Updated on February 7, 2024
6 min read

NTI Night Guards

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What is an NTI Night Guard?

The Nociceptive Trigeminal Inhibition Tension Suppression System (NTI-tss) is a dental appliance that protects teeth and relieves pain from jaw clenching and teeth grinding during sleep. 

The NTI appliance is U.S. Food and Drug Administration (FDA)-approved to treat and prevent:

  • Bruxism (teeth grinding)
  • Temporomandibular joint disorder (TMD)
  • Medically-diagnosed migraines

This small, custom-made mouth guard is usually made of acrylic or resin. Unlike traditional mouth guards that cover all your teeth, the NTI appliance fits over just the front teeth, also known as the central incisors.

If you grind your teeth at night or during the day, an NTI night guard may be right for you. This article explains how they work and what to consider before discussing night guard treatment with your dentist.

How Does the NTI Night Guard Work?

The NTI night guard fits over your front teeth. It keeps your upper and lower teeth from touching while you sleep. This prevents you from clenching your jaw and grinding your back teeth at night.

Not only does the NTI appliance prevent tooth contact, it also reduces pressure on your jaw muscles. NTI therapy relaxes the jaw and decreases muscle tension, a common cause of teeth grinding and TMD.

Benefits of NTI Night Guards

Dentists favor the NTI-tss appliance for many reasons. Advantages of the NTI night guard include:

Rapid Pain Relief

The greatest benefit is quick relief from tension headaches and muscle pain. The NTI appliance relieves pressure from the jaw joint and allows the muscles to relax by creating space between the upper and lower teeth.

Compact Size

The NTI-tss is the smallest available mouthguard. People who use this appliance appreciate that it fits comfortably over just the two front teeth. Most other night guards cover the entire top row of teeth.

Stops Clenching and Grinding

Some dentists recommend using the NTI night guard as a behavior modification treatment for bruxism.4 

The NTI dental appliance trains your muscles to stop clenching by repeatedly interrupting your unconscious attempts to bite down. Wearing the night guard may help you break the habits of teeth grinding and clenching.

Potential Side Effects of NTI Night Guards

While the NTI night guard offers fast relief for people with bruxism, some dentists are cautious about prescribing it. Potential side effects and disadvantages include:

Potential Choking Hazard

The NTI night guard’s small size benefits some people, but this also makes it a potential choking hazard. Your tongue may accidentally dislodge it during sleep, which may cause choking.

Approved FDA database information reveals that the NTI-tss falls short of the size recommendations set by Consumer Products Safety Commission Guidelines (CPSCG).2

Only Available for People with Healthy Teeth

The NTI night guard isn’t right for everyone. You may not be able to safely use the NTI appliance if you have:

  • Damaged front teeth
  • An atypical bite
  • Degenerative arthritis of the jaw joint
  • Teeth that are worn, weakened, or loose from advanced periodontal disease (gum disease)

May Impact the User’s Bite

Wearing an NTI night guard may cause the surrounding teeth to shift. This can lead to an open bite. An open bite is rare, but it occurs in about 5% of people who use the NTI-tss.4 

This type of malocclusion occurs when the upper and lower teeth don’t touch when your mouth is closed.

An untreated open bite can lead to pain and difficulty speaking, swallowing, and chewing food. 

Requires Dentist Supervision

Because the NTI appliance can change a person’s bite, regular professional oversight is necessary. 

If you decide to use the NTI night guard, plan on frequent trips to your dentist for follow-ups. Using this mouth guard without a dentist’s supervision may lead to changes in your bite.

How Much Do NTI Night Guards Cost?

The average cost of an NTI-tss night guard is about $600. Talk to your dentist about the exact price, which can vary by location.

Does Insurance Cover an NTI Night Guard?

Your health insurance will likely cover some of the cost of an NTI appliance. Because it’s an approved treatment for bruxism and TMD, most insurance providers consider the NTI night guard medically necessary.

