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JerseyGuy
01-15-2003, 11:46 AM
Hello all. This is my first post, although unfortunately I am very familiar with most sites dealing with TMJ problems. I think like most here, I could write a book on my experiences so far with TMJ. I'm posting here to try and briefly explain my situation and also ask a question or two. My TMJ problems started about 6 years ago after some dental work. I guess that combined with job stresses and some bad habits resulted in TMJ symptoms. It was just facial pain at first, then developed to disorientation, sever teeth pain, clogged ears, neck pain, and just feeling ill most of the time. I went from an athletic outgoing person to an introvert who just sat around. After many doctor, dentist, ENT, neurologist and pain management center appointments, I had had enough. I heard one Doctor briefly mention the letters TMJ, and I started to research. I found that this was most likely what I had and i began to look for help. After some real "losers" as far as dentists, I found a great dentist who really cared. He suggested equilibration to fix my bite. It cost a fortune. Unfortunately it did not help. I next found a specialist in South Amboy, NJ. I had many xrays, tests and teeth molds done. I was told I needed to wear a lower splint to pull my jaw slightly forward and down. In addition, I was given weekly sessions of EGS, ultrasound and moist heat therapy along with some other related treatments. Of course most of this was not covered and the basic expense for this specialist was approx $5,000. After 5 weeks, I did not feel any inprovement and the discussions with the specialist started leaning towards nerve block shots. I had these before at pain management and it did not help. One night, still about 5 weeks in to my treatment, the splint was hurting. I thought it probably needed its adjustment. I took it at before bed expecting to call the specialist in the morning to tell him. To my surprise, I woke up feeling pretty good, not 100%, but a big difference. For the first time in 6 years, I did not have a headache and I was wide awake. I'm still not sure why, but I suspect that the splint must have been alleviating the jaw pressure and moved my joints slightly. To sum up, I felt like I had my life back again. This lasted for quite a while until recently. I still had some pain and headaches, but i was able to manage it and it was not constant. After a recent visit to a regular dentist to have a crown put on, all my symptoms returned as bad as before. Im not sure why, but it it must be because of the work that was done. Ok, I know this is a long post. What I'm wondering is if anyone knows of any good specialists in New Jersey. I am not considering surgery, ever. Before I go back to the guy I went to last time, I want to be sure there is not someone else out there who can help me. Any suggestions? I live in Basking Ridge, NJ. I know treatmnts are a combination of things and can be very expensive since insurance coverage is minimal. Choosing the right specialist can make all the difference. Thanks for the time and I hope everyone finds relief soon.

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Jill J
01-15-2003, 11:52 AM
Try this website...
http://www.aaop.org/members/international/members_intl.htm

It lists those approved for TMJ treatments. I see a specialist in Vorhees, not sure how far away that is from you...Best of Luck...Jill

burgeke
01-15-2003, 12:04 PM
JerseyGuy

I work in Bedminster - NJ. If you find someone, I would greatly appreciate you posting the info. While I do not have the sever pain that many here mention, I have the ear symptoms and dull nagging facial pain. I am having a hard time finding a specialist or even a doc that agrees that TMJ and ear/sinus are related.

Thanks!
Keith

GenDen
01-15-2003, 12:10 PM
I found an excellent specialist on the website American Academy of Craniofacial Pain. They have a referral directory.

JerseyGuy
01-15-2003, 01:12 PM
Thanks for the responses. Keith, you may want to try the suggestions posted by Jill and Gen Den. Jill posted the website she used. The website suggested by Gen Den is www.aacfp.org (http://www.aacfp.org) (American Academy of Craniofacial Pain). This was the website I used last time to find Dr. Klemons in South Amboy. He seemed like he knew what he was doing, but it was expensive and before I decide to go back to him, I want to look at all options. On one of the wesites it looks like thee are some names in the Phillipsburg area as well as Allentown. I think your posting indicated that you were from Easton, Pa. By the way, is anyone using any equipment, traetments at home for their TMJ problems, like TENS or heat therapy? Thanks again.

Tom

Cymy Sue
01-15-2003, 06:02 PM
Tom,
One thing you did not mention trying is massage therapy. I am a life-long sufferer of TMJD and have tried everything for the past 25 years , including 7 surgeries. (no implants)
I have no disc and extensive nerve & muscle damage
from the surgeries.
At present, I am using a posterior muscle repositioning splint and seem to be getting some good results just after 3 weeks. (I have not worn any type of splint for 10 years due to the advise of my former surgeon.) I have been getting massage therapy for about 3 years from a therapist who is trained to work with TMJD patients. I could barely talk and eat when I began going to her. (The Doctors tell me that I have non-functional joints.) However, they do still function. I believe that the massage therapy has been instumental in keeping the muscles working.

