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Medical Forum / General / Dentistry / February 2007I asked the graduate school prof about an NTI
My student dentist had indicated that she thought I grinded my teeth and so should get a night guard. I said that I doubted I would be able to wear one because I am a very light sleeper and had trouble wearing the teeth whitening thing that was made for me a few years ago. So then I read you guys talking about NTI and I decided to ask her about that. So I did and she had never heard of it. She asked another student dentist and he had never heard of it. Then she asked the prof, probably 60 years old. He looked puzzled and said it was for headaches. I said, "Yes, but apparently some dentists are using them successfully for grinding problems." He said, "Maybe for short term use it might be okay, especially if grinding is giving you headaches, but long term use will probably cause the front teeth to protrude, and also it can cause problems in the jaw, leading to TMJ or other problems." I can't remember exactly what he said, but it was something like that. In any case, he was very much against it. Seemed to me that he really didn't know much about it, though and was probably behind-the-times in his views on this. But what about these assertions? Personally, the cost of a night guard OR an NTI seems overpriced to me, and I am leaning towards not getting either one. I really have no proof or indication, that I grind all that much in the first place. I have never had headaches much at all (until my recent sinus lift - see my thread on that!). So I am skeptical about my need for any kind of guard. > But what about these assertions? Pure, unadulterated BS. They do not use or understand the device and have made up complications that simply do not exist. > Personally, the cost of a night guard OR an NTI seems overpriced to > me, and I am leaning towards not getting either one. I really have no > proof or indication, that I grind all that much in the first place. I > have never had headaches much at all (until my recent sinus lift - see > my thread on that!). So I am skeptical about my need for any kind of > guard. What is it worth to get rid of pain? What is it worth to preserve tooth structure, reduce fractured teeth, avoid a root canal or two, and the subsequent crown? How about doctors visits, MRIs, CAT scans, other tests, and drugs to treat problems that will be controled with one little piece of plastic (with no side effects!). Skepticism is natural. It took me a year after learning of them to ever make one. That's been over 7 years ago, and I still can't believe how good they really are. The way I treat skeptics is to make an NTI with the deal that they can pay for it a month later or give it back to me a month later. Very few want to give it back. Of the ones who do say 'no', I don't know if any of them actually used the device for even one whole night. Steve >> But what about these assertions? > [quoted text clipped - 27 lines] > >Steve Steve, that's a great deal! If I was offered that deal, I would take it! I would also give it a fair test, forcing myself to use it for a month. Seems like a big risk on your part, to have to "eat" the device. I assume they still pay for the sessions leading up to the making of it, though, the models and so forth? You can't give away your time. Anyway, I felt that the prof should have just said, "No, I really don't know much about it" instead of feeling he had to come up with an answer. I think he was put on the spot for having to come up with an answer, not wanting to admit in front of his student that a patient knew more about something (what I have read here) than he did. So therefore he just blathered out an answer. I'd like to take him and my student dentist some info on the NTI. If I could print out just one or two articles from the net, what would you recommmend? If he was impressed, he might introduce this technology to the dental school! > Steve, that's a great deal! If I was offered that deal, I would take > it! I would also give it a fair test, forcing myself to use it for a > month. Seems like a big risk on your part, to have to "eat" the > device. I assume they still pay for the sessions leading up to the > making of it, though, the models and so forth? You can't give away > your time. No hidden charges. It takes about 10 minutes and $15 to make an NTI (once you get the hang of it). It is made directly in your mouth. No impressions. No models. No lab bill. The fee is in the knowledge to use the device and its relative value for what you get out of it (compared to drugs, full mouth rehab, conventional splints, etc.) It is so predictable and so easy that I don't have much of a risk. > I'd like to take him and my student dentist some info on the NTI. If I > could print out just one or two articles from the net, what would you > recommmend? If he was impressed, he might introduce this technology to > the dental school! The NTI website would be a good place to start (HeadacheHope.com) They could join the Internet Dental