporal arteritis is a disease that usually affects individuals older than 70 and increases in frequency with age.Ē Women, however, are three times more likely than men to suffer from this disease.
    Signs of Temporal Arteritis:
    Pain in the mouth
    bullet Pain when combing hair
    bullet Weight loss
    bullet Anemia
    It is recommended that if the clinical symptoms suggest the possibility of temporal arteritis, the patient should be referred to a physician for sedimentation or a C-reactive protein (CRP) test. Both are blood test designed to detect the amount of CRP released in the blood due to the inflammation of blood vessels.

    January/February 2007 issue of General Dentistry, James Allen, MD,

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    A Pain in the Brain 

    Of the 46 percent of women and 38 percent of men who regularly suffer from tension headaches, many may not realize the source of head pain may be directly linked to the mouth. Rather than reaching for a bottle of painkillers, people who suffer from tension headaches should consider reaching for their phone and calling their dentist. Tension headache sufferers often blame headaches on a stressful day or a bad night's sleep but when the headaches consistently keep coming back, dentists can help investigate the real source of the pain to determine a diagnosis. A dentist can look in a patient's mouth and tell by how the jaw is positioned or by how the teeth are aligned whether or not the mouth may be the source of the pain. Nearly two-thirds of tension headache sufferers clench or grind their teeth, which is known to trigger a headache. The size, position and movement of the jaw muscles also is a factor, which is why 70 percent of Temporomandibular Disorder (TMD) patients complain of this problem. Although the medical community has a role in helping patients identify and cure headache pain, the dentist's office should be their first stop on the way to becoming headache-free.  09/03

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    NTI In The Media

    USA Today

    Good Morning America

    CBS Television

    Pittsburg Post-Gazette

    USA Weekend

    Today Tonight


    Headache Prevention



    February 06, 2008

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