Good Luck,
Cymy Sue

JerseyGuy
01-16-2003, 12:19 PM
Thanks Cymy Sue. I've thought of that recently too. I hate to say this again, but money is a factor. Most places ask for money upfront. I'm still trying to figure out how to pay for my potential return visits to the specialist I saw a few years back. I remember last time i went through this I had similar shoulder and neck pain. After wearing the splint, most symptoms got better. If I go the same route this time as far as splint therapy, I will definately consider massage therapy.
Again, thanks for the reply and for the suggestion. You sound like you have been through so much, I wish you good luck and good days.

Tom

autumn83175
01-18-2003, 01:37 AM
I see Doctor Lanzi in Haddonfield (he also has a washington township office). When I started out a couple years ago, I couldn't get any help from anyone in south jersey. Dr. Lanzi is a straight forward, very knowledgable doctor. He is the head of oral and maxiofacial surgery for Cooper Hospital. Most people say surgeons rush them for surgery, I have not found that to be the case with doctor Lanzi. If nothing else he can help you determine exactly where your TMJ stands. He offers all kinds of treatment and only uses surgery as a last resort. I like him so much, I drive two hours to see him. He takes most health and dental insurances. Hope this helps...

JerseyGuy
01-21-2003, 12:54 PM
Thanks Autumn. I checked out his website, looks good. Mind if I ask what he is treating you with, splints, teeth work, physical therapy? Is any of the treatment being covered by your insurance since it is TMJ related? Thanks.

Pedro
01-21-2003, 07:30 PM
My understanding is that here in NJ, it is difficult by law for a TMJD specialist to claim exactly that ... but it is easy for a general dentist to say that he "treats" it. This means all sorts of dentists are popping in splints for $800 plus. Beware.

After a few disasters, I found Peter Baragona in Mountain Lakes, that should not be too far from you. He seesm to be good, has had the problem personally, and I find he cares. See what he says about $$$, if that's an issue.

Years ago I went to Klemons, what an ego, I spent hours doing x-rays, got hit for a $500 bill, to be told that there was nothing structurally wrong and that he would refuse to treat me.

autumn83175
01-22-2003, 12:33 AM
I have been treated by splits, braces, and physical therapy. Unfortunately I have a very severe case so I am slated for surgery soon. But Dr. Lanzi has treated me for a few years before suggesting it so we really did try alot. I have Horizon Blue Cross and they are covering the surgeries. I had AmeriHealth and they covered the mouth splint, exploratory surgery and physical therapy; they would not cover the joint replacements and neither insurance company covers the braces even though they are necessary. There is a bill slated for review requiring all insurance companies in New Jersey to cover TMJ. Make sure you look it up and contact the congressmen heading it for support. In fact if you can start a petition and mail it to him so they don't write it off, I am. Good luck!

JerseyGuy
01-23-2003, 12:04 PM
autumn-good luck with your surgery. Sounds like you are in good hands.

Pedro-funny you mention Klemons and his ego. Something about the way he acted rubbed me the wrong way. I had many encounters at his office that made me feel uneasy, nothing extreme, just little things. I also had many x-rays, all in his "special x-ray room", under some other company name. I'm sure somehow this was working to his benefit. I went for a test one day at his office that could not have taken more than 5 minutes. I figured the fees were included in the $5,000 contract that I signed, however when I checked my balance due I saw this $500 charge. The test could not have taken more than 5 minutes. I questioned it and received a runaround. The admin in the office finally waived the fee for me, however a few weeks later I found them billing the insurance company for it. I also only saw Klemons once, on the first day. After that, it was some other guys who came in each week, very mechanical and asked me those "on a scale of 1 to 10 questions" I felt that they were not that concerned abot me and saw me as just another source of money. One other thing, the first day that I saw Klemons, I was in agony. MY TMJ symptoms were at their worst and it had been going on for a long time. I was sleeping about 3 hours per night, and barely making it through a days work. At the end of my appointment, the insurance person in the office said "if you really feel that bad today, the doctor can help you, he can give you a temporary splint until the permanent one is ready, it will cost you 300.00 and has to be paid today. I should have ran after hearing that. Even with feeling so bad, I refused to give them 300.00. Now that I think of it, I prob should have just taken the 300.00 spint and forgot about the one for $1,000 that I got from him two weeks later. OK, sorry to ramble here, just recalling some wierd stuff that I dealt with. I think all these things are what is causing me to hold off on going back to him. It's that gut feeling. Maybe I will look up DR.Baragona.

