Can a teen with 2 months of chronic headaches not improve after 2 weeks of an oral appliance for tmj, still have tmj as the cause of the headaches?

Etiology: My thinking after this would be that perhaps bite related TMJ symptoms aren't causal here. I'd expect some impact from the appliance, assuming it has actually been in use ;) other TMJ issues such as articular emminence anatomy still may factor in. Does joint imaging show anything?

See your physician: Consider an exam with your physician or a referral to a neurologist to rule out other sources of her chronic pain.

Neurologic exam: Most definitely see your physician asap. Also, TMJ orthotics need to be worn as close to 24/7 if your problem is truly occlusion based and if you are having an acute episode. Orthotics also need frequent adjustment. Know that malocclusion (the reason for wearing an orthotic) does not usually have headache only as a single symptom, there are usually other problems at the same time.

Yes TMJ is Possible: Chronic headaches need to be investigated by a neurologist. Tmj can be a cause of headaches. Not all oral appliances are 100% effective in eliminating TMJ and other potential therapies and possible etilogies of the headache should be considered.

Yes: Yes, if the appliance does not help the TMj problem, then it won't help associated headaches. If you're trying to rule TMJ in or out as a cause of the headaches, you may want to consider a TMJ diagnostic injection. The TMJ is anesthetized with a long acting local anesthetic. If during the several hours the TMJ is numb, the headaches dissipate, then one can assume that headaches are related to TMJ.