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! 

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (16)
  • Nicolee.RVA
    3 years ago

    Hi there. 🙂 I am new to this site, but was searching for feedback on the NTI because I just got one a little over a month ago. I’ve gotten migraines since I was about 10 years old. Up until recently, I was in a place where I began to just give up… and accept that I get migraines – which for me means missing out on a lot of stuff (like the occasional work day, celebration, or holiday) and being anxious about when or WHY I would get a headache and how bad it would be.

    I will keep this short; but when I was about 24 I went completely blind in my left eye. I thought I was having a stroke… turns out it was an ocular migraine, it lasted for about 10 days and it was the worst headache of my life. After that, it became my mission to figure out what was wrong with me. I went to neurologists, chiropractors, opthomologists, allergists, YOU NAME IT. No one has ever been able to tell me why I am getting these headaches. I’ve been on medication after medication. None of them work for me.

    About a month ago, I woke up with so much pain in my jaw that it hurt to talk. It hurt to open my mouth. It hurt to chew, to laugh, to swallow. I know that I clench my jaw (esp. during a migraine!) and have a grinding problem… so I called my dentist because I thought I had cracked a tooth and needed a root canal. I had x-rays and to my surprise my teeth were completely fine. But he DID give me the NTI, because he agreed with me that my clenching was an issue.

    Now, I’m no expert. But I have to say that I’ve had only one headache in the month I’ve been using the NTI – and it was so minor that a little Excedrine and a cup of coffee later – I was at work with no issues. I was amazed, and completely surprised. I was just hoping I hadn’t done any permanent damage to my jaw. Then I just realized while driving to work one day that… ‘hey! I haven’t had a headache in a while!’

    I hope that those of you out there thinking about the NTI will give it some time. I don’t expect it to stop my migraines altogether… but if they’re more manageable – hey, I’ll take it!

  • deborahvan-der-harst
    4 years ago

    Hi Janet, I also clench and grind my teeth. I had no idea how big a part my TMJ played in my chronic migraines until i was hospitalized for 7 day for a DHE infusion cocktail. Biofeedback was offered so I decided to try it. The biofeedback interpreter asked me to clench my jaw after placing electrodes on my face. When I clenched the biofeedback measurement for muscle tension spiked up to almost maximum intensity. It showed how much pain can be stimulated by simply clenching your jaw. I learned how to relax by looking at the chart and monitoring my tension level. I want to get the mouthpiece, but I want to get my teeth bonded or capped first. After doing that I would need a new mouthpiece to fit my newly shaped teeth.

  • Cynthi
    4 years ago

    As soon as I got my NTI device, I realized I only clench my teeth when I have a migraine coming on or 8n full blown migraine mode. Otherwise I can relax my jaw at night.

    My NTI actually moved my teeth and now I feel like I am getting migraines because my teeth are no longer straight. Basically, I just have to laugh so I don’t cry at the stupidity of it all.

    If I try anything at all, next time I will try a basic mouth gaurd and see if that can give me relief when I have my migraines.

  • barb
    4 years ago

    I found out I ground my teeth in college and have had a ‘normal’ bruxius (sp) (grinding) guard for years. It hasn’t helped wiht my migraines anyway but has helped my teeth.

    I haven’t heard of this new one though so I’ll have to check it out, thanks for the tip!

  • Lynne
    4 years ago

    When I visited a TMJ specialist I was beyond popping jaw. I was down to crunchy sounds and my jaw literally moving far to the left, the side I have TMJ pain as well as being the side of my head where all my migraines occur. I now have advanced arthritis in that jaw.
    He informed me of the NTI and said the Dr that developed it was a migraineur thinking that relieving the temporal area would help his migraines.
    I decided to try it along with the understanding the device would be ultimately used for the overall treatment of my TMJ along with a device to be worn n my lower teeth.
    The use of the NTI did nothing to alleviate my migraines.

  • The Migraine Girl moderator author
    4 years ago

    Oh, I’m so sorry to hear the NTI device didn’t have a positive effect on your migraine. Has it had any impact on your TMJ-related pain and discomfort?

    Thanks for your comment; I hope you’re feeling good today.

    -Janet G.