JerseyGuy
01-23-2003, 12:58 PM
Pedro,

Are you able to give any details regarding Dr. Baragona? Mountain Lakes is very close to where I work. Were you treated by him for any length of time? Did he help with your symptoms? Money is only an issue for me when I feel I am wasting it. If I believe that if I am seeing someone who can possibly help me, the money becomes secondary. I think the thing that never sat right with me about going to Klemons office was that they only looked at certain things. Everytime I had to go to a dentist, it had to be someone else. I'd like to see if I can go to just one person. Thanks again for the help.

Pedro
01-23-2003, 08:04 PM
Sorry for you my friend, I think you have it a bit worse than me (although I have had it longer).

See my earlier posts. Basically when I went to PB, I had already become aware that the "wholesale" grinding down (dentist #1) of my over-built crowns (done by dentist #2, crook who has a large ego equal to Dr. K), including reduction of my "eye" teeth, had feed up my jaw to slide forward, undoing the cramping damage done by ortho long ago. I needed a good specialist to confirm this was the way to continue, and also to do it with a diamond tool, not the jack-hammer this other guy (dentist #1, no ego !) was using.

PB (dentist #3) said there were 2 ways to do it, the CYA way (you know what this means) using more 7/24 splints to verify proper mandible placement, or for him to take a professional risk and do it the unorthodox way. Well he did not sell me the bill-of-goods, he did it the second way, and I am feeling much better, will return there next week. He is not cheap, but nothing remotely like Klemons Industries. It will be $300 first consultation. But as the above experience shows, he is personable and on the side of the patient. I have only been 4-5 times yet, but there you have my opinion. On the other hand, I was at a highly unusual stage, absolutely horrible occlusion, but could feel that my jaw muscles were beginning to experience relief.

Of course, like everyone else here, sadly there have been too many other dentists. Somehow I ended up with 4 front root canals, one later proved to be cracked and needed an implant, the gums remain swollen due to improper finishing of the crowns, and strangely I have a new set of seemingly intractable dental problems - totally unrelated to TMJD, but caused entirely by dentists in my journey to get relief - even get a diagnosis (which I found myself !).

Sorry for the convoluted answer. Any questions, write here again, make sure you keep me posted.

JerseyGuy
01-24-2003, 01:23 PM
Thanks Pedro. Sounds like you have been through alot. I have been dealing with this for 5-6 years now. Started with a bad root canal, followed by the pulling of two left wisdon teeth, followed again by pulling of a molar tooth which had unbelievable pain coming from it. Now that I look back, they were all early TMJ symptoms due to massive changes in bite and support. I was told I was crazy by two oral surgeons. I traveled all the way to Staten Island to see one of these guys, just to be to made to feel like a fool. Never once did TMJ come up in the diagnosis or in discussion. It's not until I started web surfing on medical sites etc. did I discover the likely cause of my problems. I had one guy do an equilibaration, actually tried to move my jaw BACK instead of forward, he ground down an eye tooth and put a crown on it. I know now that he meant well, but it was not accomplishing anything. Thanks again for your help. I think I saw PB's name on my AETNA Doc list. If he is in my plan, I could use him as a regular dentist as well. Pedro, thanks again for your responses.

[This message has been edited by JerseyGuy (edited 01-24-2003).]

[This message has been edited by JerseyGuy (edited 01-24-2003).]

Pedro
01-25-2003, 03:22 PM
Good luck JerseyGuy ..... just a thought please don't mention to PB where your information came from. My name is not Pedro, but I am afraid that he might read the site and identify me. I just want to be his normal quiet patient, not one who writes about him (good or bad).

JerseyGuy
01-27-2003, 02:06 PM
Pedro, I would never mention your name to anyone. I appreciate your comments on this site and that is where they will stay. I feel bad that I mentioned certain dentist/specialist names when I wrote my previous posts, maybe I shouldn't have. I do feel however that when dealing with TMDs, the more info the better, I wish I had found this site 6 years ago. Good luck to you as well. Maybe if I see PB, I'll post an update.

[This message has been edited by JerseyGuy (edited 01-27-2003).]

Elaine
01-27-2003, 02:11 PM
Tom,
If you feel uncomfortable about posting names, you can edit your post. Just click on the edit button where you posted,(top of your post).
Take care,
Elaine

Pedro
01-27-2003, 08:43 PM
JerseyGuy,

Yes I will look for your update if you see him. Please call their office first to see what range of things they do, to see if it's for you.

