Surviving the Latest “Totally Effective” Migraine Treatment

Last week, my hometown newspaper posted an online article with a headline that boasted a “95% effective” migraine treatment. (I’m not going to go into specifics here, as I don’t want to speak ill of anyone involved with said article.) A loving and caring friend, who knows I both write about migraine and experience chronic attacks, posted the article to my Facebook wall. As I saw the well-meant post, all I could do was sigh.

When we migraineurs see something “new” for migraine, we often feel a number of emotions simultaneously. We feel hope that something new has come on the market that might actually make us better. We feel skepticism, because we have a long list of treatments we’ve tried already that showed few if any results. We also feel pressured – pressured to try this new treatment, regardless of whether we feel it is right for us, and pressured for it to work. After all, as society at large continually asks us, if we “really” wanted to get better, wouldn’t we try anything that purported to help?

It’s this last feeling that motivates me to research the latest treatments.

Before I shell out yet more money and energy on a treatment for my specific kind of migraine, I want to know the scientific basis for the treatment. I want to read the studies that show who and under what conditions the treatment helps. I want to see how the studies are designed and how they were carried out. After all, that’s the best way to decide whether or not it’s really worth a try.

Considering that 1) one of the trigeminal nerve’s three branches runs along the jaw bone and 2) research has shown that activation of the nerve system at any of the branches has the potential to trigger a migraine, it’s no surprise that migraine and dental issues can be related in some people. Overnight jaw clenching, for example, aggravates the trigeminal nerve system and can be a major trigger for migraines, according to Dr. Boyd, who invented the NTI (nociceptive trigeminal inhibition) device to help patients with such problems.

Dr. Boyd’s devices are relatively simple. They’re basically mouth guards/splints that keep the patient from clenching the jaw and/or grinding the teeth overnight. By reducing the level of clenching and grinding, the devices help reduce the over-activity of the trigeminal nerve, thereby reducing migraine pain and/or migraine frequency for those patients who suffer TMJ-related migraines. (There are some unique aspects to the design of Dr. Boyd’s devices, which may contribute to their effectiveness. Additional information about the devices can be found on his website.)

Several people here at Migraine.com use the devices for tension headaches and TMG-triggered migraines, and love them. However, the devices do not provide relief for all patients, nor do they stop all migraines in the patients who do benefit from them. Thankfully, Dr. Boyd’s research doesn’t claim they do.

The article in my hometown newspaper, however, said that the “new” dental treatment in question – TruDenta – offers a 95% effective rate for migraine treatment. Knowing, as I do, that nothing we’ve found so far helps 95% of migraineurs, I was immediately skeptical.

After reviewing the dentist’s website and the TruDenta website, I was unable to find any basis for the 95% claim. I can’t even really tell you what TruDenta is or what it does, though it appears to involve a computer that runs data analyses of patients’ teeth, jaws, and bites, and then offers guidance on how to treat malformations and/or mal-adjustments. It seems to require a lot of office visits – about 12 in some cases – and can cost up to $5,000.

After looking into this, it’s unlikely that I’ll try the TruDenta system, though I hope other people who wish to try it get good results. If you do try it, please let us know how it works for you in the comments below. And, if you’ve tried Dr. Boyd’s NTI devices, please let us know that as well. I’ve been clenching my jaw at night recently, and I just may have to take a look at those myself.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (11)
  • Migraine Man
    3 years ago

    Going in for my first consult in a few weeks, will keep you guys posted.

  • rktgrl
    4 years ago

    I used to work as a dental assistant back when the tmj problem was first being examined. As interest progressed, the technology did not. I have seen first hand many people actually get worse after trying to use these devices. The problem is obvious if you think about it for a moment. Where the device may save some wear and tear on your teeth, it does nothing for, or makes matters worse for the tm joint, because whatever causes the tension and grinding doesn’t go away. It only grinds on the new device, which is harder to deal with and can cause the teeth to shift around randomly.

    The only thing that can help is re-learning how to swallow and hold your tongue and mouth in a restful position while both awake and asleep. It’s not easy, and mostly only children and young adults are capable of it, but it can be done. I’ve seen it, and I’ve accomplished it. No hardwire required, no $5000 fees and no bulky devices to introduce as a substitute for your jaw muscles to wrestle with.

