Dentaltown February 2022 - 32

EARNED PLACEMENT
by Dr. Stacy Ochoa, D-ABDSM, FICOI
Dr. Stacy Ochoa, D-ABDSM, FICOI, is a general dentist,
practice owner and entrepreneur. Before graduating from
the University of Missouri-Kansas City School of Dentistry
in 2002, Ochoa was a registered dental hygienist and
attended the University of Missouri-St. Louis for premed
studies.
Ochoa has attended and delivered hundreds of hours of
continuing education on the topics of headache, migraine,
TMD, and adult and pediatric sleep-disordered breathing.
For the past decade, she has worked closely with the
St. Louis medical community to develop new clinical
pathways for patient management.
NTI Myths Busted
NTI OmniSplint: Clenching treatment reimagined
I began using the NTI-tss Plus (Fig. 1)
for my patients who were chewing through
night guards or complaining that the
full-arch appliances were making their
headaches worse. Overwhelmingly, my
patients gave us glowingly positive reports
about their NTIs when they came in for
follow-up appointments.
During my entrée to the world of
parafunctional control with the NTI therapeutic
protocol, I did encounter some
naysayers-especially a few vocal ones in
certain social media groups. I wondered
if I should stop using it. At the very least,
I had to learn more.
As a doctor, I took an oath to do no
harm. So, I dug deeper to learn more. I read
reams of research, attended CE courses,
befriended the gurus and assessed my
own patients' experiences.
32 FEBRUARY 2022 // dentaltown.com
I'm a dentist, not an epidemiologist
or a neurologist, but during this process
I did learn a lot about the etiology of
migraines and headaches; about anatomy;
and about how and why the NTI works
for my patients.
The most common myths about the NTI
seem to be traceable to some orthodontists
who said the NTI could change bites
by extruding molars or intruding anterior
teeth. The well-intended but misinformed
myths sound something like the following:
Myth #1:
" Anterior open bites develop
when patients wear the NTI
because the posteriors are out
of occlusion and supraerupt. "
Myth busted: The first thing I thought
about was the fact that patients wear the
appliance for only about eight hours,
while they're asleep. Is that enough time
to cause supraeruption if the teeth are in
normal function the other 16 hours of the
day? During the rest of the day, patients
are eating, swallowing, talking and, yes,
even clenching. According to the research
and my own empirical observations, this
alveolar stimulation is sufficient to eliminate
any supraeruption.
One peer-reviewed study of TMD
patients wearing the NTI for eight weeks
found that no tooth movement occurred
with nightly appliance wear.1
Other studies
have shown that unopposed teeth require
from anywhere from 24 hours2
eight days3
up to
for movement to occur.
Dr. Jim Boyd shared a thought-provoking
anecdote on this topic. He said, " I talked
to an orthodontist who was adamant the
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Dentaltown February 2022

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