Removable dental appliances, which are designed to minimize the effects of bruxism (grinding) and other occlusal factors. © 2017 American Dental Association warning It is misleading to report the delivery of an occlusal guard (D9940) to describe tooth whitening trays (D9975) or for TMJ treatment to increase reimbursement. Tooth whitening trays are provided for cosmetic purposes and are not a covered service.
TMJ dysfunction treatment is typically not reimbursed unless there is a TMJ dysfunction rider attached to the dental insurance policy and it is reported as D7880. caution The occlusal guard (D9940) and the occlusal orthotic device (D7880) are often confused. Report D9940 to describe an occlusal guard for minimizing the effects of “bruxism” and “clenching of teeth.” Report D7880 to describe an appliance provided to treat TMJ dysfunction, which includes multiple visits.
Additional Information If a patient requires a nightguard because of night grinding or has advancing periodontal mobility, the appliance is billed using code D9940, by report. If bruxism is the problem, a simple narrative indicating such is all that is necessary. However, if periodontal mobility is the problem, then a periodontal diagnosis along with a comprehensive periodontal charting and full mouth images is recommended.
If the patient is experiencing temporomandibular joint dysfunction (TMD), the occlusal orthotic should be billed using code D7880. A narrative needs to describe the diagnosis and symptoms, e.g., joint pain, popping, clicking, crepitus, migraines, deviated opening, etc. Some plans cover appliances for bruxism, mobility, and/or some for TMD, but few cover all three. So, make sure you know the clinical problem before you check for benefits.
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Review: The NTI night guard by your licensed dentist.Official website: chairsidesplint.com In 1998, James P. Boyd developed a splint to treat and prevent headaches and bruxism. He named it the “nociceptive trigeminal inhibition splint” (NTI). The NTI night guard has the distinction of covering only the front teeth. According to Dr. Boyd, pressure on the front teeth should reduce the intensity of the involuntary contractions that people with bruxism suffer from.
In other words, with the NTI night guard, you should not be able to clench as hard as you normally do. It is important to know, for anyone thinking about getting a NTI mouth guard that its benefits have only been evaluated over short periods of time. Some reports have been made of alteration in the position of the teeth in bruxers who wore this device for a long period. To use a NTI night guard, you need to have it adjusted by a dentist who had previous training with the NTI.
To find a dentist, use one of the links below: In canada: http://www.nti-tss.ca/pages/finddds.htm In the US: http://www.theheadacheremedy.com/fad.php In our opinion, it is not advisable to use the NTI night guard. It does not completely protect the teeth. As stated in the requirements for a good mouth guard, a night guard should cover all teeth, not just the front teeth. If you do decide to go for the NTI, make sure to have frequent follow-ups with your dentist.
Your dentist should tell you if there is any alteration in your teeth. Price for the NTI device range from $250 to $600. It is the important follow-ups that explain the high price of this night guard. Keep in mine that for a lower price, you can easily get a custom made night guard that protect all your teeth. For this reason and those specified above, we strongly recommend you use a custom night guard instead of the NTI guard.
Learn more at Step 1. Have you tried the NTI night guard? Post your review below. Create your own review Average rating: 24 reviews Nov 27, 2016 Repair and review NTI Hi Everyone,Have had my NTI for over ten years. It worked well for me, but so much hinges on your dentist adjusting your teeth, your bite and the mouth guard plus keepng an eye on your development during the first weeks and months.
As to reading about NTIs cracking, my former dentist would repair them, put them back again, so would be good to go for anotjet round. I woud wear them out frequenty during my first couple of years, but better to wear down the device instead of your teeth. My dentist was Hans Lennros, Halmstad. Nov 20, 2016 So far great After trying a full custom guard to protect the surface of my teeth from grinding, I developed horrific jaw pain that lasted 6 weeks or more.
It seems I was clenching/chewing on the guard (in my sleep). I finally agreed to the NTI and mine was fitted for my bottom teeth. It spreads out over about 6 teeth. I was scared at first that it would come off and I'd choke to death. But when you pop it on, and you hear that light snap sound, you should feel safe that it will stay put. Within a week, the muscles in my jaw relaxed and my pain went away.
It was a miracle relief. I can't sleep without it now and won't. My jaw muscles actually relax enough that I sometimes wake up with my mouth open - a rare thing for a clincher! I've had it about 4 years and clean it with vinegar and water mix. I can tell it's about time to get it adjusted or replaced because there's a little wiggle room in it now. It originally cost me 400.00 and was worth every penny.