    So how do you do it? Well first you must know that as a baby we learn to swallow either correctly or incorrectly. Correctly, your tongue puts 2 to 6 pounds of pressure somewhere in your mouth, shaping your mouth and training you for a lifetime of trouble-free tmj. When you correctly swallow, the top of your tongue should be at the tip of the front ridge in the upper palate of your mouth. As a swallow happens, you move well-chewed food or water from under your tongue to the area above your tongue while it is still touching the spot, and down it goes, with no air and creating enough suction to vacuum out your eustachian tubes and prevent ear infections.

    And most importantly, when your mouth comes to a rest, the tip of your tongue is still in place but holds your teeth comfortably apart about 1/8″. If you learn to sleep this way, you will NOT grind your teeth and eventually your muscles will relax this way and if you have a malocclusion, it may very well correct. I have seen that happen too.

    I learned all this in the mid-1970’s and at that time it was called “myo-functional therapy.” I don’t know what it has progressed to by now, if at all. But hopefully someone still uses it. Because it worked! I saw the patients, I saw the before “plaster” molds, and I saw the “after” plastic molds.

    The only problem is, in my time in this field it was never addressed for migraines in my office that I’m aware of. But there’s no reason it shouldn’t work if it relieves extra work and destruction tmj problems can cause. Here’s a link that looks promising: http://www.myofunctional-therapy.com/

  • mmontgomery
    4 years ago

    Hi Sarah,

    I’m glad to see you offering some feedback about TruDenta, and since I work closely with TruDenta I thought I could offer some more information. The comments by Judy H and Jess Reynolds do a great job explaining things (good luck with your treatments, Judy and Jess!) but I also just wanted to check in let you know that your feedback is really appreciated.

    I totally understand your skepticism of any migraine treatment that seems too good to be true; like you mentioned, no single treatment is right for everyone and there is no single cause for migraine. We really do appreciate your comments; we don’t want to accidentally come across like we are offering up something that is a perfect solution for everyone.

    Just to be clear about the “95%” statistic that the news article used: TruDenta focuses *only* on chronic headaches that are related to hidden TMJ and face/neck dental imbalances, which is partly why our success rate can be so high.

    Our pre-therapy diagnostic system ensures that *only* patients whose headaches are actually caused by dental imbalances are treated by our specialists — the diagnostic technology helps our specialists first analyze the patient’s bite force, the range of motion of their head/jaw, and muscle tension/pain to see if they have hidden imbalances that we know we can help with. Without this context the statistic might seem a little outlandish, so in the future we will try to make sure that news articles about us give the reader the whole story.

    As you know from Dr. Boyd’s work, there often is a strong connection between the trigeminal nerve system and some headache sufferers. This nerve system includes and is associated with several cranial nerves, the muscles of the chewing system, the facial muscles, the sinuses, the teeth, the airway, and other structures. Imbalance, dysfunction, and inflammation of this system are what the TruDenta dentist focuses on, and only if an assessment reveals a sensorimotor imbalance or dysfunction will the dentist intervene and start the physical therapy process. Ours is a combination treatment, not just a splint or guard — it’s essentially a carefully designed progressive physical therapy system with pain relief (ultrasound, cold laser, etc.) for the mouth and jaw.

    I would encourage anyone reading to keep checking in with the TruDenta website if you’re at all interested — you’re not the only one who noticed that it is a little light on information at the moment, and we are actually rolling out a new and more informative website in a few days to give more in-depth info on the details of the process. We want to be able to provide a diagnostic analysis that will help show whether or not you may have a trigeminal imbalance or dysfunction, so you can decide whether or not the cost/benefit is right for you.

    If you’re interested I would be happy to answer any questions about TruDenta here in the comments or through email (my address is cdo@trudenta.com). If you would like to do a quick Q and A session I could dig into some of the research behind our method and give you some citations and more details.

    Again, thanks for the feedback, and best wishes.

    Mark Montgomery, DMD

  • Jules2dl
    4 years ago

    I’ve tried the NTI device with no results.
    Would I try Tru Denta? Perhaps if I won the lottery and had a spare $5000 to fritter away on a shot in the dark.

