Thursday, March 15, 2007

The "Gentle Dentist" and his philosophy.

I have Google News Alerts set so that I receive emails about news and new blog entries related to Migraine disease. They're generally interesting, and help me learn and stay up-t0-date. There are times, on the other hand, when one of the catches my eye for another reason -- doubting what I'm reading or even the reason someone wrote it in the first place.

Case in point, is a Blog Alert I received about half an hour ago. The title was "Migraine headache treatment," and it led to a blog titled "The Gentle Dentist." The description on the blog reads, "Press Releases and Ask The Dentist Q and A. This particular blog entry is of the Q & A variety, and the question was about Imitrex and the person asking the question having read that "there may be something I can do about it that doesn't involve drugs."

In his response, "The Gentle Dentist" states that, "Medications such as Imitrex have been used to help, but only in about 50% of the cases is there a resolution from the pain." Hmmmmmmm. That figure seemed low to me, so I did a bit of research. According the the University of Maryland, "Unfortunately, recurring headaches with sumatriptan develop within the first 24 hours in 20% to 40% of people who have taken the drug... Studies on the newer agents (triptans) have reported pain relief within two hours in between 60% and 91% of patients." That would seem to contradict the dentist blocker, but let's not go on just one source.

On the American Council for Headache Education site, I found this, "About three-quarters of migraine sufferers will report significant improvement within an hour after taking sumatriptan by injection. One-half to two-thirds will have a good response 2-4 hours after taking the oral form of sumatriptan.

The Gentle Dentist goes on to say, "There is a new dental device that has been approved by the FDA to treat migraine headaches and has been actually shown to be more effective than the medications." He's referring to the NTI-TSS, developed by Dr. Jim Boyd. The NTI device is excellent. However, what the blogger dentist doesn't mention is that it's not for acute treatment, bur for prevention, and is effective for a subset of Migraineurs, those with triggers related to the temperomandibular joint and the effect it can sometimes have on the trigeminal nerve. The main web site for the NTI-TSS device,, states, "In a large percentage of migraine sufferers, the motor root which travels within the conduit of the (sensory) third division is hyperactive, commanding tremendous amounts of potentially damaging activity from the jaw muscles during sleep. This results in a bombardment of noxious (negative) information going back to the sensory nucleus, thereby sensitizing it, making the patient far more susceptible to migraine attacks."

Comments were closed on the Gentle Dentist's blog, so I couldn't leave him a comment there. If I could have, I'd have
  • asked him to check his statistics on the success rate of Imitrex
  • suggested that it was a bit narrow of him to only mention one of many Migraine treatments
  • pointed out that it would be helpful to say that the device is appropriate for a subset of Migraineurs, not all.
But, since he's not open for comments, I'll have to make my comments on my own blog. :-)


The Gentle Dentist can be found on his own blog.

My info on Imitrex success rates came from:


Abigail said...

To Dr. Jim Boyd,

I'm sorry, but I accidentally hit the delete button instead of the publish button for the comment you recently posted here.

After going through several of your Web sites, I've given up trying to find an email address, so am leaving you a note here.

One comment I would like to offer is that I and some others I know would be more likely to be more interested in the NTI if you would stop saying "Migraine headaches." I'm not going to go into details here, but I really have a problem with practitioners who insist on calling episodes of Migraine disease "headaches."


Debbie said...

I have had severe recurring migraines for at least 30 years. I can no longer use triptans due to hemiplegic migraines and a prolonged aura.
I tried the NTI device. It worked for a couple weeks, then I started gnashing on it in my sleep. I've worn a 5mm divot into it. And I still get severe migraines. So I guess it works for some, but not others.

catmum said...

My dentist also tried resurfacing my bite, thinking that perhaps there might be some TMJ triggering going on. It didn't seem to help me, though I do note tension occasionally in the jaw and temporal area when I have a migraine. I do some acupressure and breathe and try to relax it.