NTI Night Guard?
Hey you! There’s something stuck in your teeth. Oh that’s right – it’s an NTI-TSS…
What is the NTI-TSS (Tension Suppression System)?
The NTI TSS (Nociceptive Trigeminal Inhibition Tension Suppression System) is a small plastic device that is originally designed to prevent headache and migraine caused by teeth clenching and grinding. The objective of the NTI is to relax the muscles involved in clenching and teeth grinding.
The NTI TSS device is an anterior bite stop, worn over the two front teeth at night to prevent contact of the canines and molars. It is fitted by a dentist trained in the technique, who can quickly customize such a device for a patient’s mouth.
“…The NTI dental guard is technically also a biofeedback device (translating physical bite force into an uncomfortable feeling in the front teeth)… “ (wikipedia)
The NTI TSS decreases the strength of tooth clenching by triggering a nerve reflex that relaxes the muscles, and at the same time prevents the molars from touching. It aids the user in stopping unconscious forceful clenching and biting, preventing common consequences such as worm out teeth, jaw pain and inflammation and tension headaches.
The NTI TSS device and therapeutic protocol were developed and patented by a California dentist, James Boyd, DDS. Dr Boyd developed the NTI TSS device to prevent tension-type migraine and headache he used to suffer from for 12 years. Scientists believe that most migraine sufferers have their headache as a consequence of teeth clenching.
NTI TSS has been approved by the FDA in 1988 for the treatment and prevention of “bruxism, temporomandibular disorders (TMDs), occlusal trauma, tension-type headaches and/or migraine”.
What do the scientists say?
Research results on the effectiveness of the NTI TSS are varied. One study found the NTI-TSS more effective than an occlusal splint in reducing clenching. However, in another study, this partial-covering device has shown to be less effective than occlusal guards that provide fuller cover (and thus complete separation of the top and bottom teeth). Although there were few side effects, one wearer reported an open bite after wearing the TSS..
According to the review of the five random studies of the effectiveness of the NTI TSS devices conducted by Swiss scientists, the device may be used with significant success for the management of bruxism and TMDs. To avoid potential side effects, the user should be regularly monitored. It is successful only if the desired effect the reduction of jaw closer muscle activity (e.g., jaw clenching or tooth grinding). It can also be used as an emergency device for people suffering from the acute temporomandibular pain.
See this few clips for a demonstration of the NTI-TSS:
Health forum has a long thread of discussion on the NTI TSS. Many users are complaining about the lack of success. The users that were happy with the TSS reported that it is very important to keep adjusting the device with the dentist until it works as it should. It requires patience and persistence. General conclusion is that the device is not for everyone. Some users complained that their dentists charged them too much ($850).
Reviews on the effectiveness of the device published on Dr Nissani’s site  are varied. One wearer and one dentist found the NTI-TSS highly effective. Another user warned against wearing the NTI-TSS if one has crowns on either of the center incisors. The leverage pressure from bruxing, in their experience, fractured the crowns.
Use with care
If you and your dentist think an NTI-TSS is a good option for you, make sure it is properly fitted to your teeth so that you don’t need to hold your bottom jaw too far forward or back to be comfortable. Arrange for regular check-ups so that your dentist can see if there are any potential problem developing from the use of the TSS device, and discontinue its use if necessary. See your dentist if you notice any new symptoms or discomforts.
In general, with all dental appliances (mouth guards, NTI-mouth-guard), treatments have to be started as soon as the problem is diagnosed. This allows for early treatment and prevents additional damage to the tooth enamel – damage which will require more expensive and complicated treatment.
Where can you get the NTI TSS?
NTI TSS devices are not available to average consumers. They have to be installed and adjusted by a trained dentist, who takes detailed measurements of your teeth and jaws and sends them to a specialized lab. It is very important that the device gets adjusted to your particular needs and it often requires several adjustments to fit right. If not adjusted, TSS can cause additional problems and jaw misalignment. If your dentist has no experience with it, ask him to recommend someone who does. Dentists should refuse to install the device to patients who refuse to commit to the monitoring and adjustment. There is currently no database of dentists who are experienced in installing NTI TSS, but the www.NTI-TSS.COM website promises to have one soon.
- Nissani, M. Bruxism: Advice, Links, Resources. Retrieved October 17, 2008, from http://www.is.wayne.edu/mnissani/bruxnet/Advice.htm
- Yahav, R. (2007). Everything About Tooth Grinding. In beOk. Retrieved October 2, 2008, from http://www.beok.co.il/SelectedArticle.aspx?ArticleID=4823 [With the kind help of translation services]
- Baad-Hansen, L., Jadidie Castrillon, F., Thomsen, P.B., et. al. (2006). Effect of a nociceptive trigeminal inhibitory splint on electromyographic activity in jaw closing muscles during sleep. Journal of Oral Rehabilitation, 34(2), 105-111.
- Falace, D. A. (2007). Bruxism. In J. F. Pagel and S. R. Pandi-Perumal (Eds.) Current Clinical Practice: Primary Care Sleep Medicine: A Practical Guide (pp. 275-282). NJ: Humana Press Inc.
- Wikipedia. NTI Tension Suppression System. http://en.wikipedia.org/wiki/NTI_Tension_Suppression_System
- Stapelmann, Henrike and Türp, Jens C. The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature. Retrieved June 24, 2012 from http://www.biomedcentral.com/1472-6831/8/22
- http://en.wikipedia.org/wiki/Bruxism –> Dental guards and splints–> paragraphs 2-3