NTI-tss PATIENT FORM___ Wear the appliance continuously (except when eating) for the first four weeks (if you have one for sleeping and for waking). Sleeping use may continue indefinitely, while daytime use will eventually be tapered off to, at most, stressful occasions.___ Never wear an NTI appliance while eating. (Doing so may be painful and possibly damaging to the opposing teeth). Discontinue all gum chewing even when not wearing the NTI. Also limit the amount of hard and rubbery foods you eat for some time. Note: use you container when you take out your NTI and dont wrap it in a napkin. We will have to make a charge for lost appliances. ___ Avoid sleeping on your stomach. Sleeping on your stomach forces your head to be turned to the side, which may allow significant muscle strain. NTI use should be temporarily be discontinued and adjusted by us: ___ if it is uncomfortable, too tight or binding, too loose (can be removed with your tongue or lips), or damaged. ___ if, when wearing the NTI, your back teeth or canine teeth can somehow touch each other in various jaw positions, or if you notice an obvious notch or divot where your opposing teeth contact the device. ___ if you notice your teeth are no longer coming together as they did prior to NTI use. This is an indication that your jaw is re-aligning. Although this is usually a good sign occurs as symptoms have resolved (or are resolving), the improving alignment of the jaw may be undesirable without some type of modifications to the teeth. Otherwise, you may continue to have jaw pain, headache or damaged teeth. Patient understands that: ___ The NTI suppresses muscle dysfunctions and is not an orthodontic appliance which can move teeth. Daily chewing (without wearing the NTI) will maintain each tooths original position. Those familiar with any type of removable custom mouthpiece realize that a mouthpiece may fit poorly if it has not been worn for an extended period. This is due to the constant slight adjustments teeth make to the forces around them. ___ The jaw is like a garage door (spring hinge type). Just as the tension of the door springs influence how the door closes, so does the tension of the jaw muscles influence the path of closure and final fit of the teeth. If one garage door spring is significantly tighter than the other, decreasing the tension of that spring will affect the final fit of the door, and may require modifying the door to ensure efficient closing. Similarly, reducing jaw muscle tension may allow the jaw joints to achieve their most natural, relaxed position allowing the jaw to close in its best and most natural path, which may be different from what the patient originally started with. This occurs as symptoms are finally relieved. In this event, we may recommend modifying your teeth to achieve the most efficient closure (or bite). This may be done by shaping the teeth, adding to them by fillings or caps or even moving them by orthodontics (braces). ___ Pre-existing jaw joint noises may not necessarily be indicative of disease of damage, but may also be the bodys way of adapting to irritated muscles of injury. The NTI may allow the degree of loudness to decrease or resolve completely. Or sounds could increase ___ Part of the historical Standard of Care in dentistry for jaw related conditions had been to provide a full coverage mouthpiece. These appliances cover all of the upper or lower teeth and intended to deflect, absorb, or modify the forces generated by muscle clenching or tooth grinding. Unfortunately, these appliances can also allow for the intensity of bad habits to increase, by simply providing a more efficient surface to bite on. The NTI appliance is specifically designed to suppress muscle bad habits. ___ Complete resolution of your symptoms may not occur immediately. Sometimes these bad habits put up a fight (while youre asleep and are unaware)! Typically, the jaws range of motion improves. Symptoms may change over time and must be reported to us. Sometimes we must modify the device as the condition adapts and attempts to defeat the NTI. ___ Clean the appliance thoroughly with cool, not hot, water, and brush with regular toothpaste. Do not put it in the dishwasher or microwave! Once in a while you may have to soak it for a half hour in diluted vinegar if crusty deposits are starting to develop. Soak, then brush. Note: the plastic portion of the NTI will often chance color with time. This should not affect the function of the appliance. ___ Keep the appliance away from pets. They love to chew on them too.  | 
