| Below is a series of messages from the parent of
an 11 year chronic headache sufferer. This is intended to demonstrate
the attention to detail that can mean the difference between success or
failure of treatment. |
Dr. Boyd,
I was wondering if you could help me.
I have an 11 year old child who is suffering from headaches 24 hours a
day, 7 days a week, for 8 weeks. He had an MRI which ruled out any
medical problem. I have been to an oral surgeon who said that he
clenches his teeth. He fitted him with the traditional splint.
After 5 weeks there has been no improvement (it may have even gotten worse).
A neurologist that I took him to said that the headache were not TMJ related.
He put him on Depakote. No relief after 2 weeks. At this point,
I don't know how to proceed. Are the headaches related to clenching
or not?
There is tenderness in the temporalis muscles
and his jaw hurts upon waking in the morning the jaw pain disappears during
the day). On the other handthe headaches are not typical TMJ type
headaches. It is a
throbbing pain across the forehead plus a shooting pain every thirty
seconds.
-Elliot W.
Elliot,
The oral surgeon has the correct diagnosis, but
wrong treatment. Clenching is not reduced with the mouthpiece your
child received, but in many cases, is increased. http://www.headacheprevention.com/pages/whatisit.html
Either have the O.S. make an NTI, or check this
list for one near you: http://www.headacheprevention.com/pages/finddds.htm
-Jim
My wife this afternoon took my son to a dentist
who does NTI. The dentist said my son has classic MFP. However
he cannot do NTI because his bite is too deep. So I am back to square
one. I cannot even begin to describe my son's suffering.
Thank you,
Elliot W.
Hey, not so fast!
Go to: http://www.nti-tss.com/slide10.htm
picture 3a
A custom device can be made. http://www.nti-tss.com/Cstm-NTI.htm
-Jim
Dr. Boyd,
On Sunday I spoke to the dentist again. Apparently there was
some confusion. He told me that he didn't say that he can't do it
but that he wanted my son's orthodontist to do it. I brought my son
to him this morning and he took an impression. My son's problem is
an overbite; his top front teeth go to far over his bottom front teeth
to use the prefab NTI. His technique in this situation is to create
for the patient a standard type acrylic bi-plate that attaches to the palate
and is held in place by a wire around the teeth and the DE is attached
to the bi-plate, preventing contact between the molars and the canines.
Perfect!
-Jim
Dr. Boyd,
I am sorry to bother you again. I'm the one with 11 year old
with chronic 24/7 headaches (10 weeks).
My son has received his custom appliance. He has worn it for
6 nights (and most of the day). There has been no improvement at
all. He has the headaches with the same intensity and his jaw still
bothers him. My wife spoke to the dentist and he said he would
wait another week. If there is no improvement, he would open the bite a
little more (he said he kept it at minimum for fear of worsening his overbite).
Is it possible for the healing process to take this long to begin
taking effect ?
Any chance you can provide a picture of the device
while in place? (more than one view would be good).
As for vertical dimension, sometimes nothing
happens until it is opened up a bit more.
http://www.nti-tss.com/EMG-vertical.html
Standing by,
-Jim
(These are the photos received of the above
described device: (they were labeled by Dr. Boyd))
Elliot,
It sure looks as though
this device didn't accomplish what it was intended to do, which is prevent
canine contact. (those were great pictures, BTW.)
Review this page to see the potential clenching
difference between a bite plane (what your son has) and a bit stop (what
we're trying to create): http://www.DrJimBoyd.com/CanineSignificance.html
I've altered your photos to demonstrate what
modification could be made to your son's current device.
See if the orthodontist, or your dentist can
add a "Discluding Element" to the bite plane, or even easier, reduce the
acrylic at the far ends of the bite plane so that the canines can't touch
it.
Let me know how it goes.
-Jim
(the altered photos sent to Elliot)
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