Beautiful Smiles        Microscopically Assisted Dentistry        Gentle Dentistry


 Gregory C. Dilger D.D.S.           General Dentist            1353 Edgewater St.          West Salem          (503) 378-0466   

NTI Bite Appliance
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 Dysfunction)                        

ØChronic tension headaches 



They all are controlled and/or moderated by the Trigeminal nerve system.    

The Trigeminal Nerve has two divisions: 

A) Motor Root, which sends nerve impulses to the jaw muscles to make them contract;

B) Sensory Division (far more massive) which is made up of the nerves that bring in information from the periphery.

The Sensory Division is divided into three distinct segments of sensory reception (thus the term Trigeminal):

1) First Division: Opthalmic: receives sensory input from arteries that surround the brain to around and behind the eyes

2) Second Division: Maxillary: receives sensory input from the area below the eyes and the upper jaw.

3) Third Division: Mandibular: receives sensory input for the entire lower jaw.


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 NTI Graphic lowerinformation 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 NTI Lower 

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 and/or migraine.


"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.


NTI GraphicThe 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 device.

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.


Ready to appoint?  Call Julie at (503) 378-0466, or Request An Appointment


Patient Testimonials 


Dr Dilger told me I needed an NTI for my teeth but when I heard how much it was I thought forget it. I went to the grocery store and bought one of theirs. I felt it in my mouth all night long because I was still trying to grind my teeth. I finally broke down and bought the NTI - no comparison. I sleep all night now and my neck feels so much better. Not to mention how great my jaw and mouth feel.


Cleanne D




Dr. Dilger and Staff,


I want to begin by expressing a sincere thank you for a most positive experience yesterday in your office.  As always, the entire staff went out of their way to make my wife and I feel welcome.  It never ceases to amaze me what new gadgetry and technology you bring to your practice and your willingness to explain it to us all.  I'm such a techno-junkie, I can't wait to see what's next. As I reflected on my visit afterwards, I couldn't help but think just how far advanced dental technology has come over the years.

Let me close by saying a sincere thank you for being our dentist and our friend.


Bruce A.




Dr. Dilger,


What a building! With high tech dental equipment, and relaxing decor-best quality. I believe that this office should be the model for all offices. To replace this staff would require a worldwide search!


Bill M.