  • Dolly Ward Paice
    4 years ago

    I too have TMD (since I was 16, now 43). I have a splint and while yes, it does help the TMD induced migraines, it dies absolutely nothing to help the migraines from my tri-nerve issue. I can scrub to hard in one side, lightly brush that side of my face even and boom, I get a migraine from tri-nerve aggravation. I would research extensively before trying any mouth guard to alleviate migraines…..

  • Judy H
    4 years ago

    Serendipity that you posted your article about TruDenta on Nov 25, 2014 – precisely the day that I had my 3rd TruDenta appointment and picked up my new splint for my lower jaw.

    I was diagnosed with TMD in March 2013 when crushing pain kept me from opening my jaw all the way while trying to eat a sandwich. My regular dentist fitted me with a splint (not the TruDenta variety) which I wore every night to prevent me from clenching my teeth and further contributing to the pain. I was sort of skeptical, but did grudgingly admit that when I was lazy and “forgot” to wear it nightly, I did soon afterward experience a migraine when I neglected to wear my splint. Coincidence? – Don’t know for sure…

    Fast forward to October 2014 when I first heard a recommendation for TruDenta on a migraine blog. I searched it on the internet and found an orthodontist specializing in TruDenta about 90 minutes from my house. I made an appointment. I figured “what do I have to lose?” I have had migraines for 40 years, have tried nearly every preventive drug out there, have gone through the triptans (1st client at my pharmacy to try them), DHE, botox, acupuncture, chiropractic (which aggravated more than it helped), Cefaly (not bad, but not perfect), biofeedback, etc. I have been to the Diamond Headache Clinic, the Michigan Head Pain and Neurological Institute (MHNI), as well as every well meaning neurologist and quack in my home town (9) whom I had consulted over the years seeking relief from hereditary migraines. I have had to abandon the last preventative – methergonovine – due to side effects. At that time, my specialist at MHNI, gave up on finding another preventative. Gee, thanks.

    Following my TruDenta custom fitting, I wore my lower jaw splint home from the orthodontist’s office on November 25. After wearing it (for the very 1st time) from 10 am until 7 pm yesterday, I couldn’t wait to get home to brush my teeth after dinner out and re-insert my splint into my mouth – it was that much more comfortable wearing it than going without it! I am optimistic.

    Although I am a clear “newbie” when it comes to the TruDenta experience, I can assert that everything that Jes Reynolds has shared is consistent with what I am learning about the TruDenta experience. The areas of the head, neck, and shoulders involved in the TruDenta treatment, are the same areas where I have had Botox injections, 5 separate Botox treatments, 3 months apart. A word to the wise about TruDenta and Botox – my TruDenta orthodontist asked me to refrain from getting Botox while I am undergoing the TruDenta treatment phase. The objective is to be able to determine whether the TruDenta is responsible for migraine relief, or if the Botox is the relief agent. Plus, I can assert that if I had had Botox actively working to ameliorate the pain in the TruDenta examination points, it would have been difficult to determine which minor adjustments my orthodontist performed to my bite were actually contributing to finding the “sweet spot” of my optimal pain-free bite adjustment. So, if you have recently had Botox, and are considering a TruDenta exam, it is probably advisable to let the Botox run its 3 month course before scheduling an exam.

  • jes reynolds
    4 years ago

    Call me gullible or hopeful, but I am actually working with a TruDenta dentist now. It made sense to me because it’s working on a lot of the same areas as botox (my next treatment option) but without drugs or toxins. Since it seems that tension headaches often trigger migraines for me and I knew that I had TMD – it made sense as a treatment option for ME.

    I can give a little more insight into the treatment I am doing across the 12 weekly visits. It’s a pretty comprehensive rehab program, like a sports medicine rehab almost, that focuses on the TMJ (jaw joint) and the upper cervical spine (neck).

    Part of the treatment is more purely dental. One is getting a bite guard to wear at night that won’t allow you to clench at all (unlike the cheaper ones you can get at Walgreens). This is not meant to be a permanent solutions but one to be only used for a few months to help “retrain” and relax the muscles. And the other is using the sensor and software to guide very precise and minute adjustments to your teeth to adjust your bite. I have had one session (of maybe 2 or 3) of that and it was incredible how much my jaw immediately relaxed.