Forum or visit us right here on smd. :-) Steve >No hidden charges. It takes about 10 minutes and $15 to make an NTI >(once you get the hang of it). It is made directly in your mouth. >No impressions. No models. No lab bill. The fee is in the knowledge >to use the device and its relative value for what you get out of it >(compared to drugs, full mouth rehab, conventional splints, etc.) Interesting... >It is so predictable and so easy that I don't have much of a risk. > [quoted text clipped - 4 lines] > >The NTI website would be a good place to start (HeadacheHope.com) Thanks. I'll print out some stuff and hand it to the dentist or the prof. >They could join the Internet Dental Forum or visit us right here on smd. Fat chance they'd do that. But I'll put the info on the sheet I print out. What is the Internet Dental Forum, or Where is it, specifically (url)? Is it www.internetdentalforum.net or http://www.internetdentalforum.org? >:-) >Steve >>The NTI website would be a good place to start (HeadacheHope.com) > [quoted text clipped - 7 lines] > (url)? Is it www.internetdentalforum.net or > http://www.internetdentalforum.org? You have to use the '.org' to get to the sign up web page. Regular subscription are $120/yr, but dental students may sign up for free. I'm not sure if there is a discount for dental educators. It was a combination of posters from smd and the IDF that got me to try the NTIs. I've learned a lot about local anesthesia techniques and endo as well. Once in a while I also get a 'heads up' about a material change, new product, or upcoming shortage while I have time to prepare myself. Steve > My student dentist had indicated that she thought I grinded my teeth > and so should get a night guard. I said that I doubted I would be able > to wear one because I am a very light sleeper and had trouble wearing > the teeth whitening thing that was made for me a few years ago. Your mileage will vary, but since I changed from a lower jaw soft nightguard to an upper NTI last week here's my impression. The nightguard is bulky and fell out the first few nights I have worn it. The NTI on the other hand is tiny and stays in place. However, it puts some pressure on upper and lower incissors, I also wake up with a sore tongue since it seems to rub against the occluding element. So far I would rate the soft nightguard higher in comfort, but if you can't sleep with your mouth feeling full then the NTI might be a better choice. Price for night guard ~ $200 (back in 2002), price for NTI ~ $450 (last Wednesday). > I really have no > proof or indication, that I grind all that much in the first place. I > have never had headaches much at all (until my recent sinus lift - see > my thread on that!). So I am skeptical about my need for any kind of > guard. That might also reduce the willingness to wear them. My jaw clicks when opened wide and the muscles are sore, so there was good motivation to do something about it. The nightguard reduced symptoms by 50%, with the NTI I have not seen any change yet (but it's only been 4 nights so far). >> My student dentist had indicated that she thought I grinded my teeth >> and so should get a night guard. I said that I doubted I would be able [quoted text clipped - 23 lines] >by 50%, with the NTI I have not seen any change yet (but it's only >been 4 nights so far). Thanks for the unbiased report. Keep them coming, please! Yes, personal experiences are generally good to hear about. If your tongue is sore, you need to have the device trimmed and polished. Sore incisors are not normal either. How 'tall' is the discluding (not occluding) element? The original NTI devices had a rather long and tall discluding element. It required significant trimming for most cases. The newer 'reduced vertical' NTI needs much less trimming for the average case, but for closed bites, it may not open the bite sufficiently. For significant overbites, even the reduced vertical sometimes needs adjusting. I suspect that an adjustment with your vertical might help. One size doesn't fit all. That also brings up a point about the fees. There are times where I may need to make a different NTI than I first construct. There are lots of times that I need to fine tune the device. I may need to trim and polish for a sore tongue. I may need to alter the bite. I may need to make a 'slide bar' to go along with the regular NTI. The point is that we should not be saying, "An NTI cost $X", and a patient should not just have an NTI made and be dismissed as if the treatment is complete! The fee should include working with the patient and their NTI until everything is as comfortable as possible. The fee is for treatment that includes an NTI. Not a fee just for an NTI. If the patient is not told to communicate any problems, return for possible adjustments, keep the device away from pets (especially dogs, they will chew them up in a heartbeat), bring the NTI in when getting check-up, to occasionally check the discluding element for wear or notches, etc., then the patient is being short changed. JMO, D >>>My student dentist had