Bruxism White Paper
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The NTI Clenching Suppression Device. The inventor of this mini-splint, Dr. Jim Boyd, describes it as "a patented pre-fabricated, easily retro-fitted anterior-point-stop device which suppresses clenching intensity in all excursive and protrusive movements." The device is said to effectively reduce clenching behavior. To find out more about this device, go to Dr. Jim Boyd's web page.
According to Dr. Boyd, the device may cause an annoying anterior open bite (this link contains a photo of a severe open bite). As well, as in the case of all other bruxism claims, a systematic, large-scale, double-blind study remains to be carried out. Here are the independent testimonials of two chronic bruxers:
I have been wearing Dr. Jim Boyd's NTI appliance three and a half weeks and it does suppress clenching. My sore muscles are healing and I haven't felt better in two and a half years. It feels so good to go to bed and know that I will not be beating up my muscles, nerves, joints, etc. with clenching I cannot control. As for cost. I went to California to a dentist there who charged me an outrageous price that is not typical. In addition, the NTI was not correctly fitted. Dr. Boyd had met me in Las Vegas and modified it to correctly fit it at no charge. To give you a better idea of cost, my adult daughter also clenches, so we called her dentist. His total cost is $190. There are no lab costs because the NTI can be fitted right in the office. Also, no dental impressions or molds are needed. It takes approximately half an hour to fit the appliance.
I checked out Dr. Boyd's device from your website link. The NTI-TSS involves a small oral appliance which was fitted by my dentist, preventing contact of the front teeth. The manufacturer asserts that the majority of bite force is generated by the rear teeth and, as such, by preventing their ability to connect, bruxing forces are reduced and symptoms of sleep bruxism alleviated. I experienced a problem with the device, which rendered it ineffective, for I continued to brux and simply became sore in new areas. Moreover, recent literature has discussed a number of cases where the NTI-TSS has been swallowed.
Another user writes:
In my personal experience, Dr Boyd's NTI clenching incisor device should NOT be used in patients with a crown on either of the center incisors. The crown will fracture because of the leverage applied by the device from the activity of clenching and grinding.
Dr. Alan Budd, a clinician, summarizes his experiences with the traditional splint and the NTI thus:
Once I realized the inescapable effects of bruxism, I began treating patients with splints. Then I learned about the NTI, and I haven't made but one or two full-arch splints since. I find the NTI everything it's cracked up to be. It takes practice to get good, and an anterior (never posterior) open bite may occur. As you say, the patient must be warned in advance of this potential side effect, and a treatment plan can be devised to deal with it if the patient so desires. Sore masticatory muscles, headache, neck ache, ear congestion, tinnitus, and sinus pain -- I've had one or more patients with each of these problems. They all got better. If there's a true joint disease, the NTI may not work and then it becomes a diagnostic tool.
A preliminary short-term study (Baad-Hansen et al., 2007) found that, unlike the ordinary splint, the NTI has an inhibitory effect on jaw-closing muscles during sleep, thus suggesting that the NTI may effectively inhibit bruxism in some cases.
Recommendation:Visit Dr. Boyd's web site, read independent reports, compare his approach to others in this page, and decide for yourself.
A Parting Word: If you are a clinician, you may wish to consult all links and references in this hypertext before prescribing a splint to one more bruxer (Harada et al., 2006). If you are a bruxer, I hope this hypertext helps you take charge of your health.
Good Luck!
"Unfortunately, owing to a shift in my research interests, frequent field work in places where I have no ready access to the internet, and the great volume of mail I receive on a daily basis, I am unable to provide bruxism-related advice or therapy." -Dr. Moti Nissani