  • DollyJean
    4 years ago

    I was diagnosed with TMD when I was about 15 and had a splint made that since deteriorated with age. Luckily (at 44) my insurance covered it. However you really need to watch out for “dentists” that treat this problem, there are TMJ specialists out there. Mine luckily billed the device as if it were a therapeutic device which is why it was covered. I too am a clencher, hell, if I’m reading too intently sometimes I find my self clenching. These devices are not meant to prevent the clench or grind, it is meant to lessen the pressure of doing so…I actually woke up yesterday with a migraine that graduated into a TMJ migraine along side. I went to bed with the splint and my pain was reduced when I woke this morning. The pain from the TMJ is from the clench or grind aggravating the masticatory muscles only, the cracking and/or grinding sound will never go away. To this day, I have to have someone on occasion massage near my ear where the joints meet allowing me to pop both sides to sometimes alleviate any tightness there.

    I looked into the NTI before I went to the specialist, it clearly states in their fine print not for use with persons diagnosed with TMD/TMJ disorders, so I would make sure to really monitor the improvements.

  • The Migraine Girl moderator author
    4 years ago

    Thank you for your well-founded and thoughtful comments! I have noticed that the last two mornings I’ve woken up with my jaw clenched. The discomfort isn’t as bad as it is when I clench all night without the device, but it was certainly notable. As someone who considers herself to have a healthy amount of skepticism, especially where illness is concerned, I made sure my dentist had expertise in the treatment.

    It’s been a long while since I had a massage therapist treat my TMJ-related pain, but I remember getting such relief in the past–I may need to look into that again.

    Hope you’re feeling good today!

    -Janet G.

  • Christine E.
    4 years ago

    My dentist made me a hard mouthguard that is built up behind the front teeth so that only the front teeth touch it (the back teeth don’t touch). You can’t really clench well on just your front teeth. I find that my jaw is much less sore now than when I wore a softer guard where all my teeth clenched on it. Can’t tell you how many of those I chewed through….

  • The Migraine Girl moderator author
    4 years ago

    To the best of my knowledge, I think that’s how the NTI device works! Let me know how it goes with your mouthguard as time goes on. I’m so happy to hear that your jaw is less sore with this current setup.

    Take care,
    Janet G.

  • kim716
    4 years ago

    When I started seeing my neurologist at the end of last year, one of the first things she did was order a sleep study because of a lot of fatigue. I’m not sure about all of the results on the report from the study, but that’s for another post… The sleep study showed I had mild sleep apnea. I opted to try an apnea mouthpiece first instead of going straight to the cpap.

    It was specially made and was expensive which my insurance didn’t help with. It covers upper and lower teeth, all the way around and is quite a mouthful. I had never considered myself a teeth grinder or clencher, but I had talked to previous dentists about possible TMJ problems because of jaw pain/stiffness and popping, but they always said no. It wasn’t until I went for the impressions for the device that the dentist started working with and moving my jaw and noticed some “crackling” in the joint. He had me bite and he pushed on a muscle and asked if it hurt. I almost come out of the chair. He said the device should help with the clenching and TMJ problems.

    I still have quite a bit of jaw popping in the morning and during the day, but I think it is helping with the jaw clenching. There are still times at night that I wake up and find my teeth locked down on the mouthpiece. Crazy that I had no idea I even did that at night.

  • The Migraine Girl moderator author
    4 years ago

    Isn’t it fascinating to realize something about yourself you somehow never noticed before? Thank goodness for healthcare specialists in your life who can take the time to really look for patterns in your behavior and body. What a bummer that insurance didn’t help with the device. I hope you continue to feel it’s worth the investment–keep us posted!

    -Janet G.

  • kellyeliz07
    4 years ago

    Hello from a fellow North Georgian (Braselton)! 🙂

    Oh my goodness, yes! I have TMJ and am a grinder (with 5 broken teeth to prove it- yikes!)… I’ve never heard anyone else say it until now, but I’ve always believed that the well-meaning advice of my previous dentist that athletic mouth guards are just as good as the expensive custom kind made my grinding/clenching/TMJ worse too. Luckily, after I “married into the military”, the dental insurance we have covered over half of a custom fit, and although I’ve seen vast improvement in the health of my teeth with the pricier version, no such luck with the clenching and pain. And that’s one of my biggest migraine triggers. Can’t wait to hear if the NTI works after consistent use!

