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NTI: Prophies, Parafunction and Your Patients Anita McMillen, RDH

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Prophies, Parafunction and Your Patients
by Anita McMillen, RDH

Over the past 25 years, I’ve seen patients in my chair for prohys or SRP that exhibit the artifacts of parafunction. Whether I’m noting the chart about a fractured crown on #3 or wear facets on anteriors, the one constant is that patients are almost never aware of their clenching or grinding. After I notify patients that they brux, they typically tell me that they don’t. My observation is usually met with a chorus of ‘no one has ever said they heard me grind my teeth.’ Then I use my mirror or the monitor to show them what I’m seeing. Sometimes I’ll ask them to clench their teeth together as hard as they can and hold that position. Then I’ll ask what they heard. After that, most patients accept they are indeed parafunctioners. After they’ve arrived at that determination, I’ll begin asking about symptoms such as TMD, headaches, migraines and face, neck or head pains that are often associated with parafunction. Most patients don’t see any correlation between their bruxism and painful symptoms, so I help connect the dots for them.

I ask patients if they have had a night guard in the past. I find that they need to be educated on why they are wearing an occlusal guard while they sleep. Oftentimes, patients balk when I mention occlusal guards, complaining that they’re too bulky and cumbersome. This allows me to go into depth about the NTI-tss Plus. I discuss its small size, unique design and benefits experienced from wearing it. I tell them that it usually only covers four teeth so it’s easy to wear, and also that it’s different from traditional night guards because it guarantees canine and posterior separation not only during excursions but also during a centric clench. I usually ask them to clench their teeth together with their hands on their temples. Doing this, they can feel the muscles tense and bulge beneath their fingers. Then I have them do it again with a tongue depressor between their central incisors. They feel the decreased intensity of the clenching and you can almost see the light bulb go off for them.

Sometimes patients take issue with the cost of an appliance. Unfortunately, too often, splints are not covered by insurance. I assure patients that the NTI’s unique design is durable, easy to wear and might not only alleviate their symptoms but also reduce the need for expensive dental work in the future. It will protect their teeth and restorations, decreasing the need for pricey crowns and future root canals.

I am able to allay many of their concerns by sharing my own experience with the NTI. Much of my life I’ve suffered from facial, neck and head pain. Throughout the years I tried many different treatments, including mouth guards, with little to no relief of my symptoms. My pain was caused from nocturnal clenching and the full coverage guards did not relieve the pain. Like many other clenchers, these full coverage appliances made my symptoms worsen. About five years ago, I heard about the NTI-tss Plus and Dr. Greg Hillery prescribed one for me. Almost overnight, my pain was eliminated.

It wasn’t too long before I realized that most of my clenching occurred during the day while working chairside with patients. Knowing that, I started wearing both a nighttime and daytime appliance. This is very helpful when patients comment that they “cannot wear an appliance during the day because their job dictates that they speak on the phone with customers.” At this point I ask them if they are having a hard time understanding my speech and I lower my mask to show them I am wearing my daytime NTI.

For me the NTI has been a godsend. I’m still practicing and I wear it daily. Using my own experience and showing my patients the actual device in my mouth helps convince them that it truly does bring relief and it won’t affect their daily lives in a negative way.

Author's Bio
Anita McMillen graduated from the New Hampshire Technical Institute, Dental Hygiene Program and now works as a periodontal therapist in Concord, New Hampshire. Her greatest passions are strong family bonds and providing the best possible care for her patients. Hygienetown online participation has provided Anita with a wealth of knowledge and expertise. Anita can be reached at needardh@hotmail.com.
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April 2024
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