BlueCross BlueShield of Tennessee Medical Policy Manual

Intraoral Devices for the Treatment of Headaches


Intraoral devices are being offered for the treatment of headaches (e.g., migraine, tension-type). There are different types of the intraoral devices. One type is the pericranial muscular suppression device (e.g., Nociceptive Trigeminal Inhibition Tension Suppression System or NTI-tss®). Another similar device is the anterior midpoint stop appliance (AMPSA CS™, Migran-X™). These devices are plastic mouthguards fitted by a dental practitioner and worn during sleep. They are proposed to treat migraine associated tension-type headaches by reducing muscular tension and activity.




Well-designed studies published in peer-reviewed journals are lacking regarding the use of any intraoral device for the treatment of headaches.


Franco, L., Rompre, P., de Grandmont, P., Abe, S., & Lavigne, G. (2011). A mandibular advancement appliance reduces pain and rhythmic masticatory muscle activity in patients with morning headache. Journal of Orofacial Pain, 25 (3), 240-249. (Level 3 evidence)

Moeler, D. (2013, Spring) Evaluation of a removable intraoral soft stabilization splint for the reduction of headaches and nightmares in military PTSD patients: a large case series. Journal of Specialized Operational Medicine, 13 (1), 49-54. Abstract retrieved December 19, 2017 from PubMed database.

Stapelmann, H., & Turp, J. C. (2008). 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, 8 (22). (Level 2 evidence)

U. S. Food and Drug Administration. (2001, June). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K010876 (NTI-tts®). Retrieved February 6, 2012 from: 




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