    Have you ever been offered/tried any type of muscle relaxer at night to help with the jaw tightness? I have a few friends whose dentists have prescribed those to them short-term, but I’m not sure how well they work. It seems that if I can catch a migraine coming on from fatigue and take my migraine medication right before bed, I wake up with less tightness and pain in both my jaw and neck, but I haven’t done much research to determine whether it’s “all in my head” 😉

  • The Migraine Girl moderator author
    4 years ago

    Braselton, eh? You’re right down the road! 🙂

    I have a prescription for Flexeril (cyclobenzaprine) for my arthritis, and I sometimes take about 1/2 to 1/4 of my normal dose to help with neck and shoulder tightness–I guess they’ve come in handy with jaw tightness, too. (Often when my jaw is tight my neck and shoulders are as well–par for the course.) Unfortunately, even taking 1/4 of my prescribed dose can leave me really groggy the next morning, and I sometimes have a weird tension headache the next day.

    I hope you’re feeling good today–thanks for the comment!

    -Janet G.

  • Nell
    4 years ago

    I used to work as an office manager in the Dentistry field till my medical issues became too much (hard to be good at your job when dealing with not only physical issues but having to deal with medication that fricking muddles the brain). I worked for a Dentist that used NTI’s in her office. I tried one and loved it. Unfortunately I lost mine (they are small, and sometimes unconscious I would take it out halfway through the night – dogs love any type of night guards because they smell like you and are fun to chew on), I no longer work for the Doctor who originally made it. I spoke to my new boss about replacing it and he said he believes in the traditional Night Guards (NG) and would not recommend a NTI. Now don’t get me wrong – I have total respect for him and his dentistry, but he has an old school mentality and did not want to hear that I did better with the NTI (he doesn’t like the fact that the NTI is strictly on the front teeth where as a NG is molded to the structure off all your teeth – whether it’s an upper or lower NG). And now that I don’t work there anymore (:-( worked there over 12 yrs and miss it dearly),I was thinking of tracking down my old boss and have her make me a new NTI.

    You may not see a huge difference right away from the NTI, but give it time. I think you will find that your jaw (TMJ) will finally be in better shape which will be less likely to trigger a migraine or even contribute to to one. I don’t know about you, but the association between stress and anxiety caused by jaw pain isn’t always obvious – my neck and jaw muscles can get painfully tight – tight jaw, neck, and shoulder muscles can sometimes act as a trigger for my migraines or at least a tension headache.

    If you have a NTI or a regular NG it’s all about consistency. Make sure you wear it always and if you wake up with either your teeth sore or even your jaw (this is after wearing it for few days)you need to have it adjusted. Also bring it to your regularly scheduled cleaning appointments – you can have the hygienist clean it and your Dentist adjust it if need be. There should be no charge if the dentist is the one who provided it. This is why these devises cost so much – they may always need a little tweaking here and there.

    GOOD LUCK in finding out what works best for you. I don’t think people know how much goes into trying not to trigger a migraine – from NG’s to hair (external compression headaches), earrings, handbags, sunglasses and so on.

  • The Migraine Girl moderator author
    4 years ago

    Hey there,

    THANK YOU so much for this thoughtful, thorough, and educated reply. Just this morning I took out my NTI and wondered if my article about my experience with the NTI device had been published on Migraine.com yet. Imagine my happy surprise to find it had been at that the first comment was so great!

    I am famous for giving up on treatment without perhaps giving it as long to work as I should, so I appreciate your encouraging me to wear it every night with consistency. Mine is just tight enough that I don’t spit it out as I did with a retainer post-braces (years ago) and the traditional mouthguard (which just seemed too big and uncomfortable to wear, and so easy to spit out!). One gross thing I’ve noticed is that I sometimes drool now when I sleep on my side. Ha! Luckily my cat has no interest in it apart from knocking it around if I forget to seal the special glow-in-the-dark box it comes in.

    My next cleaning is in the fall, and I will bring the device with me and talk with my dentist about how it’s working.

    Now I hope you will reach out to your old boss and see about getting a new one, especially since it sounds like it was really helpful for you.

    Take care, and please stay in touch!

    -Janet G., “The Migraine Girl”

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