    The other part that happens at every visit is more PT-like and lasts about 60-90 minutes. First my therapist at the dentist uses ultrasound on my jaw and neck. Then I am hooked up to micro-current (alpha-stim) while the therapist uses cold laser on my jaw and neck while I perform some jaw exercises. That is followed by a very therapeutic and relaxing massage therapy session on my jaw and neck and shoulders.

    All of this is complemented by daily home exercises (again, very much like what I’ve done in the past in physio therapy), daily use of the alpha-stim (which is really different from a TENS unit and uses micro-current more similar to Cefaly that some people have looked into), and supplements.

    I am 3 treatments/weeks in and have already seen some improvement in my migraines. Instead of getting maybe 1 day between multi-day migraine cycles, I’m now getting a 2-3 day break. My migraines when I do have them are responding better and faster to rescue meds. And I haven’t had a truly severe migraine in 2 weeks. These may seem like tiny improvements – but any improvement is incredible when you live with chronic migraines.

    Believe me, I am very skeptical and jaded. I’ve lived with migraines for almost 30 years and have been through countless failed medication and other treatments. I still have 9 weeks of treatment to go, but the fact that I’ve already had some improvement in a relatively short period of time gives me some hope. This seems to be a good treatment option for me and my body. We’re all different and respond to treatment options differently, so of course, your milage may vary.

    I apologize for the long-winded comment, but maybe that will help shed some light on what this is and that it’s more comprehensive that hocus-pocus. I believe any TruDenta-associated dentist will give you a free consult and hopefully, they’d be honest if it didn’t look like this might be an effective treatment option.

  • chriszahn
    4 years ago

    Thanks Sarah, this was a “new” treatment back in the 80s, when I was told my migraines were related to TMJ. Problem is my TMJ was from a car accident a couple years after I was diagnosed with migraine. Over $10K was spent for treatment, splints didn’t improve anything.

  • Dr Andrew Knowles
    4 years ago

    Hello Ms Hackley,

    I would like to offer the opportunity to have you try my product. I will send it to you free of charge. I will not mention the name or website but will mention the ingredients: Feverfew, Butterbur, Magnesium, and Riboflavin. All in one easy-to-swallow caplet taken twice a day to help prevent migraines. Can also be used to treat for people not getting them so often (such as hormonal/menstrual migraines). If you would like more information, please let me know.

    Thanks, in advance,

    Andrew Knowles
    Anesthesiologist and Pain Management Specialist

  • Anna Eidt
    4 years ago

    Hi Sarah,

    Two people in my family (both who, like me, have trouble with clenching and migraines) tried an NTI for an extended period of time.

    It helped with pain at first… but then moved their teeth so much that it caused more pain.

    Small sample I know, but I am skeptical. I’ve taken to jaw relaxation activities before bed and that’s the best I’ve got at the moment.

    Thank you for writing about the difficulty of facing new *successful* treatments. There are good reasons we try to keep hope on an even keel.

    Anna

  • monkeybrew
    4 years ago

    This sounds so familiar! I have some news feeds that send articles to my email inbox that contain phrases such as “migraine treatment” or “chronic migraine” and a few other variants.

    As I scroll through the email messages I can usually tell from the sentence if it is some new, something old, or some kind of scam. Over the years I have tried many alternative, as well as traditional western treatments. Unfortunately I have had little to no relief. In fact the migraines have marched ever-onward to a point of being daily!

    I feel a sense of guarded hope when I hear reference to a new treatment or when a family member or fiend asks, “Have you tried…?” Coming from the place, a desire to see someone they love healed and well, but after two decades of battling it is hard not to scoff at these “magical cures” folks bring to my attention.

    Sometimes the frequency of chronic migraine puts me in a dark place where there seems to be little, if any, positive (about anything, including a “new migraine” cure).

    Sarah, I was pleased to see you mention price. Those of us who have been around the corner a few times, so to speak, know all to well that health insurance does not cover all the costs of traditional therapies. Worse yet, if one goes the alternative path, such as kinesiology or acupuncture, there is zero coverage, at lease from my insurance carrier. This means choosing to spend more money (or put more on a credit card) on a treatment that may or may not work.

    The migraines are bad, not the entirety of the experience. Research, validation and due diligence and strict budgeting are also part of the path.

    Sarah, thanks for a great article!!!!

    MB

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