Evaluation Service

Thank you for inquiring about your facial and head pain problems.

Neuromuscular examination TMJ Migraine Headaches

We prepared this website to be as informative and helpful as possible. Many of our readers write to us about the fact that they are very skeptical about the relationship between jaw dysfunction and head pain (i.e. migraines, headaches, ear pain, tinnitus, etc.) How can the jaws cause migraines? How can jaw dysfunction cause neck pain, ear aches, headaches, and so many other facial and head pain issues? There is one thing that is clear and certain: jaw dysfunction/misalignment is usually the one and only reason behind your pain! You just need to find the right doctor to help you recover and cure your pain issues. So, even if you have been suffering with migraines for over 20 years, you will be happy to know that the future of headache treatment is here now and we can cure your problem…with guaranteed results!

We receive hundreds of inquiries, every week, for specific answers to individual problems. Most of the answers to these questions can be found on our website. Please go back and take the time to read through the website for your answers. Although we would like to be able to respond to individual inquiries, we cannot properly evaluate specific concerns without performing thorough in-office examinations. Also, due to legal reasons, we cannot render medical or dental advice to our readers without proper evaluations. Our clinic is located in Michigan, and for our nationwide/international readers, we can offer the following advice:

Visit the AACFP.ORG website. This organization has a list of specialists who treat patients with problems involving TMJ, Headaches, Facial Pain, etc. You may be able to locate a specialist close to your home that can answer your questions.
Interview the doctors that you find. Many dentists claim to know the answers, yet few can provide the proper treatment. The most important aspect of successful treatment is a proper diagnosis. An in-depth examination must include detailed patient examination forms, as well as some of the following diagnostic methods:
a. Transcranial X-Rays, Cephalometric X-Rays, MRIs, CatScans, or Tomograms. A skilled specialist must use one, or all of the above, for adequate diagnosis of your problems.

b. Complete Orthodontic Examination, including Sassouni Plus Tracing, that is used to analyze the jaw to jaw relationships. Proper treatment of facial pain problems involves repositioning the jaws into better alignment with each other. Proper diagnosis, using orthodontic measurements, must be made before any such treatment is proposed.

c. The specialist you find must be skilled at functional orthodontics, as well as prosthodontics. He/she must be able to align your teeth and jaws using braces, appliances, or crowns/bridges/implants. This requires an immense amount of skill and knowledge. Don’t be surprised to learn that there are only a handful of such super-star dentists! Our experience indicates that there are less than a few dozen such doctors available nationwide.

d. Your future specialist must also work closely with a team of doctors, including ENTs, neurologists, sleep specialists, physical medicine, therapists, chiropractors, etc. for optimal care.

Once you find a skilled specialist he/she can alleviate your pain and return you to a normal life. It is hard for most people to believe that a few select dentists are leading the way into head pain treatments (including migraines), but it is the future – today!

Although a complete neurological assessment is critical to proper diagnosis, most medical treatments aimed at curing head pain are not successful. It is somewhat hard to understand why physicians cannot help headache sufferers, and skepticism is not unusual for patients who do not understand how a dentist can cure headaches and facial pain. If you have reviewed the information on this website and our sister website www.646care.com you will find the answers to your dilemma.

You must also realize that treating your pain problems with medications is NOT correct treatment. Most medications prescribed for head pain simply hide the underlying problem by trying to fool you into believing that there is nothing wrong. Doctors prescribe these medications due to a lack of proper understanding of what is causing the pain. If a doctor prescribes medication for you without telling you specifically what is causing the pain, why would you trust such treatment? It is ignorance and lack of knowledge that causes such inadequate treatment to be performed by a large number of doctors. From our experience, treatments with medications (such as Imitrex, narcotics, pain relievers, and other agents) are usually not beneficial and can cause more long term problems. Muscle relaxants can help during treatment, but only if used temporarily. Just say NO to drugs!

Many of the questions that we receive also come from patients who have had previous treatments for TMJ or Headaches by specialists who claim to be able to cure these problems. Usually, these inquiries include concerns about the fact that previous treatments, bite appliances and braces did not help their problem. If you have received previous bite appliance treatments and your pain has not subsided, then we would advise you to have a second opinion regarding the adequacy of your treatment. The majority of the appliances that we evaluate lack efficacy. Some appliances can actually worsen your pain, if not constructed properly. That is why we advise all of our readers to find a skilled specialist who can properly diagnose pain and implement effective treatment. Likewise, a lot of orthodontic care can actually cause more pain, if not performed judiciously. There are many impostors posing as skilled doctors, in medicine as well as dentistry. Don’t be fooled by them!

Again, at the sake of being redundant, we cannot offer medical/dental advice to individual problems. If you are unable to locate a specialist in your area and you would like a first, or second, opinion to your problem, you can gather your medical information and mail it to our office for review. Here are the steps that you must follow for this process:

Send us a self addressed Manila envelope with 4 regular mail stamps on it. Send this to:

Michigan TMJ/Headache Institute
30003 Southfield Rd.
Southfield, MI 48076
We will mail you a detailed patient health questionnaire that you must complete
We must receive ONE (any) or all of the following tests for proper evaluation:

a. Transcranial x-rays of the TMJ (in closed and open positions)
b. Tomograms of the TMJ (in closed and open positions)
c. MRI's of the TMJ (with coronal and sagittal cuts, in closed and open positions)
All of these tests must be specific for your TMJoints, and MUST be performed with your mouth closed and back teeth touching with medium to heavy biting pressure. Your family physician, or ENT specialist, can order a MRI without any problem. The other two tests may be harder to locate. Oral surgeons in your area may have tomogram or transcranial x-ray machines in their offices. We would prefer to receive a tomogram.
Study casts of your teeth with a wax bite record of your normal bite. Your dentist can do this for you for under $100.
Dental x-rays of all your teeth
Panoramic X-Ray
Get together all of your previous medical records, including x-rays and lab results (include summaries and physician dictations)
A physical medicine evaluation would be valuable. A physical therapy report can substitute.
Any orthodontic records
Neurologic testing, preferably performed by a neurologist

Please do not submit letters or requests without gathering above information (steps 1-5 mandatory, steps 6-8 optional). We will not evaluate incomplete information.

Please submit check in amount of $175 made payable to Michigan TMJ/Headache Institute. You will receive a detailed opinion/evaluation of your individual problem. Sorry, we cannot submit diagnosis or insurance billing.

Many readers also want to know the cost of treatment. Although it is impossible for us to quote any prices without proper diagnosis, we can tell you that prices for such treatments start at approximately $475 and can range into thousands of dollars. Some patients can benefit from a simple device, such as a NTI deprogrammer, while other patients require extensive reconstruction. The average cost at our office is $950 for the first phase of treatment.

Dr. John Halmaghi and staff