Michigan vs Nti device

[TheTinyDancer]

Hey, so I was diagnosed with TMD a year ago and I'm a terrible clencher at night. As soon as I drift off my teeth instinctively clamp together which has caused numerous issues. For long and complicated reasons I have 2 dentists. One has recommended a michigan splint (but it's taking ages to get made/adjusted). Dentist number 2 made me a temporary nti device 2 weeks ago to see if that would help. So far I'm on the fence but I do think it's helped a bit and it has certainly lessened my anxiety about further damage to the molars. He said if it works he'll make a more permanent device. I know there are holy wars with dentists in general regarding various splints, but just wondering can anyone share any words of wisdom? Incidentally, I queried an nti device with an oral medicine consultant about 6 months ago and he was very dismissive of the concept, stating that it would cause an open bite and/or cause the molars to over erupt. Personally I can't understand that logic as its only worn whilst sleeping but I obviously have no dental knowledge. I need to make my mind up by tomorrow as to what device I think would be best so any advice would be greatly appreciated. Thank you.

 

[drhirst]

Hey TheTinyDancer,
Having studied this over the last couple of years, I would say that the nti is no more likely to cause an open bite than any other type of splint for exactly the reason you mentioned, that it is only warn at night so any tooth movement will correct during the day. It is a fact that open bite can occur with any type of splint including a Michigan, and this is due to the changes in the way the jaw sits in the joint. Relaxation of the muscles and reduced inflammation can all allow the jaw to change position slightly. It is rare and most likely to be noticed if you have a very shallow overbite.
If a Michigan is not perfectly constructed and adjusted to accommodate changes in your bite over several visits, it may also end up with not all the teeth in contact, and so, would also, by the oral medicine consultants logic result in overuption. In real life very few Michigan splints end up being properly adjusted.
So I would say, if the nti seems to be working, and the dentist who provided it feels like it is a suitable device for you then go for it. My wife and receptionist both have one and swear by them.
Hope this helps

Lincoln

 

[TheTinyDancer]

Thank you so much for the reply @drhirst , really appreciate it. It's very reassuring to hear that it's a subject you've spent time on and that your wife and receptionist both wear ntis.