Migraines, bruxism and TMJ dysfunction are but three of many conditions associated with the Trigeminal Nerve System (TNS) - all of which can have a painful, debilitating effect on sufferers. Unfortunately, while these conditions are undoubtedly distressing, all too many people suffer in silence, and are unaware that there are real, scientifically validated solutions available that can make dramatic improvements to their daily quality of life.
One solution that's gained a lot of support in recent years is the NTI Tension Suppression System (NTI-tss). NTI-tss works by utilising occlusal splint technology to reduce the parafunctional intensity of the temporalis, masseters, and to a degree, the lateral pterygoids.
In 1998 NTI-tss was officially approved by the FDA (Food & Drugs Agency USA), and to this day is the most effective non-drug FDA-approved method of migraine prevention available. Among its many benefits the NTI-tss system is recognised as producing excellent clinical results, and with fabrication taking around 10 minutes, is an extremely simple and fast chair-side procedure.
Indeed, evidence would suggest that NTI-tss uptake has been huge, especially in the USA, and success rates have been very good. Furthermore, a 2008 literature review of academic studies in the area found that, 'Evidence from RCTs (randomised controlled trials) suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs.'
Despite the obvious advantages of NTI-tss and its high success rate, there still exist many rumours, or 'myths' surrounding the technology and the appliance itself – all of which are proven to be unfounded, with no base in scientific evidence.
One of the most common myths surrounding NTI-tss relates to supra-eruption of posterior teeth. Some of the most revealing research in this area was conducted by Kinoshita et al. In their study researchers demonstrated that it took at least eight days of hypofunction (no occlusal contact at all) of the molars before eruption of the unopposed molars occurred. Although the specimens in this study were rats and not human beings, the results still demonstrate that a long period of time is required before unopposed molars begin to erupt, and this is only after prolonged periods of no occlusal contact at all.
Barry Glassman agrees with this conclusion. Renowned as an international speaker on pain management and sleep disorders Barry has repeatedly supported the use of NTI-tss and has rejected arguments of supra-eruption when taken in the context of the limited time the NTI-tss is worn each day.
A further common myth surrounding the NTI-tss appliance is the likelihood of patients swallowing or even aspirating the device in their sleep. Naturally this would signify a significant health hazard were it at all likely. In his technical analysis of the NTI-tss however Wes Shankland dismisses this concern. According to the former president of the American Academy of Head, Neck and Facial Pain, the mean average maximum tongue-tip pressure of the human being is 1136.58 gm/cm2 (which decreases with age), while the mean average pressure required to dislodge an NTI-tss appliance is approximately 2958.73 gm/cm2. Given this consideration, and the fact that the forces generated when performing parafunctional activities would actually aid in retention of the appliance, Wes concludes that 'it seems totally inconceivable, within reasonable certainty, that an NTI-tss appliance could be dislodged by a patient while sleeping.'
Another associated concern surrounding the NTI-tss appliance relates to disk perforation. For an appropriate response to this concern, and indeed previous concerns raised in this article, readers should remember that NTI-tss Inc is obliged to report any and all adverse results to the FDA so that the public (both patients and dentists) can be fully informed of its limitations. These results can be found using the FDA's own website www.fda.gov, using the MAUDE database which represents reports of adverse events involving medical devices. It should be noted that thus far, for over 1.5m NTIs in use, not a single disk perforation has been reported – nor indeed has there been a single case of swallowing, aspiration, or any other concern linked with the NTI-tss appliance.
The figures then, would seem to speak for themselves. While there will undoubtedly continue to be some dissenting voices in the NTI-tss debate, the scientific evidence, supported by the FDA findings are clear. With an expansion in splint technology, and the number of practitioners adopting it in the treatment of bruxism, TMD, migraines, and other conditions, there should be no reason for patients not to receive the treatment they desperately need. With NTI-tss technology the help is out there – it's safe, it's affordable, and it's highly effective.
References available on request.