I wouldn't worry about naming other exploiters of the TMJD problem, unfortunately around here it is more the norm.

Once I faxed to one dentist (with a dedicated tmj website) a note to explain my ongoing symptoms, as he always refused to come to the phone. He was in the same town as our office, and he knew our large building, knew I worked in a large office. I had been treated by him unsuccessfully (crowns, etc) for 18 months. Incredibly he faxed back to our office a 1-page letter listing several on my visits and relating notes he had taken, concluding that I was impossible to please - all of this WITHOUT A COVER PAGE ........... and it just sat on our receptionist's desk all day long - I was out-of-office - for the entire office (175 people) to read.

And the money I had paid this guy. It is not easy with any kind of TMJD problem, especially with practitioners like him around.

chrissiek
01-28-2003, 12:00 AM
Originally posted by autumn83175:
I have been treated by splits, braces, and physical therapy. Unfortunately I have a very severe case so I am slated for surgery soon. But Dr. Lanzi has treated me for a few years before suggesting it so we really did try alot. I have Horizon Blue Cross and they are covering the surgeries. I had AmeriHealth and they covered the mouth splint, exploratory surgery and physical therapy; they would not cover the joint replacements and neither insurance company covers the braces even though they are necessary. There is a bill slated for review requiring all insurance companies in New Jersey to cover TMJ. Make sure you look it up and contact the congressmen heading it for support. In fact if you can start a petition and mail it to him so they don't write it off, I am. Good luck!

What type of surgery do they do for this?

I just found a dentist (after the first one screwed up that sent my bite off to the point of where my neck is so inflamed in the muscles I can't wear anything even remotely touching my neck). I"m a grinder at night time and have been under high amounts of stress before this even started.

now ever time I go for a filling it sets my bite off and this new dentist is going to try to rectify that.

The first round with the dentist who thought he knew what he was doing (at $2100 and filing down all my teeth) filed my teeth down so much there isn't anything left to file. So now they may have to build up.

All I want to do is to be able to wear something around my neck but the TMD treatments doesn't guarantee that. Since I've had this problem starting in October 2001 (initial problems started in January 2000) I've lapsed into panic attacks with situational depression. I can't wear most of my clothes because they touch my neck, no scarves, no high coats etc. It's been very difficult this winter to even go out with this pressure in my neck. :(

Is this common with TMD? Everything else has been ruled out. I've even beento phsyical therapy. They told me to see a psychiatrist. :(

Christine.

autumn83175
01-28-2003, 01:54 AM
Chrissi-

Your problem sounds more related to or caused by your teeth. Mine is all in the joints. Other than having an extremely tiny mouth, my teeth have not really been an issue. The surgery is for joint replacements and to widen my tiny mouth. Joint replacements are an extreme measure as i'm sure you will or have read here. Doesn't sound like anything you need. I've never had problems with my neck. My problems are in my joints and ears. I get extreme headaches and often dislocate my jaw with little effort. I would check around before getting any more dental work done. Since you are a teeth grinder a splint would probably help you alot. As for the panic attacks, mind over matter. You can visit all the doctors in town, and unless you want to change you train of thought, it won't happen. It's hard, but you have to keep telling yourself not to give into panicing. In fact, the whole situation defintely requires a positive outlook. Just take one day, and one turtleneck at a time. Please don't think i'm being harsh or condesending, I was just raised with this train of thought and it's always worked for me. Good luck.


[This message has been edited by autumn83175 (edited 01-28-2003).]

JerseyGuy
01-28-2003, 12:38 PM
Christine-I'm not sure what is going on with your neck, but I will say one thing, unless you feel it necessary yourself, FORGET THE PSYCHIATRIST.. They all tried that on me and I wouldn't buy it. Before all this dental work and bad Dentists, I was fine. I had stress etc. all my life, but it never caused me immediate pain. Maybe in the long haul it contibuted to my current situation with TMD, but it was mostly due to bad dental work. My suggestion is to read as many posts as possible in here, absorb the info, make notes. Post more questions if you have them. I have found that when dealing with TMJ problems, you have to educate yourself and share info with others. You may even have to go through a few quacks before you find a caring and knowledgable dentist/specialist. You are not alone, remember that! I know that does not help your symptoms, but go one day at a time. Try and relax if you can and believe that there is an answer even if you have to find it yourself. Good luck. Keep posting.

[This message has been edited by JerseyGuy (edited 01-28-2003).]