Paying with an FSA or HSA

Another option is to pay with funds from a health savings account (HSA) or flexible spending account (FSA):

  • HSA — an HSA is available to people with high-deductible health plans who aren’t eligible for Medicare and can’t be claimed as a dependent.
  • FSA — an FSA is part of a benefits package through an employer. You can’t get an FSA on your own.

Both accounts allow you to set aside pre-tax dollars for healthcare expenses like a night guard.

Is an NTI Night Guard Right for You?

As mentioned earlier, the NTI night guard isn’t right for everyone. People with severe periodontal disease or damaged front teeth may not be eligible for treatment.

You may be a good candidate for treatment with an NTI appliance if you:

  • Have healthy teeth
  • Experience sleep difficulties due to teeth grinding
  • Want to relax your jaw and facial muscles
  • Are willing to follow up with your dentist for regular follow-ups 

NTI therapy may also help migraine sufferers who want to reduce their need for medications.

About Bruxism

Bruxism refers to persistent teeth grinding or clenching. It can occur during the day or while you sleep. 

Sleep bruxism is common, affecting about 13% of adults.6 However, many people don’t realize they’re grinding or clenching their teeth until they experience symptoms such as:

Treating bruxism is necessary to prevent more serious dental health problems like cracked teeth and gum recession.

What Causes Bruxism?

Stress causes about 70% of bruxism cases.2 Other common causes include anxiety and sleep disorders like sleep apnea.

Alternative Treatments for Bruxism

Exploring other treatments can help you decide if the NTI night guard is right for you. Alternative treatment options include:

Traditional Mouth Guards

You can get a custom-fitted mouth guard that prevents clenching and grinding and requires less dentist supervision. These appliances are sometimes called occlusal guards or bite guards.

Size is the main difference between the NTI night guard and other mouth guards. While the NTI appliance fits over only the front teeth, a standard mouth guard covers the entire arch. 

A larger mouth guard won’t pose risks of choking or teeth shifting, which are significant concerns about the NTI appliance.

Stress Reduction

Because stress is the leading cause of teeth grinding, stress-management techniques may help. 

Methods to reduce stress include:

  • Meditation
  • Hypnosis
  • Cognitive behavioral therapy (CBT)
  • Biofeedback
  • Regular exercise
  • Massage therapy
  • Acupuncture

Lifestyle Changes

Stress isn’t the only lifestyle factor that contributes to bruxism. Other changes that may help prevent grinding and clenching include:

  • Reducing alcohol and caffeine consumption 
  • Avoiding chewing gum, pencils, and other objects
  • Practicing keeping your jaw in a relaxed position by placing your tongue behind your front teeth
  • Implementing a relaxing bedtime routine, such as a bath 


The NTI night guard is an FDA-approved bruxism treatment. NTI-tss stands for Nociceptive Trigeminal Inhibition Tension Suppression System.

This night guard prevents the upper and lower teeth from touching during sleep. This relaxes the jaw and facial muscles and prevents you from clenching your jaw and grinding your back teeth.

The NTI appliance differs from other mouth guards in that it only covers the front teeth. Because the appliance is so small, choking and teeth shifting are concerns. People who wear an NTI night guard must see their dentist regularly.

Last updated on February 7, 2024
7 Sources Cited
Last updated on February 7, 2024
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. NTI-Tss Plus™” NDX National Dentex Labs, nd.
  2. Causes of Bruxism.” The Bruxism Association, nd.
  3. Tooth Clenching or Grinding.” The American Academy of Oral Medicine, 2015.
  4. Stapelmann, H, and Türp, J. “The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature.” BMC Oral Health, 2008.
  5. Wajid, MA, et al. “Open bite malocclusion: An overview.” Journal of Oral Health and Craniofacial Science, 2018.
  6. Yap, AUJ, and Chua, AP. “Sleep bruxism: Current knowledge and contemporary management.” Journal of Conservative Dentistry, 2016.
  7. Krishna, PD, et al. “A Review of Current Concepts in Bruxism – Diagnosis and Management.” Journal of Health and Allied Sciences, 2014.
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