Nociceptive Trigeminal Inhibition Tension Suppression System (NTItss)

 

Patient Informed Consent for Use

 

Please initial each item as your read and understand it.

 

__ Wear the appliance(s) for the first four weeks (you may have one for sleeping and one for waking).  Sleeping use

     may continue indefinitely, while daytime use will eventually be tapered off to at most, stressful occasions.

 

__ Never wear an NTItss appliance while eating.  The NTItss is not a functional appliance.  (Doing so may be painful

     and possibly traumatic to the opposing teeth).

 

__ Avoid sleeping on your stomach.  Sleeping on your stomach forces your head to be turned to the side, which may

     allow significant muscular strain.

 

__ Discontinue all gum chewing.

 

NTItss use should be discontinued and adjusted by your doctor:

 

__ if it is uncomfortable, too tight or binding, too loose (can be removed with your tongue), or damaged.

 

__ if when wearing the NTItss, your back teeth or canine teeth can somehow touch each other in various jaw positions.

 

Patient understands that:

 

__ The NTItss suppresses muscle dysfunctions and are not orthodontic appliances and do not move teeth.  Daily

     chewing (without wearing the NTItss) will maintain each tooth's 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, casual adaptation of the teeth to the varying (para)functional forces being

     applied to them.

 

__ The jaw is like a garage door (spring hinge type).  Just as the tension of the garage door springs influence the path of

     closure of the door and its final fit, so does the tension of the jaw musculature influence the path of closure and final

     fit of the teeth.  If one garage door spring is significantly tighter than the other (even though the door may be fitting

     adequately upon closure), decreasing the tension of that spring will affect the final fit of the door, and may      

     necessitate the modification of the door to ensure efficient closure.  Similarly, reducing jaw muscle tension may

     allow the jaw joints to achieve their most natural, relayed orientation and allow the jaw to close in its best and most

     natural path of closure, which may different that what the patient originally presents with.  This only occurs in the

     presence of relief of symptoms.  In this event, your dentist may recommend modifying the occlusal scheme of your

     teeth to achieve the most efficient closure (or "bite").

 

__ Pre-existing jaw joint noises are not necessary indicative of pathology or disease, but may be permanent adaptive

     conditions to historical muscle dysfunction or trauma.  The NTItss may allow the degree of "loudness" to decrease

     or resolve completely.  Your dentist will recommend diagnostic tests for specific jaw joint disorders.

 

__ Part of the "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 are intended to deflect or modify the forces

     generated by muscle parafunction.  Unfortunately, these appliances can also allow for the intensity of muscle

     parafunction to increase, by simply providing a more efficient surface to bite on.  The NTItss appliance is

     specifically designed to suppress muscle parafunction intensity, not enhance it. 

 

__ Complete resolution of your symptoms may not occur immediately.  Muscular parafunction can be aggressive in its

     attempt to maintain itself.  Typically, the jaw's range of motion improves, allowing it to achieve orientations that

     allow for continued, or new, symptomatic presentation.  Your dentist may need to adjust or modify the NTItss as the

     condition adapts and attempts to “defeat" the NTItss.

 

 

Signature of patient or guardian _____________________________ Date___________