Part One: Diagnosis and Kois Deprogrammers

Occlusal Appliances (dental mouth guards) are devices that will serve one of two functions, diagnostic, or preventative. Depending on the application, they may be referred to as a mouth protector, mouthpiece, gumshield, gum guard, nightguard, occlusal splint, bite splint, or bite plane.

Treatments are prescribed according to where patients fall within three distinct categories.  

Around 10 percent of all people are considered to have “acceptable function” and therefore have no issues with their bite. Another 10 percent have what is referred to as “true parafunction” meaning there is some sort of significant issue with their bite. This can stem from a number of causes, including Nocturnal Bruxism (nighttime grinding), past drug use, Parkinson’s, or Down Syndrome.  

Finally, 80 percent of patients are not within the “acceptable function” and fit into the category of either CCP (constricted chewing pattern) or Dysfunction (posterior bite instabilities). People with these types of irregularities would require some form of treatment to correct the issue.  

There are three major types of Occlusal Appliances:

Kois Deprogrammer

• This device serves primarily as a diagnostic tool to determine the extent of a patient’s biting issues.  

• It can also be used as a type of NTI if this helps the patient (keeping the back teeth from touching the front).

• It must be worn for at least one week and possibly for up to one month. It must be worn at all times except when eating.

• Its true purpose is to find the centric relation by “deprogramming muscle engrams”. In other words, it helps the jaw joint decide where it really wants to be.  

• If there is a great deal of pain from this device, then it is not working properly and is likely set too high.

• If there is no discomfort whatsoever, it could also not be working properly, likely because it is set too low.

• When not wearing their device patients may notice a slight change in their bite.

For patients who notice a posterior bite change after treatment, this indicates a dysfunction that is typically marked by clenching, wear, or pain. An Occulusal Adjustment would be recommended as treatment with prescribed use of a deprogrammer for starters. It is also sometimes possible to adjust the teeth down until all of them are touching, which would potentially eliminate the problem.  

If the concern is too severe to be treated in this manner, full arch rehabilitation or comprehensive orthodontics may be indicated.  This would of course mean comprehensive orthodontic treatment.

Next: Part Two: Symptoms, NTI’s and Occlusal Splints