The pineal gland is an endocrine gland that is located in the posterior aspect of the cranial fossa in the brain. Its importance is in the circadian cycle (24 hour cycle) of sleep and wakefulness is related too the production of melatonin, a neuroendocrine hormone made from tryptophan and is  associated  with natural periods of light and darkness

Pineal Gland  sympathetic innervation is derived from the superior cervical ganglion while the parasympathetic innervation is from the optic and pterygopalatine ganglion (Sphenopalatine Ganglion, Sluder’s Ganglion, Meckel’s Ganglion) which is the largest parasympathetic gangliion of the cranium..  The sympathetic fibers of the superior cervical chain travel through the Sphenopalatine Ganglion (SPG) and travel along with the parasympathetic  fibers of the SPG on all the branches of the trigeminal nerve.  The pineal stalk of the gland also has nerve fibers along with innervation from neurons from the trigeminal ganglion.

The Pineal gland is implicated in the control and regulation of female hormone levels, and it may affect fertility and the menstrual cycle.  A commonly noted side effect in female patients who self-administer SPG blocks is an increased libido and orgasm frequency.  That’s due in part to the melatonin produced and excreted by the pineal gland.  I have not observed this in male patients, but I hypothesize that sexual experiences in females are more parasympathetic in nature and in males is more sympathetically driven.  Much like sympathetic aggressive male behavior noted in other mammalian species the need to spread sperm is a genetic imperative.

Recent studies have shown that about 1/3 of essential hypertension can be cured or eliminated by Sphenopalatine Ganglion Blocks. An excellent 2016 study from the International Journal of Cardiology was “Infiltration of the Sphenopalatine Ganglion decreases blood pressure in newly diagnosed and never treated patients with essential hypertension”.  It concluded “SBG block might be a promising, non-invasive, safe, painless and easy to perform therapeutic option of BP decrease. As with renal denervation, Sphenopalatine Ganglion Blocks should be effective in those hypertensive patients with an activated SNS, so a period of patient selection should precede the application of this procedure.”  In other words Sympathetic overload patients or patients with high levels of chronic stress can be effectively treated for hypertension with SPG Blocks.  A 2018 study “Bilateral sphenopalatine ganglion block reduces blood pressure in never treated patients with essential hypertension. A randomized controlled single-blinded study”  in the same journal concluded “SPG block is a promising, minimally invasive option of BP decrease in hypertensives, probably through SNS modulation. Additionally, due to its anesthetic effect, SPG block might act as a method of selection for those hypertensive patients with an activated SNS before any other invasive antihypertensive procedure.”

These articles point to the fact that neuromodulation of the Sphenopalatine Ganglion and/or blocking can have both diagnostic and treatment options in hypertension..  A disease closely linked to high stress and sympatheetic overload is TMJ /TMD or Temporomandibular Disorders which are often associated with a wide variety of head and neck pains, migraines and other Trigeminal Autonomic Cephalgias.  Neuromuscular Dentistry is widely acknowledged for it’s success in treating  TMD and this may be directly related to the use of a Myomonitor.  The Myomonitor is a ULF-TENS (ultra low frequency TENS) that acts as a Triigeminal Nerve, Facial Nerve  and Sphenopalatine Ganglion Neuromodulation unit.  It has over a 50 year safety record and it is effectively utilized in diagnosing and treating one of the most complex disorders known that is so confounding it has been called “The Great Imposter”.

The method of action on hypertension is not known but it may be related to the pineal gland.  A 2016 study in Current Opinions in Lipidology “Effects of Melatonin on Cardiovascular diseases: progress in the past year” looked at the effect of the  pineal gland and melatonin(N-acetyl-5-methoxytryptamine).   According to that article recent findings include “In the past year, studies have focused on the mechanism of protection of melatonin on cardiovascular diseases, including myocardial ischemia-reperfusion injury, myocardial hypoxia-reoxygenation injury, pulmonary hypertension, hypertension, atherosclerosis, valvular heart diseases, and other cardiovascular diseases.”

The article summarizes “Studies have demonstrated that melatonin has significant effects on ischemia-reperfusion injury, myocardial chronic intermittent hypoxia injury, pulmonary hypertension, hypertension, valvular heart diseases, vascular diseases, and lipid metabolism. As an inexpensive and well tolerated drug, melatonin may be a new therapeutic option for cardiovascular disease.”  If we can control the pineal gland by the utilization of Sphenopalatine Gangliion Blocks and/or Neuromodulation of the Sphenopalatine Ganglion and Trigeminal Nerve we may hold answers to those problems and many more.

The pineal gland may  also be helpful in mood stabilization and the size and  functioning capacity of the pineal indicate your risk for certain mood disorders. Seasonal Affective Disorders (SAD) is directly linked to melatonin, circadian rhythms and length of daylight.  It is commonly treated with light therapy, ie exposure to bright full spectrum light.  A Study Psychiatr Danub from 2015 “Pineal gland volume in schizophrenia and mood disorders”  that volumetric changes in the pineal gland of patients with schizophrenia may be involved in the pathophysiology of this illness.

Another question is whether the volume of the pineal gland is affected by timing and intensity of light exposure as well as whether input of the somatosensory triigeminal nerves the go to the pineal gland affect volume.

The use of autonomic blocks to treat anxiety, depression and PTSD is also well known.  SPG Blocks are exceellent, especially when they are self administered by patients to turn off anxiety and to prevent it.  Stellate Ganglion Blocks (SGB) used to treat shoulder pain are be studied by the military as a “one shot cure for PTSD” and have been called the “God Block”.  Sphenopalatine Ganglion Blocks have been called “The Miracle Block” after the publication in 1986 the popular book “Miracles on Park Avenue” which detailed the amazing and seemigly miraculous practice of NYC ENT Dr Milton Reder”

A 2017 paper in J Cereb Flow Metab “Perivascular neurotransmitters: Regulation of cerebral blood flow and role  in primary headaches” (pubmed abstract below) does and excellent job of putting this information into excellent order to explain the role of the trigeminal nerve and the sphenopalatine ganglion and their role in primary headaches.  The trigeminal nerve is often called “Thee Dentist’s Nerve” because of the innervation of dental pulp, periodontal ligaments, masticatory muscles, TM Joints, tonge as well as numerous eye, sinus and ear issues.  Many do not realize that it also controls the blood flow to the anterior two thirds of the meninges of the brain.  Nociceptive input into the trigeminal nerves often results in creation of primary and vascular headaches of all types.

The article states that ” During headache attacks, ganglia such as trigeminal and sphenopalatine (located outside the blood-brain barrier) are variably activated and sensitized which gives rise to vasoactive neurotransmitter release.” but ignored that that activation is from peripheral input from the dental and masticatory complex.  This is what computer engineers would call an I/O error (Input/ Output error) or in common computer speak “Garbage in / Garbage out”.  Nociceptive inpur is the underlying impetus behind trigeminal modulated  headaches of all types.

The Myomonitor was originally invented by a Seattle prosthodontist Dr Barney Jankelson to aid in diagnosis and treatment of masticatory function and associated pains.  Barney was also looking to help his wife who suffered from MS or Multiple Sclerosis.  He created a modern miracle in dentistry  50 years ago that is just beginning to be understood.  Dr Jankelson was the father  Neuromuscular Dentistry and also formed ICCMO, the International College of CranioMandibular Orthopedics as iits Scientific Organization seeking to advance and perfect the field of Neuromuscular Dentistry.

Dentistry has been intimately involved in all headache treatments since TMJ disorders were first described by Costen in 1934.