The NTI Nightguard

December 16, 2020 · Dr. Lara Coseo

The NTI Nightguard: Everything You Need to Know

This article has been reviewed an updated for accuracy on 03/29/2023

What is an NTI?

NTI night guards, or Nociceptive Trigeminal Inhibition Tension Suppression System, are a type of dental appliance designed to help treat teeth grinding and clenching during sleep. These guards are different from traditional night guards as they only cover the front teeth.

The purpose of the guard is to reduce teeth clenching by blocking the sensation of pain from a specific nerve in the head, the trigeminal nerve.

The trigeminal nerve provides sensation to a large portion of the face and all of the mouth. The goal of this specific night guard type is to prevent the damage associated with teeth grinding & clenching, stop pain, especially headaches, by inhibiting this nerve.

The trademark version of this appliance is NTI-tss, which adds Tension Suppression System. The appliance is marketed as a remedy for migraines and tension headaches that are associated with bruxism.

In this article, we will explore everything you need to know about NTI night guards, including their benefits, disadvantages, how they work, and how to properly care for them.

Benefits of NTI Night Guards

NTI night guards offer several benefits over traditional night guards. Here are some of the advantages:

1. Some Individuals Find NTI’s More Comfortable

NTI night guards only cover the front teeth. They are also custom-fitted to your teeth, which ensures a comfortable and secure fit.

2. Effective

NTI night guards are effective in treating teeth grinding and clenching during sleep. They work by preventing the back teeth from touching, which reduces the intensity of the grinding and clenching.

3. Easy to Use

NTI night guards are easy to use and can be worn while sleeping. They don’t require any special maintenance or cleaning and are small enough to be carried in a pocket or purse.

Disadvantages of NTI Night Guards

While NTI night guards offer many benefits, there are also some potential disadvantages that patients should be aware of. Here are some of the possible drawbacks of wearing an NTI night guard:

1. Only Effective for Certain Types of Bruxism

NTI night guards are most effective for treating clenching or grinding of the front teeth. If you grind or clench your back teeth, a different type of night guard may be more effective.

2. May Cause Jaw Pain or Tension Headaches

In some cases, wearing an NTI night guard can cause jaw pain or tension headaches, particularly if the appliance is too tight or worn for an extended period. If you experience any discomfort while wearing your night guard, talk to your dentist.

3. May Affect Speech

NTI night guards can affect your speech, particularly when you first start wearing them. You may experience some difficulty speaking or lisping while wearing the appliance.

4. May Cause Tooth Movement or Shifting

Because NTI night guards only cover the front teeth, they may cause the front teeth to shift or move over time. This can cause changes to your bite and may require orthodontic treatment to correct.

5. May Require Adjustment Period

It can take some time to get used to wearing an NTI night guard. You may experience some discomfort or difficulty sleeping while wearing the appliance, particularly during the first few nights.

While NTI night guards offer many benefits for patients who grind or clench their teeth, there are also some potential disadvantages to consider. These include a limited effectiveness for certain types of bruxism, potential jaw pain or headaches, speech changes, tooth movement or shifting, and a required adjustment period. If you are considering an NTI night guard, talk to your dentist about whether it is the right choice for you and how to properly use and care for the appliance.

Why Do I Need a Night guard?

Night guards serve several important functions, including protection of the teeth, reduction of muscle force, and decompression of the jaw joints. A night guard is typically the first line of treatment for patients suffering from the effects of bruxism and/or TMD. Let’s explain those terms first.
Bruxism is the scientific term that encompasses both clenching and grinding of the upper and lower teeth with heavy forces. This can occur at any time, but it is most common during sleep.

TMD stands for TemporoMandibular Dysfunction or Disorder, and it refers to a problem with the jaw joints or TMJs (TemporoMandibular Joints). TMD means there is a problem within the joint, like a slipped disc or arthritis.

Bruxism may occur on its own or in conjunction with TMD, and vice versa. Many people clench or grind their teeth without having any problems in the jaw joints. Some people have severe problems in the joints without the clenching or grinding habit.

Frequently, these two conditions occur together.
Though these two conditions are different, they often benefit from the same general treatment of wearing a night guard.

How NTI Night Guards Work

NTI night guards work by creating a barrier between the front teeth, which prevents the back teeth from touching. When the back teeth touch during grinding and clenching, it triggers the trigeminal nerve, which sends pain signals to the brain. By preventing the back teeth from touching, NTI night guards reduce the intensity of the grinding and clenching, which helps to alleviate pain and discomfort.

NTI night guards are designed to fit snugly over the front teeth, using a unique design that separates the upper and lower front teeth. The appliance is worn during sleep and should be removed in the morning.

How to Properly Care for NTI Night Guards

Proper care of NTI night guards is essential to ensure their effectiveness and longevity. Here are some tips on how to properly care for your NTI night guard:

1. Rinse and Brush

After removing your NTI night guard in the morning, rinse it thoroughly with warm water. Use a soft-bristled toothbrush and non-abrasive toothpaste to clean the appliance. Be sure to brush gently to avoid damaging the appliance.

2. Soak

Soak your NTI night guard in a dental appliance cleaner, such as Efferdent or Polident, for at least 15 minutes each day. This will help remove any bacteria or plaque buildup on the appliance.

3. Store Properly

Store your NTI night guard in a clean, dry container. Avoid leaving it in direct sunlight or heat, as this can cause the appliance to warp or become misshapen.

4. Replace as Needed

NTI night guards should be replaced every six months or as recommended by your dentist. Over time, the appliance may become worn or damaged, which can affect its effectiveness.

Who Should Use an NTI?

