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Old 12-27-2012, 05:17 PM   #1
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NTI and bruxism

I am pretty new here and haven't yet managed to get a diagnosis of TMJ disorder. My jaw does not pop, click or grind. But i have been having annoying ear symptoms i.e fullness, tinnitus, pressure...off and on for a few months now and am experiencing discomfort, tightness etc. around my jaw joint area, just in front of the left ear. My physio suspects my problem is mostly muscular.

I have had a long problem with bruxism and my dentist just fitted me with an NTI splint. It is not the most comfy thing to wear but I have stuck to it for nearly a week. However some nights, I think I still clench while wearing it and my ear symptoms are coming back to plague me. Is it normal to still clench over the device over the front teeth? Should I persist with it or discontinue in case it makes my problem worse?

 
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Old 12-27-2012, 06:47 PM   #2
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Re: NTI and bruxism

NTI's and many other splints don't really do anything to stop the clenching. Rather, they help prevent damage from occuring to the teeth with the clenching.

Personally, I've tried 2 types of NTI devices and I found them to be awful. I was in so much pain last year when I tried one again. I went in several times for adjustments and the device felt comfortable enough, but my jaw muscles were in horrible spasm with it. I ended up with increased ear problems also. My orthodontist decided after a week or so that it wsn't the right device for me.

I wore another type of splint prior to this that worked wonders, but I had to give it up when I got my upper braces. That was when I got the NTI. That splint was an upper splint with a wedge that came down in behind my lower teeth. It had a "beak" in the front that gave me appropriate bite height as well. After a while in it, I found my muscles had loosened up significantly and I wasn't bruxing any more. Without it, the bruxing returned.

I'd recommend going in for a follow-up with your dentist to discuss the NTI issues you are having.

One question. What is the training of your dentist? Some dentists have much more training in dealing with bite issues than others do. If you aren't seeing one, I'd recommend a consult with a Functional Orthodontist. When I finally saw one, I found out that a splint my general dentist had me wear for years actually contributed to my TMJ issues.
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Old 12-27-2012, 09:54 PM   #3
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Re: NTI and bruxism

MountainReader, thank you for your reply. By the way, I am Trex... I forgot my password on my other computer and so had to create a new account when posting from there! Oops.

I was given an NTI device by my dentist and was told that it would PREVENT me from clenching. The NTI literature seems to suggest that when you try to clench on your front teeth, you will automatically stop... but I don't think I do. The first time I tried it, I think I was "tapping" the splint but last night I was vaguely aware I was fighting it and probably clenching over it, as the vertical separation is quite small and allows my jaw muscles still to clamp hard over the splint. I am wary of causing even more damage while wearing the splint, so I may discontinue it, but I only see my dentist again on the 7th.... sigh.

My dentist is very experienced, 40 years as a general dentist, but I am not sure he is very well versed on TMJD issues. He said I had a deviation when opening/closing my jaw, but since I had no real jaw pain, he didn't think it was an issue at all. He said my ear issues weren't "dental" related. But he admitted my bite/occlusion was terrible and we're in the slow process of fixing my crappy old fillings.. my teeth did not meet up, were of uneven height, etc.

I am getting pretty desperate for a proper diagnosis though. The intermittent muscle spasms are driving me crazy. I've had countless sleepless nights already.

 
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Old 12-28-2012, 08:17 PM   #4
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Re: NTI and bruxism

With the NTI, I clenched worse. I know some people find success with them, I just found more success with other types.

Ironically, I never had any jaw pain. I wasn't even aware quite how tight my muscles had gotten or the fact I was in spasm so much. I brux when I sleep and didn't even realize that for a long time.

Tests on my tmj area showed I had the slipped discs and some degeneration of my condyles. If it hadn't been for the ear issues, I would never have known how bad things were getting. My general dentist had done a sleep splint for me, but totally missed my tmjd issues.

I hope you make progress with your dentist at your next visit.

If you continue to have so many problems, it might be worth getting a more thorough evaluation from someone trained in treating tmjd issues. Typically that may be a Functional Orthodontist, or a neuromuscular dentist.
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Old 12-29-2012, 11:59 AM   #5
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Re: NTI and bruxism

I had a bunch of TMJ symptoms and my dentist told me I didnít grind my teeth. My doctor sent me for an EMG sleep study and found out that while I wasnít ďgrindingĒ, I was clenching like crazy in my sleep. I told my dentist and he sent me to a friend of his who specializes in TMJ. That guy prescribed me an NTI mouth guard which was supposed to stop my clenching. It didnít work for me. I clenched on and it really messed up my jaw and my bite. I searched online and found some horror stories about the damage that clenching on an NTI can do, so I quit using it and started searching for another solution.

I read the Wikipedia article on bruxism and I decided to try a biofeedback headband. It doesnít go in your mouth. You wear it on your head and it tracks when you clench by muscle EMG signals like the sleep study, and it makes a sound when you clench when the biofeedback is turned on. The idea is to train yourself to practice some during the day relaxing your jaw when you hear the sound, so you can do that in your sleep without waking up. It took me a few days to get the hang of it, and since I have, it has really helped. All of my swelling and almost all of my jaw pain was gone within a month. Iíve had it about two months now, and have very little pain, and am hoping for a complete recovery. Iím still searching for ways to reverse the damage that I did by clenching on the NTI, but I am very glad that the biofeedback headband has allowed me to reduce my clenching to the point where that is not a problems any more.

 
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Old 01-01-2013, 12:34 AM   #6
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Re: NTI and bruxism

MountainReader, thanks. I read Dr Boyd's online book where he said that you still clench on the NTI splint, but with much less intensity, so it will not cause any more problems i.e headaches and such.

I am seeing my dentist only in a weeks time and am uncertain whether to keep wearing the splint until I talk to him.

Soundster, the biofeedback device sounds great in theory, but I am afraid that everything I have read about it online sounds like it is a waste of money... a lot of the reviews are fake and I am not sure I would like to be woken up every time I snored or moved in my sleep, which is what some reviewers have complained about! I'd do anything to stop bruxing at night, but I'm a little wary about springing several hundred dollars for something of dubious value.

 
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