Dentist advocates cold gel for migraines

Dentist Mark Friedman has invented an oral cooling device, in use here, to help stop migraine pain.

By Christy Feig
CNN Medical Unit

(CNN) -- A New York dentist is challenging the conventional thinking about what causes migraines and has developed a controversial new way to treat the debilitating headaches that affect some 28 million Americans.

More than a typical headache, experts believe migraines are triggered when blood vessels in the brain constrict, then expand, pressing on nearby nerves and causing the pain.

But Dr. Mark Friedman, a jaw specialist who works in Scarsdale and with the New York Medical College, has a different theory. He believes inflammation above the top molars presses on the maxillary nerve and causes the headaches.

"My practice is limited to jaw disorders," says Friedman, "so as a result I poked around a lot and I found tenderness occurred often, and when I looked at the history, these were always headache patients."

The tenderness occurred in a spot between the upper molars and the cheek, a spot "as far up and back as you can go," Friedman explains.

So he built a device to treat the problem.

"What do you do for swelling?" asks Friedman. "Cold."

His machine pumps cold water through plastic tubes to metal ends that are placed against the tender area.

"It's reducing the inflammation and reducing the swelling," he says.

VIDEO As CNN's Christy Feig reports, a New York dentist is challenging the conventional thinking about what causes a migraine (February 11) Play video (QuickTime, Real or Windows Media)

Friedman also created an anti-inflammatory gel that patients can use at home to prevent the inflammation from ever starting, or to help the headaches.

"If I have a headache and I put on the gel, inside 20 minutes the headache is gone," said Bethann Byrne, one of Friedman's patients.

Byrne used to miss several days of work a month because of migraines.

"When I would get headaches all the time, (I would think) 'I wonder what it's like not to have pain all the time,'" Byrne says. "Now I think to myself, 'I wonder what it's like to have headaches all the time.'"

Friedman has published his work in the journal Heart Disease, and says he's treated thousands of patients, many of whom are happy.

"It's absolutely changed the quality of my life," said Byrne.

Some experts, however, aren't convinced.

"I'd like to see multi-clinic studies, maybe doing 500 or 1,000 patients to see if his work proves out," says Dr. Seymour Diamond, executive director of the National Headache Foundation and author of Conquering Your Migraine.

Friedman believes migraines are triggered by swelling above the top molars.

He says triptan drugs, the newest class of migraine medication, "have been just like a miracle."

It also isn't unusual for migraine sufferers to turn to alternative treatments for relief.

Some patients swear by magnesium. Diamond says 400-500 mg of magnesium a day can prevent many migraines.

Clinical trials in Britain have shown that daily doses of the herb feverfew reduce the prevalence and severity of migraines in patients prone to the headaches, but Diamond adds that new studies there are showing the effect wears off over time.

Diamond's headache clinic has had great success with biofeedback for migraine headaches.

And, he says, about 30 percent of sufferers can control their headaches by simply avoiding certain foods. Aged cheeses, red wines, and chocolate all contain chemicals that are well known to trigger migraines.