While some patients may find great headache relief from a balancing of the dental forces, patients who exhibit an internal derangement of the temporomandibular joint may require the fabrication of an orthopedic appliance, called an orthotic, which reestablishes proper relationships within the joint. These patients often have a displaced disc that does not come back into position once the muscles are relaxed or a degenerated condylar situation similar to arthritis called degenerative joint disease. Other discrepancies in growth and development may alter the balance of the structural components of the lower jaw. An orthotic is a specifically designed and custom fabricated orthopedic appliance designed to maintain a predetermined bite relationship that supports optimal muscle balance, TM joint harmony, and a functional chewing relationship. While headaches may be your primary reason for seeking TMJ migraine treatment, you will enjoy the many other benefits such as relaxing of your muscles, eliminating migraine trigger points and alleviating nerve and vascular compression of your joints. Some dentists recommend treating TMJ with surgery. In the absence of acute trauma, that is almost never necessary. In my 35 years of experience I have never recommended surgery to a patient. Our phase one TMJ headache treatment is nonsurgical, noninvasive and reversible. The National Institute of Dental and Craniofacial Research recommends that surgery to correct TMJ issues be avoided whenever possible.