Jill J
01-28-2003, 01:41 PM
Chris......they did the same thing to me. GP sent me to psych because of panic attacks. I never had panic attacks until 2 months after TMJ diagnosis. I didn't put 2 and 2 together until a few months ago. The psych couldn't figure out why I was seeing her. I explained it to her and she just said it was TMJ and the drs who were raising my anexity level due to them telling me there wasn't anything wrong with me. Boy were they wrong!!

After reading an earlier post by pedro, I have just figured out that my TMJ started after having a filling replaced.....well guess what????? The DDS didn't fix my bite after the filling.......I see ortho to get it fixed on Friday and keeping fingers crossed that this resolves my TMJ.

Jill

J-man
01-28-2003, 09:01 PM
Hi everyone,

I think most of us who've been in the 'Tmj circuit', so to speak, for any length of time have had someone imply to us that we must have psychological problems because we have Tmj problems, especially if we are reporting symptoms of feeling stress, or maybe having panic attacks.

Funny though, because when you think about what is going on when you have a typical Tmj condition (if there is such a thing..lol), once the condition develops, a number of your muscles are tight pretty much all the time. This 'permanent tightness' is, for the most part, a result of physical problems that have developed with your jaw joint and muscles.

When you have tight muscles you can't be relaxed at the same time, so it stands to reason that if you experience a circumstance that's stressful, which might cause anyone to tense up...then people with Tmjd will tense up or tend to feel panicky, that much more easily. Again, this is because our muscles are already in a tense state to start with. We're like 'tight piano strings', and it only takes a little bit of plucking to get sound out of us.

Just a few thoughts,

John

chrissiek
01-28-2003, 09:36 PM
Originally posted by J-man:

Hi everyone,

I think most of us who've been in the 'Tmj circuit', so to speak, for any length of time have had someone imply to us that we must have psychological problems because we have Tmj problems, especially if we are reporting symptoms of feeling stress, or maybe having panic attacks.

Funny though, because when you think about what is going on when you have a typical Tmj condition (if there is such a thing..lol), once the condition develops, a number of your muscles are tight pretty much all the time. This 'permanent tightness' is, for the most part, a result of physical problems that have developed with your jaw joint and muscles.

When you have tight muscles you can't be relaxed at the same time, so it stands to reason that if you experience a circumstance that's stressful, which might cause anyone to tense up...then people with Tmjd will tense up or tend to feel panicky, that much more easily. Again, this is because our muscles are already in a tense state to start with. We're like 'tight piano strings', and it only takes a little bit of plucking to get sound out of us.

Just a few thoughts,

John


John and everyone else thank you!

I really had no idea that little fillings and dental work could screw so much stuff up.

My other dentist had no clue either so I dumped him.

Here is more of my scenerio.

This past year I've been going from doctor to doctor to rule things out and in the end, it looks like the whole problem was the bite.

It started out with an onlay that the dentist didn't do right (my bite was off but thsi was the straw that broke the camel's back). After that I had facial pain and couldn't chew correctly. (BTW the original dentist that screwed up gave me my money back so I could find someone to do the onlay correctly). In this time I had a root canal and bite adjustment with filingdown of all my teeth.

During this year and after I was at a stressful job where I was clenching all day. In October, I started to have neck problems where I couldn't have any pressure or anything touching my neck.

I wound up with mono at this time (we thought it was the mono) and I quit my job.

More doctors (thyroid, psychologist, panic disorder support group etc.) to rule out problems. X-rays and CT scans found nothing in my neck but two swollen spots on my shoulders. Everything is a pressure point. I kept telling them "when I yell it hurts, when I move my neck around it hurts, when I get stressed, the neck tightens up etc." No one believed me.

I had a bunch more fillings and the last batch set my bite off so bad that my teeth hit each other in a way that it hurts when I chew.

I finally found a dentist that went to Las Vegas to train in TMJ/TMD and how small fillings set off people's bites. He said that all my muscles in my neck are inflamed and the first doctor filed my teeth down so bad that there isnt' anything left to file.

He said that thsi will be a long process to get things back on track (at this point, I don't care about the money, well I do but you know what I mean *g*). Had I found this guy in 2000 maybe this wouldnt' have come to this.

My whole worry is that I hope my neck will stop being inflamed so I can get back to wearing things around it. I never realized that all the muscles are so tense in there until last night when I was under a lot of tension that I could feel in my jaw, neck, head (it felt like it was going to explode) etc.

now I know I'm not alone! Thanks everyone. Your posts are so helpful! I'm learning a lot here! :)

In this forum I finally found the board I needed - I went from allergy to thyroid and I wasn't any of those problems!

Christine.





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