Trying the NTI device for TMJ pain and migraine prevention
Several years ago, I talked with my then-dentist about my tendency to clench my teeth at night. (Though I’ve occasionally been a grinder, I generally just clench in my sleep, or even when I’m working at the computer and am not paying good attention to my body.) The dentist told me about a custom-fitted mouthguard that could prevent clenching and grinding and perhaps even help with not just my TMJ dysfunction but also my possibly TMJ-triggered migraine attacks. Unfortunately, I didn’t have the money to purchase the mouth guard, nor did I feel as if I had enough evidence on my side to merit saving up for it. I know there’s no guarantee with any medical treatment, but the evidence my dentist told me about was wishy-washy at best. (“Some of my patients never get migraines anymore,” I was told, and I hope that’s true—but I was skeptical.)
When my dentist left the exam room, the hygienist told me that I could get a mouth guard at a sporting goods store that would basically perform the same function as its $500 counterpart. Always one to save a buck, I bought a mouth guard that was advertised to custom-fit to your bite (with a little work involving heating it in a pot of hot water first to make the material malleable). I wore that for a couple of years but found that, more often than not, I was clenching really hard into the squishy rubbery-plasticky material, and my jaw still cracked each morning when I removed the device. Instead of helping me not clench, it was getting worse than ever. I eventually tossed the thing a few years after I stopped wearing it all together.
Since my failed experiment with the athletic mouth guard, I have thought from time to time about what the professionally-fitted mouth guard might do, but I still couldn’t stomach the price and the potentially wishy-washy results. The only option I really considered was the NTI device, which I had heard about from fellow migraineurs and had read about here on migraine.com. I’d done a little research about the device but nothing formal, and I was told I would probably have to go to Atlanta (about a 90-minute drive from where I live) to get fitted for a device. I nixed it.
Then, about a year ago, I was at a dental checkup and got into a conversation about my jaw clenching. My dentist told me that she actually was certified to do fittings for the NTI device and that we could talk about that as an option if I was ever interested. (I really, really like my dentist and she knows I am careful with what little money I have to spend on such things.) The next visit, I brought it up myself and said I wanted to talk about it. She told me all about how she fitted patients for the device; she told me about how she herself wears one every night; she offered to set me up on a payment plan if I decided to get one and needed some extra time to pay off the bill (less than $200 for the device and the appointment for the fitting).
I did more research and then called her up and booked an appointment to get fitted for the NTI device.
This was the part that was supposed to be super-easy, but it proved to be a little bit of a pain in the butt (mostly for her, as she was frustrated!). You see, she couldn’t get the molds to work right. She had done this hundreds of times but for some reason couldn’t get the right measurements to get me set up for the device she makes in-house. She apologized (which was kind but not necessary) and said she’d have to do a different type of mold and send it off to a company that has a wider variety of equipment to use to make the NTI devices. A few weeks later, I had my freshly-delivered NTI device fitted to my mouth. After some minor adjustments, I was good to go. Turns out my dentist wasn’t alone in having trouble, though: apparently I have some crazy teeth combined with an overbite that made it hard to get the right fitting, so instead of having the type of NTI device that fits over my top teeth, I wear it on my bottom teeth.
It’s been about six weeks since I started wearing it regularly (I actually remember to wear it about 90% of the time—go me!), and I can tell a difference my my jaw pain and tension. It fits tightly enough on just my front bottom teeth that I can’t easily spit it out in my sleep (something I did post-braces when I wore a retainer), but not tightly enough that it causes discomfort. For the first couple of weeks, my bottom teeth felt slightly realigned and my bite felt off the first hour or so after removing the device, but that effect wore off. I brush it when I take it out of my mouth in the morning (because otherwise: yuck—bacteria and morning breath?), and I brush it before I pop it in at night.
Noticeable differences so far: my jaw, which cracks and pops a lot, makes far fewer ear-splitting sounds throughout the day when I open and close my mouth. That’s a good thing, especially because sometimes those sound effects came with bad, sharp pains.
Things I haven’t noticed (yet?): any significant reduction in migraine frequency, severity, or duration; full relief from TMJ dysfunction pain.
Overall, I am not quite ready to recommend it wholeheartedly, but I certainly don’t feel like I’ve wasted my money. I’m glad I made the investment and hope to report back in a few months with even better results!
How many of you deal with TMJ-related pain? Do you notice that the pain triggers migraines for you? Have you tried a mouth guard or even the NTI device itself? Share your experiences below!
Can you tell when a migraine attack is coming?