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Migraine Etiology Hypothesis

Pediatric application of an NTI-type device

This is a re-print of a post made by Dr. Boyd (developer of the NTI device and protocol) on an internet message board for dentists, regarding headache pain in children.

In this circumstance, my primary concern is if the child is experiencing any pain... and the weird part is these kids sometimes have no clue as to what pain-free is to begin with. Like others who've posted here, my 8 year old was a big-time grinder/clencher when he was 5. Nobody knew he usually had a headache until we compared it to a stomach ache. "Do you ever a tummy ache inside your head?"

" Uh huh"...

Of course, you always suspect that the child wants to say the right answer, so when you've got somebody's child seated in the dental chair, I stand behind the chair and have the parent stand in front of the chair. I announce that I am going to draw shapes on their head with my finger, and the child has to guess what shape I'm making...

Then I do my usual-and-customary palpations.
First, I start at the forehead/midline/hairline and rub back and forth a bit, "What shape is this?" " A line!".
The parent is watching the child's expression... On top of the head, I rub sort of 'round & 'round... " A circle!".
Then I gently find a fibrous band in the temporalis and press in a "smaller circle"...before the child says anything, they are grimacing because it hurts, and the parent sees this, whereas the other areas didn't get this response.

That's when I start asking the child if he/she ever wakes up with a tummy ache on their head...since their temporalis is still sore, it reminds them of what the heck I'm talking about...

You see, if it's "only grinding", and there's no pain involved, I have a hard time recommending anything to the parents. But when we all realize that this child's world is not what we thought it was, then we consider treatment.

Making an NTI-type device for a child is not too difficult. Instructions for doing so are on the NTI dentist's website.

Just as shoes worn all day don't inhibit the growth of feet, neigher does a plastic maxillary NTI-type device worn at night. In about 2 months, it'll not fit too well and the symptoms will have been reduced considerably. So you make another one. Two months later, not only have the symptoms been eliminated, but you've intervened on their developing sleep patterns...sort of like "curing" them of intense noctural clenching.

Most of my experience with this is treating the child who's mother has taken him all over the place, from one "specialist" to another, to try and find some answer/remedy for her son's "atypical pediactric migraine". I still get a Christmas card from a gal whose 4-year-old son used to lay on the ground out of no where, throw-up from his his migraine pain, get up and move on. He went through three of the NTI-types described above. The treatment was completely successfull...he's 12 now (and stopped using the NTI-type deal after the third one didn't fit anymore).

I make sure to advise the parent that I can not be absolutely positive that these series of NTI-type devices won't alter normal growth patterns...so therefore, an increased potential of orthodontics later exists. The mom says, "Don't worry about it...his brother had braces and his sister is in them right now".

Oh, one last thing. My heart breaks when I hear the history of these kid's headaches...especially when the mom is sitting there helpless as this 5 year old describes pain as if it were a natural part of life. I know I should, but I usually don't charge for this service (well, I didn't used to... ). Usually, adult patients with successful outcomes with their NTI device aren't that great of a referral source...they never used to talk about their headahes anyway, so they really don't talk about headaches that they don't have. But a mom who's child has been greatly helped by her dentist...she just seems to tell everybody. Heck, who doesn't like talking about their kids?
-Jim Boyd, DDS


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