An NTI is a wonderful treatment for patients who need temporary relief from the facial pain and headaches caused by bruxism. It is important for a dentist to verify that the condition of bruxism is occurring prior to the use of an NTI. If the headaches have a cause outside of the facial muscles, this treatment will not help.

It is a simple task for your dentist to confirm whether you are clenching or grinding your teeth. The heavy forces of bruxism leave pretty obvious evidence inside the mouth that your dentist can easily spot during an oral evaluation.

Another prerequisite for treatment of headaches and the pain of bruxism with an NTI is two healthy jaw joints. The health of the TM is a little more difficult to discern without advanced imaging and complicated testing.

Many dentists actually use the NTI as a tool for the diagnosis of the source of complex facial pain.
• If an NTI produces an almost immediate relief of pain, then the problem is likely originating in the muscles of mastication (the muscles that open and close the jaws).
• If wearing the NTI actually increases the pain, this implies that the source of the pain is inside one or both of the jaw joints.

Who Should Not Use an NTI?

Because of the risks of wearing an NTI, which we covered above in this article, you should NOT wear an NTI if you do not plan to remain under your dentist’s supervision.

A dentist must oversee any patients wearing an NTI to monitor the health of the jaw joints and intercept problems before they occur.
Patients with degenerative arthritis in the jaw joints are not a candidate for treatment with an NTI. Neither are patients with a displaced, or slipped, disc in one or both of the jaw joints.

Wearing an NTI or any type of anterior deprogrammer can aggravate the symptoms of TMD.
It is important for patients with untreated obstructive sleep apnea (OSA) to avoid the use of an NTI. Because the NTI allows the lower jaw to rest and position itself in a more retruded position, this can exacerbate sleep apnea by shrinking the size of the airway behind the lower jaw.

Alternative Night Guard Choices

The most common type of night guard made is a full arch dental night guard. This type protects the teeth from the effects of grinding and clenching and is the most popular type made in dental offices!

Please note Sentinel Mouthguards® does not make or carry the NTI device. We are a direct to consumer lab specializing in a variety of full arch dental night guards for teeth grinding and jaw clenching.

What are the Advantages of Wearing an NTI?

The NTI appliance carries many advantages that make it an attractive option for patients suffering from migraines, muscle tension headaches or other effects of bruxism.
• Compact size – The NTI is the smallest type of nightguard available. As opposed to most full-arch appliances, it is the width of four to six teeth and about a centimeter in height. Its small size means it is unlikely to stimulate any feelings of claustrophobia.
• Quick relief – When you use the NTI appliance for the right situations, it can provide almost immediate relief of the pain and muscle tension caused by heavy muscle forces.
• Appropriate for both daytime and nighttime use – The small size and unobtrusive nature of the NTI make it useful during the day for those who experience habitual clenching or grinding as they work, perform chores, exercise, commute, etc…
• No stimulation of gag reflex – As the NTI only covers front teeth, it does not touch the soft tissues near the back of the mouth that lead to gagging. Patients with very sensitive gag reflexes may be unable to tolerate full arch appliances.
• Fewer speech effects – Its position over the lower front teeth causes fewer lisps and other speech impediments when wearing the NTI.
• Protection of the teeth – Because it effectively separates the upper and lower teeth, the NTI appliance protects the teeth from the damage that occurs during bruxism. This includes cracked teeth, flattening or shortening of the teeth, and gum recession.
• Helpful tool for diagnosis of TMD – We explained this in the previous section. Wearing an NTI can help your dentist determine the underlying problem causing the pain you are experiencing.

What are the Risks of Wearing an NTI?

After reading through the previous section on the advantages of an NTI, you may be convinced that it sounds just about perfect. We hate to burst that bubble, but it is essential that you understand the risks associated with long-term NTI usage.
• Aggravation of TMD symptoms – When a patient has problems within the jaw joint(s), the positioning of the ball in the socket affected by an NTI can cause those problems to worsen. For example, if a TMJ has a slipped disc, NTI wear can actually push the disc further out of the joint. This is good news and bad news. The good news is that the worsened symptoms will cause you to stop wearing the appliance. The bad news is that the damage could be irreversible.
Due to the above risk, you should never wear an NTI without a dentist’s prescription and direct supervision.
• Serious bite changes – Many people find so much relief from headaches and facial pain that they wear the NTI religiously. By covering only a few of the teeth for many hours each day, the NTI appliance actually allows a serious change in the bite to occur. The NTI separates the upper and lower teeth, but it only provides a barrier on the front teeth. This leaves an air gap between the upper and lower back teeth. Over time, these back teeth will drift together, while the front teeth remain separated by the barrier of the appliance. This causes an orthodontic condition called an open anterior bite. It takes time for this to happen, so wearing an NTI is fine as long as it is only temporary.
Due to the above risk, you should never wear an NTI for more than three months.

What is the Most Important Thing to Know about NTI?

Unfortunately, most of us are not perfect. The puzzle-piece fit of the teeth (what dentists refer to as occlusion) takes precedence over the position of the ball in the socket of the jaw joints. Therefore, a “bad bite” could fit the teeth perfectly together while pulling the ball out of the socket.

When there is a disparity between these two positions (where the teeth want to be versus the appropriate position of the ball in the socket), the facial muscles become overactive, leading to muscle tension and headaches.

An anterior deprogrammer (like the NTI-tss) removes the teeth from the equation so that the jaw joint can settle into its ideal position with the ball firmly in the socket when the joint is at rest. By taking the teeth out of the equations and letting the jaw joint rest, you can actually “turn off” the muscles. This relieves muscle hyperactivity and tension. That is the goal of an NTI.

The most important thing to understand is that an NTI appliance is a valuable tool in the treatment of facial pain and headaches as long as it is used temporarily and under a dentist’s supervision.