Researchers, led by Andrew M. Blumenfeld, assessed the ability of the Nociceptive Trigeminal Inhibition (NTI) dental splint—an oral device to reduce nocturnal jaw clenching—to improve headache impact test-6 (HIT-6) scores. In their article, published in BMC Neurology, the investigators reported that the NTI device improved HIT-6 scores, supporting the notion that “intense nocturnal jaw clenching” contributes to migraine pathology.

The authors suggested that this jaw clenching activity may be commonly undiagnosed in patients with migraines. They further proposed that pain inputs from “affected teeth, bone, temporomandibular joints, and muscles… produced by nocturnal jaw clenching should be considered as a potential perpetuating and confounding co-factor of chronic migraine.”

The cross-over study was conducted with Institutional Review Board oversight, assessing the efficacy of the NTI splint via change in HIT-6 scores compared with placebo. The authors observed that “68% of refractory chronic migraine sufferers using the NTI, as measured by sequential HIT-6 scores, had at least a one-category improvement (severe to substantial, or substantial to some, or some to none) compared to 12% when using a placebo device.” Additionally, 36% of NTI device patients achieved a two-category improvement in their HIT-6 score compared to 0% of placebo patients.

Given that the authors found no prior placebo-controlled studies on the efficacy of the NTI splint, they presented their positive findings as the strongest evidence to-date that nocturnal jaw clenching may be a contributing factor in chronic migraines. They advised future investigators that “an NTI device should be considered as a method of assessing whether jaw-clenching is a contributing factor to ongoing migraine.”