indicated that she thought I grinded my teeth >>>and so should get a night guard. I said that I doubted I would be able [quoted text clipped - 25 lines] > > Thanks for the unbiased report. Keep them coming, please! Excellent points. Webby > Yes, personal experiences are generally good to hear about. > [quoted text clipped - 68 lines] > > > > Thanks for the unbiased report. Keep them coming, please! > Yes, personal experiences are generally good to hear about. You're welcome! > Sore incisors are not normal either. How 'tall' is the > discluding (not occluding) element? The original NTI > devices had a rather long and tall discluding element. It > required significant trimming for most cases. Oops. I knew it was a ...cluding element ;) I would say that it is rather long- maybe 8mm. The diameter of the semi-cylinder is ca. 4 mm. This is not uncomfortable while I am awake, but in the morning it feels like the underside of my tongue has been pushing against the element. > The fee should include working with the patient and their NTI until > everything is as comfortable as possible. The fee is for treatment > that includes an NTI. Not a fee just for an NTI. There's little information on prices even at smd, so for patients trying to get as much data as possible this might be a useful ballpark estimate. I was charged $110 for oral eval, $450 for NTI, with an expected $350 for occludal adjustment. I am sure that adjusting the NTI would have been free of charge, but since my appointment with the dentist making that NTI has been rather traumatic, I will have to find someone else to make the necessary adjustments. Unfortunately the joint pain has not disappeared though it's a little less now. I did notice my lower jaw resting in a little more forward position though. > > Yes, personal experiences are generally good to hear about. > [quoted text clipped - 26 lines] > less now. I did notice my lower jaw resting in a little more forward > position though. Maybe it was made improperly. Webby *SOUNDS LIKE* an original standard NTI that was fitted to the teeth without further adjustment. Pretty poor therapy IMO. D >>I would say that it is rather long- maybe 8mm. The diameter of the >>semi-cylinder is ca. 4 mm. This is not uncomfortable while I am awake, >>but in the morning it feels like the underside of my tongue has been >>pushing against the element. > Maybe it was made improperly. > > Webby > *SOUNDS LIKE* an original standard NTI that was fitted to the > teeth without further adjustment. Pretty poor therapy IMO. [quoted text clipped - 9 lines] > > > > Webby Well... I wasn't going to "say" anything ... but.... Webby > *SOUNDS LIKE* an original standard NTI that was fitted to the > teeth without further adjustment. Pretty poor therapy IMO. [quoted text clipped - 9 lines] > > > > Webby I *thought* I posted this, but it hasn't come in as it should have by now. So ... here goes again ... (more cox ISP trouble???? I hope not). > *SOUNDS LIKE* an original standard NTI that was fitted to the > teeth without further adjustment. Pretty poor therapy IMO. [quoted text clipped - 9 lines] > > > > Webby Well... I wasn't going to "say" anything ... but.... Webby You could never be trouble.  Signature/ Amatus / > >> *SOUNDS LIKE* an original standard NTI that was fitted to the [quoted text clipped - 31 lines] > > Webby I agree I hate it when people adapt new therapies before they understand them. Signature/ Amatus / > > *SOUNDS LIKE* an original standard NTI that was fitted to the [quoted text clipped - 10 lines] >> >> Webby I do not intend to disparage the treating dentist, but the trauma you described in having the NTI made plus the description of a *seemingly* unaltered stock device, does not leave me with a good feeling about your care. Unfortunately, dentist can start fitting these without really knowing how or what they are doing. It is pretty simple, but it's pretty easy to screw up too! D >>Yes, personal experiences are generally good to hear about. > [quoted text clipped - 26 lines] > less now. I did notice my lower jaw resting in a little more forward > position though. > > My student dentist had indicated that she thought I grinded my teeth > > and so should get a night guard. I said that I doubted I would be able [quoted text clipped - 23 lines] > by 50%, with the NTI I have not seen any change yet (but it's only > been 4 nights so far). When you say that the "nightguard reduced symptoms by 50%", is this a subjective estimate or is was the value quatified by some testing method? Webby > When you say that the "nightguard reduced symptoms by 50%", is this a > subjective estimate or is was the value quatified by some testing method? Oh that's a completely subjective statement- lots of salt required. Basically the incidence of joint discomfort went down a lot, but there were still days when it didn't feel good after waking up. However, what I can clearly state is that I have not had my jaw "stick open" after wearing the nightguard. Thank you for your feedback, Webby & Steve. |
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