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Dental Appliances: Are All Created Equal?
Almost everyone clenches and grinds their teeth at night. Dental night guards are often prescribed in these situations but with the countless designs available, how do you know which will work best for you?
Oftentimes dental splints, commonly known as night guards are prescribed by dentists for bruxers. These nightguards are available in a variety of different designs and are fabricated using a number of different materials. They are usually prescribed by a dentist and created by a dental laboratory. However, over-the-counter (OTC) appliances can be purchased at drug stores but should be avoided at all cost. They are not custom fit for the user and can possibly increase TMJ pain. OTC night guards are typically not durable and very difficult to wear due to their excessive bulk.
Probably the most commonly used night guard is a hard acrylic "full arch" appliance that covers all of the teeth on either the upper or lower arch. While these devices do protect the teeth from wear, many users find them to be cumbersome and simply will not wear them. Another problem with the traditional full arch night guard is that it can actually cause users to clench and brux with greater intensity, as shown in Doctors Arun Chandu and Tuija Suvinen's study published in Volume 31 of the Journal of Oral Rehabilitation. The majority of clenching forces are derived from the posterior teeth (molars) and cuspids (canine teeth). Full arch night guards provide the user with a large flat surface to clench into, thereby potentially increasing the intensity and the likelihood of painful side effects.
Another type of bruxism guard growing in popularity is the NTI-tss Plus. It was invented by Dr. James Boyd, DDS and has been FDA approved for the prevention of migraines, tension-type headaches, and symptomatic TMJ pain caused by clenching and bruxing. It is a small, hard acrylic appliance with a patented design that separates the canine and back teeth during sleep. It only covers four front teeth and can be worn on the upper or lower arch, increasing patient comfort. The NTI-tss Plus still protects the teeth from wear but because it prevents molar and canine contact, it greatly inhibits the user's clenching intensity by nearly 70%, allowing muscles and joints to relax. In a study reviewed for FDA approval, 82% of NTI-tss users experienced a 77% reduction in migraine episodes.
The causes of nighttime clenching and bruxing have been debated for decades with no clear resolution. With that being said, all would agree that a protective, therapeutic dental appliance is the best treatment option. Consult with your dentist regarding your clenching and bruxing to determine the appliance best fit for your situation.
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There are over 30 million migraine sufferers in the US. The NTI-tss Plus is a small biteguard, FDA approved for the prevention of migraines, tension-type headaches, and TMJ dysfunction with no pharmacological side effects.