NTI-tss Dental Device, TMJ and Headaches
Did you ever wonder what these
symptoms have in common other than making your life miserable?
ØTMD (TemporoMandibular Joint
are controlled and/or moderated by the Trigeminal nerve
Trigeminal Nerve has two divisions:
A) Motor Root, which sends nerve impulses to the jaw muscles to make
Division (far more massive) which is made up of the nerves that bring in information from the
Sensory Division is divided into three distinct segments of sensory reception (thus the term
1) First Division: Opthalmic: receives sensory input from arteries that surround the brain
to around and behind the eyes
Second Division: Maxillary: receives sensory input from the area below the eyes and the upper
Third Division: Mandibular: receives sensory input for the entire lower
All three divisions feed into the Trigeminal Sensory Nucleus. The current understanding of the
nature of the migraine, is that it results from a disorder of "sensory modulation", meaning that information received by the Sensory Nucleus is misinterpreted, thereby resulting in
either a disproportionate response, or an inappropriate response altogether. For example, during a migraine
attack, the simple pressure changes of the fluid that surrounds the brain (resulting from the beating of the
heart), is perceived as "pounding".
The therapeutic goal in migraine prevention is to limit the amount of noxious sensory input
(that is, to limit your migraine "triggers") to the Trigeminal Sensory Nucleus, so that it is not perceived as
nociception (noxious sensory input). Essentially, the goal is to limit as much negative input to the Trigeminal
Sensory Nucleus as possible.
The basic principle behind the NTI-tss
When considering an
abnormal Trigeminal system where the Sensory Nucleus is hypersensitive, it is not unusual for the Motor Division
to be also hyperactive. A hyperactive Trigeminal Motor Root results in excessive jaw muscle contraction, during
certain stages of sleep, resulting in intense jaw clenching and/or vigorous teeth grinding.
These two activities
produce a significant bombardment of noxious input (nociception) to the Sensory Nucleus, while also being the
known cause of "TMD" (temporomandibular disorders), thereby becoming a self-perpetuation of chronic headache
"NTI" refers to the
nocturnal inhibition of trigeminal nociception.
In order for jaw
clenching and teeth grinding to achieve pathologic intensity, the molars and/or canine teeth must be touching
each other, or another object (like a traditional mouthpiece). By keeping the molars and canines from touching
anything during sleep, Nociception to the Trigeminal is Inhibited.
Minimizing jaw muscle
intensity (that is, Trigeminal Motor Hyperactivity and the resultant nociception) therefore requires providing
for incisor (front teeth) contact only during sleep.
The NTI device is a dental mouthpiece that
a trained dentist provides for the patient. The NTI fits securely on either the patient's upper or lower front
teeth while asleep. The unique presentation of the patient's bite dictates the design of the NTI
The most distinguishing
characteristic of the NTI device is the discluding element, or "DE", which creates the exclusive contact between
the incisors. In addition to preventing any molar or canine contract during sleep, the practitioner must also
ensure that the device's design does not overly "open" the patient's mouth. Excessive opening while the patient
is clenching on an object can create a strain of the TMJ (jaw joint), which would result in another noxious
sensory input, thereby defeating the purpose of the NTI device.
appoint? Call Julie at (503) 378-0466, or Request An Appointment