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Medical Forum / General / Dentistry / January 2005New user of NTI device. Improvement, but still clenching. Ideas?
Wearing it for about a week. Made in one visit. It spread my front teeth a little and pushed up the gum between them (not a big deal). Definitely reduced the soreness and tension but not completely. I still find myself clenching by pressing the lower front teeth against the device. The theory is that as long as your four anterior teeth are the only teeth to contact, you cannot clench with as much force. This is why your symptoms have diminished (less force on clenching, less problems with your muscles). Dr. Bonilla Also, if the NTI was properly fitted it would act like a retainer for the teeth that it is fitted over. There could be no spreading. It sounds like a change in the vertical opening could improve this case, but I can't say for sure being over the internet and having limited information on the case. Fawks > The theory is that as long as your four anterior teeth are the only > teeth to contact, you cannot clench with as much force. This is why > your symptoms have diminished (less force on clenching, less problems > with your muscles). > Dr. Bonilla I was also thinking that increasing the vertical opening between the teeth might do it. My lower teeth are worn down a millimeter or 2 and the upper teeth are a little chipped. If I understand correctly, there should be no increase in horizontal distance between the 2 upper front teeth? >Also, if the NTI was properly fitted it would act like a retainer for >the teeth that it is fitted over. There could be no spreading. > >It sounds like a change in the vertical opening could improve this case, >but I can't say for sure being over the internet and having limited >information on the case. I agree with Falks. Also you should not have the spreading or spacing or impingement on the gums. NTI should be adjusted . It would be nice to see a picture of your bite > I was also thinking that increasing the vertical opening between the > teeth might do it. My lower teeth are worn down a millimeter or 2 and [quoted text clipped - 9 lines] > >but I can't say for sure being over the internet and having limited > >information on the case. Thanks Westerman. <VBG> 'Falks' > I agree with Falks. > > Also you should not have the spreading or spacing or impingement on the > gums. NTI should be adjusted . > > It would be nice to see a picture of your bite Are you saying that it's ok that some clenching occurs. I was under the impression that NTI causes the jaw to open as soon as the teeth touch it (via reflex movement). >The theory is that as long as your four anterior teeth are the only >teeth to contact, you cannot clench with as much force. This is why >your symptoms have diminished (less force on clenching, less problems >with your muscles). >Dr. Bonilla > Are you saying that it's ok that some clenching occurs. I was under > the impression that NTI causes the jaw to open as soon as the teeth > touch it (via reflex movement). Your device needs adjusting, but I can't be sure what's wrong without seeing it. Your teeth shouldn't separate either, nor your gums recede. Dr. Bonilla Clenching is just biting with too much force. You will still bite, obviously. The thing is when do you consider it's biting and when do you consider it's clenching. I would say that it's clenching if you have symptoms. The NTI device should make it uneasy for you to clench since you are contacting only on a small anterior area with teeth that will alert you of any undue force. If by any chance, a canine is contacting the device, then you will be able to bite down harder (and symptoms may persist). Dr. Bonilla I don't think the 'reflex' action is 100% during sleep. Find the proper shape for the NTI, and it will still work just fine. Finding a verical dimension that is comfortable and still interrupts bruxism is sometimes more difficult than others. On cases where teeth have been badly worn, or there is some other problem leading to an 'overclosed' bite, there are times that I leave the discluding element at the 'stock' opening. Experience helps the dentist to have an 'educated guess' at where to start. Fawks > Are you saying that it's ok that some clenching occurs. I was under > the impression that NTI causes the jaw to open as soon as the teeth [quoted text clipped - 5 lines] >>with your muscles). >>Dr. Bonilla ok, thanks to Westerman, Falks, Barilla et al. for responding. :-) The last part on which I am unclear is whether the lower teeth should touch the NTI. I always thought that anterior teeth do not touch if jaw is relaxed. Is this the same with NTI, i.e. should the lower teeth not touch the NTI most of the time or is it OK if lower teeth touch the NTI and minor clenching occurs. >I don't think the 'reflex' action is 100% during sleep. Find the >proper shape for the NTI, and it will still work just fine. [quoted text clipped - 17 lines] >>>with your muscles). >>>Dr. Bonilla Yes, as long as no posterior teeth touch (including cuspids). Fawks is it OK if lower teeth touch the NTI and > minor clenching occurs. |
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