I highly recommend it to people who clench their jaw during sleep. The pain from TMJd is no joke and those muscles need to be relaxed and retrained. Jun 13, 2016 Something changed for the worse I used to grind my teeth so bad I was cracking them and I never found a mouth guard that was comfortable.Tried all types of custom and OTC guards and spent hundreds if not thousands of dollars.Got my 1st NTI 5 years ago and it worked great.
Dentist recommended, cost me $485 and they took an impression and I got it back weeks later. It was comfortable and stopped the grinding and I never needed to have it adjusted.It broke a month ago (from wear) so I went to the dentist and now it costs $585 and it was a different color and they literally put in on my front teeth (it felt warm) and I took it home on the spot.This one doesn't look the same, doesn't feel the same on my teeth and it gave me intense jaw pain when I woke up.
I've gone back to the dentist 3 times for adjustments in 4 weeks and it's only getting worse. I'm actually worried it's causing TMJ.Not happy about spending $585 to cause myself pain. May 27, 2016 Choking Hazard Over the past two nights I awoke from sleep with the NTI in my mouth. The NTI is a potential choking hazard. If there were a "stopper" connected to the NTI outside of the the mouth it would be safer.
Perhaps if it were even larger, covering more teeth, that may help. Aside from the choking scare, it is well constructed and I found it to be unaffected by the rigors of grinding. May 27, 2016 Bad--changed my bite Do NOT use the NTI night guard. After 4 years of nightly use it is obviously that my front teeth no longer make contact--there is a gap between upper and lower incisors. I wish I had known this was a possibility--I was very satisfied with the full mouth guard previously.
I am hoping the dentist and/or Keller Lab will take responsibility for potential repairs! May 27, 2016 I love the NTI I have used the NTI for about 10 years now. When I first started to use it I noticed a little wear on my bottom front teeth due to my grinding/clenching. Since then I've combined the use of the NTI with a full-piece bottom mouthguard made out of acrylic. ( I only use them at night when I sleep.
) Now if I grind my teeth at all, the NTI slides easily against the bottom mouthguard and none of my teeth receive any wear. More importantly I believe that I'm not clenching as hard and that I have fewer headaches. I think the NTI and the bottom mouthguard are the perfect combination!!! I recommend them to anyone. May 27, 2016 AVOID! AVOID! AVOID! after consulting a "specialist" for intense clenching and resulting TMJ issues I was sold an NTI as the supposed best solution for the problem.
Never once was it mentioned to me that the potential existed for this appliance to move my teeth. I wore 3 NTI's in as many years, as each would break after about a year of nightly wear. At $600 a pop, this wasn't a cheap exercise. There was some reduction in my pain and headaches but still some tension in the joint itself as Im sure there was still some pressure exerted as I slept with it in, although less than without it.
When the 3rd started showing signs of loosening I casually googled the appliance and stumbled upon the warnings of teeth moving and open bite developing as a direct result of wearing an NTI - went to the mirror and low and behold, my teeth had moved substantially but gradually enough that I hadn't noticed it. Not once had the "specialist" I was seeing even suggested checking for any movements, he was happy just to pass a bill for another $600 each time.
No follow ups required either, just to go back if I could move it out of my moth with my tongue alone. Its been 6 months since I stopped wearing it. In that time I'm clenching more than ever, developed terrible sensitivity due to increased recession and I'm now staring down the barrel or periodontal work and orthodontics to deal with the fall out. DO NOT wear this device!!!! May 27, 2016 Love the NTI My husband and I have used these for years.
When I use it, I no longer wake up with a headache that lasts 4-6 hours, even with 800 mg of ibuprofen. I haven't had any issues with my teeth moving. Love it! May 27, 2016 It's a trade-off I have also been negatively affected by the NTI appliance. My story mirrors the other comments here. I wore mine for 4-5 years, and never noticed that it slowly moved my front teeth outwards, until one day I could no longer rip things open with my front teeth! Pretty upsetting, after my parents paid for braces when I was younger.
However, NTI was a little more helpful than my 1st nightguard for preventing the awful "clenching headache" and muscle tension... Sep 4, 2014 Beware of NTI This appliance ended up moving my front tooth out, dramatically affecting my bite and allignment and causing both my daughter andI to have to spend $4,000 to have "Invisiline " repositioning proceduredone on both of our mouths.Terrible invention!! This was only after 5 months!