Question:
Are the OTC devices for bruxism OK, or does one really need to have one
custom made?
Answer:
I was referring to a device sold OTC in drug stores, at least here in
California. It's called "The Doctor's Night Guard", and sells for about $25.
There are directions with it to custom-fit it to your own teeth.
Anyone here familiar with it, either a dentist, or a patient who has used
one?
I've seen them. I was tempted to get one
but realized they were nothing more than a "chew
toy", they would not keep me from grinding my
teeth, instead, they'd give me something to grind
my teeth against.
I've had my NTI-TSS for about 16 months now.
I've gone from 2 - 3 major migraines a week to
*two in 16 months*! I'd say I'm a success story!
:) My NTI-TSS cost $200 but I've seen them cost
a lot more.
Here's Dr. Boyd's website...
http://www.nti-tss.com/whatisit.html
The others cost way more than that ........ I guess the drugstores are getting back because so many dentists are peddling
toothpaste and mouthwash! Where will it end? I just got scaling and root planing from my personal trainer, but do not worry he is a
massage therapist too.
The NTI is covered by *medical insurance* when used to prevent medically
diagnosed migraine. This became a reality the day the FDA approved it
for the prevention of medically diagnosed migraine pain.
They can range in cost from a couple hundred USD to over a thousand. It
generally depends on the amount of support which has to be given with the
appliance, not the appliance itself.
It is not up to Delta to decide if it is a covered benefit. It is up to the
employer. Think of the cafeteria line. Your employer goes down the line
with his/her tray. They have only XY dollars to spend. They take a high
paying cleaning benefit because they think their employees would like that
benefit. They grab a bowl of 75% coverage for fillings, root canal work,
etc. figuring their employees will like that. Most of their employees are
young, so they grab a plate of 50% coverage for replacement of any missing
teeth. Towards the end of the line (think dessert), they come upon implants,
orthodontics, and appliances. Their pick up a little ortho (since their XY
dollars are down to almost nothing). They don't have enough money left to
buy implant coverage. They never heard of their employees talking about
these appliances, so they leave them off, too. Another employer may have
had one of these appliances in the past, so knows what it is and saves a bit
of money for it at the end.
The OTC device will work on a few people. But, these same people would get
success by placing a ball of wax on their tongue. These are the people who
could get by with the ping-pong ball. The OTC device will allow more
efficient clenching, which will *often* set up greater parafunctional
activity and more pain. I had one patient try it and claim to be happy.
But, this person had a change in lifestyle (which greatly reduced stress) at
the same time. I tell my patients to go ahead and try it if they need to
see if they can save money. Like you said, it is only about $25 USD.
Except for this one person, they come back and get the NTI device.
Oh yes, very different concept. The OTC
night guard, AFAIK, fits over a large number of
your teeth, molars included. The NTI-TSS fits
only on your upper two front teeth. When I wear
my NTI, if I bite down onto it, my lower front
teeth ache a bit and I back off of it, more or
less like a reflex. Apparently, this goes on all
night while I sleep. Because the OTV nightguard
covers more teeth, you don't automatically
unclench your jaw as you do with the NTI, hence my
"chew toy" description.
The above is very typical. We were taught is school that it was the teeth
causing the muscle problems. The idea of the NTI is the opposite,,,,, the
muscles cause the teeth problems. Many dentists are not able to think
through the entire scenario to make the change. It is interesting that
dentists who are absolutely convinced that it is the tiny occlusal
interference causing the lateral pyterygoid muscle to fire and start the
problem will only change their minds if they can be convinced to try an NTI
once.
The OTC kit is not much different from an athletic mouth guard. Those are
designed to cushion the teeth during impact. Athletes often have to clench
hard while participating in their sport. Prolonged clenching sets up all
sorts of painful problems. For those patients who are not fully trusting
yet, I invite them to try that OTC device. They always come back for the
NTI. I figure they only lost $25 USD and some time for trying it. That is
about the cost of dinner for two at Big Boy's. Like The other Dr. Steve
said, the NTI is very different. It only sits on 2-4 upper teeth and
contacts only 1-2 lower teeth with a small plastic bar. It totally frees
the back teeth from any contact at all. The OTC device puts all the back
teeth into intimate contact -- a recipe for lots of forceful clenching.
But,,,,, there will be probably somewhere between 10-20% of people who will
benefit from any device and this OTC device will be okay for them.
Predictability is very low though. I would not put it in my mouth.
