"My teeth feel fat (or "itchy")"
        This is due to the re-establishment of normal PDL health.  Prior to using the NTI-tss, the patient had been compacting their teeth within their sockets on a regular basis.  Explain to the patient that it is similar to the tingly sensation one gets after one's "foot falls asleep" from sitting on it wrong.  As the PDL regains its normal state, it can be hypersensitive, creating the sensation of "fatness".  The sensation will resolve with 2 or 3 days.

"My jaw joint is sore"
    Typically, this occurs when the Discluding Element has opened the patient's vertical dimension too far.
With the NTI-tss in place, have the patient move excursively as far as possible to both the right and left.  The direction they hesitate going in (which is uncomfortable) is the direction they go while asleep.  Since the DE has already created a degree of opening, it is also creating an additional degree of translation in excursive movement.  Reduce the height of the DE and have the patient perform the movement again.  A change in sensation (decrease in discomfort) confirms the excess of vertical dimension.  Close the vertical as much as possible.
    Upon reducing vertical, confirm that the DE doesn't continue its downward slope beyond the opposing
incisors.  It should be re-directed to by paralled to the maxillary plane.  Excessive vertical upon protrusion
will create, or maintain, joint strain.

"I can't close my mouth"   "I'm always drooling"
  What the patient may really be trying to say is, "I can't seal my lips together".  The bulk of the labial wall should
be thinned  and blended to a near knife-edge as possible.  Reduce the labial bulk of the DE if possible.  The primary-clenching patient should be reminded that their assumption that lip-seal is necessary is really "the parafunctional muscular condition trying to fool you into thinking that's so".  Many of these patients' clenching
habits include a tight lip-seal and creating a vacuum within their mouth.  When they no longer can do that, they feel that something is "wrong", when if fact, what they have been doing is part of the parafunctional disorder.  Also,
with a new "foreign" object in their mouth, it is normal for excess saliva production for a period of time.
Sculpting the device to make it as "natural" as possible will help.

"It's too tight on my teeth / I feel pressure"
    Even though the device may appear to be fitting as it should, if the patient senses any discomfort / disruption, the NTI-tss device becomes more of an irritant to them than a muscular suppressant.  The device should feel "like a part of their teeth", not "like a object stuck in their mouth".  If an internal adjustment does not rectify the issue, relieve the internals entirely,  place it over the retaining teeth and have the patient clench on it.  Confirm with the patient that the sensation of pressure/pushing is gone (of course it will be because of the internal relief just performed).  Re-do the reline procedure, making sure to not remove the device prematurely during curing (doing so may have caused the minor internal distortion that was bothering the patient).  (Using orthodontic acrylic instead of the acrylic intended for temporary crowns, such as SNAP, can result in a sensation of tightness.  It does not have the resiliant memory that SNAP does upon initial removal).

"My lower tooth is sore"
    There are three common scenarios.  1) The orientation of the DE to the opposing incisors needs to be re-established, or;   2) an incisal corner of an incisor is contacting the DE in excursive activity, or;  3) An posterior contact exists in excursive movement, thereby allow increased clenching intensity which traumatizes and incisor.
    If while in a centered clench, the opposing tooth feels tender or sore, repeat the reline procedure as in the above example.  Re-orienting the DE will most likely eliminate the discomfort (it may not look perpendicular to the long axis, but the absence of tenderness or soreness during clenching is more important that how it looks).  In the event an incisal corner catches the DE during excursive activity, attempt so smooth and round off such irregularities, creating as little resistance to the movement as possible.  If a posterior contact exists, equilibrate the interference.

"My teeth have moved"
    The first assumption a patient usually makes when becoming aware of a change in their occlusal scheme is that individual teeth have moved.  They are somewhat convinced of this based on their identification of just one tooth that seems to have moved.  What they are actually reporting is an occlusal interference that their musculature had been adapted to and accommodated for up until the use of the NTI-tss.  They should be reassured that without orthodontic intervention, an individual tooth cannot move by itself in a matter of weeks (especially when they perform normal chewing daily). (background page)  Ideally, the interference should be reduced (equilibrated) while advising the patient that as their muscular condition continues to resolve, another occlusal adjustment may be indicated.  ("I can't bite with my front teeth")

"I'm still getting headaches"
    Although the patient's headaches may have been reduced, the patient may change their focus from headache reduction to headache elimination.  Inquire as to when they are getting their headaches.  Upon awakening?  Later in the day?  Typically, the patient's morning headaches are noticeably improved, but they now focus on the
headaches that come on later in the afternoon.  This is an indication for a daytime device.  In the event they have already been provided a daytime device, they may not be using it (due to the awkwardness or embarrassment).  If so, consider making a daytime device on the lower teeth.  Also, review the protocol for night time use, confirming there are no oversights.  For a migrainuer who has shown little noticeable improvement within the first two weeks, consider opening the vertical.

"My jaw is sore after I eat"
    This is most likely an indication for occlusal equilibration. (see above)

"My speech has changed"
    As the muscular condition resolves and the mandible assumes its most musculoskeletally stable position,
the patient's speech and diction may change.  The new jaw position and occlusal scheme may not allow
them to create the same sounds as prior to using the NTI-tss.  This is usually accompanying by a reduction in symptoms.  Occlusal equilibration may be indicated.

"My headaches are better, but my neck and shoulders are still sore"
   First, see My jaw-joint is sore. and
    The reason the NTI works so well and quickly on face, jaw, & head pain is because it *directly* suppresses the intensity of muscular responsible for those pains. Keep in mind that muscular activity has 3 components:
-Frequency of acts;
-Duration of a given act;
-Intensity of the act.
    The NTI can only suppress the intensity of an act, which has a direct effect on certain muscles,
*and indirect effect on others*.  The musculature in the neck/shoulders continues to parafunction with the same frequency and duration as before...but now to a lesser intensity, due to the NTI "taking the wind out" of the jaw's activities.  It is not unfamiliar to have a patient report:  "Wow, my headaches were helped right away, but my neck and shoulder discomfort seemed to slowly improve. After a couple of months, I noticed it wasn't anywhere near as bad as it used to be!".

The condition may be trying to fool you...
     The patient may tell you things that they think you want to (or might need to) know.  They may provide what they think are insights or suggestions. Something to consider always:  Imagine the patient has been "possessed" by the muscular parafunction "condition".  Sometimes, "The Condition" is speaking to you through the patient.  It is trying to mislead you.  It does not want to be disturbed.  For example, the patient might say:  "I feel that my bite is off", or, "I can't find a place where my teeth are supposed to come together".  The Condition is trying to convince you that you should improve the occlusal scheme, thereby improving the occluDING.  Why?  Because that would make The Condition a better clencher.  At this moment, remind the patient: "You see!  'The Condition' is talking to us!  It wants to keep on with its activity.  Point out that having a "malocclusion" is not unusual, but the constant occludING, is.
     Eventually, as the musculature is normalized with the NTI, occlusal interferences can be addressess and eliminated.  However, it is the regular nocturnal use of the NTI which reduces the daytime hyperactivity.
The patient's daytime "habits" are a reflection of their nocturnal parafunction.  As the parafunction is reduced, so are the reflexive daytime habits.