Diagnostic Insight

A person is formally diagnosed with migraine or tension-type headache after all diagnostic testing has been confirmed negative and/or "within normal limits".  Essentially, the migraine/headache sufferer is assured that nothing physically is wrong with them, as migraine is a "benign" disease whose symptoms must be managed.  For many of those sufferers, their search continues for some underlying cause or condition that drives their disability. 

The migraine patient is often asked, "When and how often do you get your migraines?", which then helps determine the necessary level of medications.  But what of the rest of the time when the patient is not having a specific migraine attack?

For example, we would ask our patient:

"On a scale of 0-10, where a 10 is the worst discomfort you can imagine anywhere above the shoulders, and a zero would be you feel no discomfort/pain at all, that is, you feel fabulous, how many mornings per week do you wake with a zero, that is you feel fabulous?"

The typical response is first a hesitation, and then a qualification, such as, "Fabulous?  Well, I never feel fabulous...but I'd say I wake with anywhere from a 3 to a 7"

The significance here is that other than "medication rebound", there is no common disease or condition where the only symptom is "waking with a headache".  For the chronic migraine/headache sufferer, waking "with a number" has become completely normal for them, and therefore, unremarkable, whereas waking with a zero is surprising and rare. 

The dental industry has long held that intense nocturnal jaw clenching could easily present with headache upon waking. So if someone were to chronically clench their jaws during sleep (specifically, it happens during the transition from light to deep sleep, and in the stages preceding waking), they would develop stronger-than-normal clenching muscles.  

In a study published in the Journal of Headache, migraine sufferers who woke with headache discomfort had jaw clenching muscles that could produce more than twice the force as asymptomatic controls:

At the time of the publication, the common practice in dentistry was to provide a mouthpiece that covered all of the posterior molars, thereby providing a smooth and "balanced" bite.  Unfortunately for many, an "idealized" biting surface simply provides for a platform to enhance one's clenching intensity, so when the patient doesn't improve, or gets worse, they are referred off to the next practitioner.  

The NTI MigraineGuard employs the natural protective physiology of front incisor biting to limit the pathologic intensity of back molar clenching.  By providing mouthpieces that only allow for an "anterior mid-point contact" (similar to biting a cracker with your front incisor teeth), the posterior teeth never touch each other during sleep, thereby preventing the ability to clench with pathologic intensity. 

In the years immediately following the FDA's first approval of the NTI MigraineGuard for the prevention of medically diagnosed migraine pain, practitioners had to be educated on the concept and its therapeutic protocol.  The following video is a clip demonstrating the differences in EMGs (electro-myo-graph, a method of measuring muscle contraction intensity) of the clenching muscles when using an NTI MigraineGuard.


It's important to realized that nocturnal jaw-clenching is not the cause of migraine pain, but is one of the more prominent and common contributors to migraine frequency and intensity. 

NTI MigraineGuard therapeutic protocol has evolved considerably over the past 20+ years.  The influence of the on-going demand for bona-fide preventive modalities to be made available without a prescription has allowed the NTI MigraineGuard to now be available without a prescription.