CherylLynn24
10-16-2003, 02:59 AM
Hi,
I have a question that might sound silly. My Son has had several tests including an MRI and tomogram of the joints. (they all came out fine) His problem seems to be muscular in nature. Now, his current Neuromuscular dentist made him a repositioning splint that he's been wearing for about a month and a half. I guess what I'm wondering is, if your joints are in the right position, then why wear a repositioning splint?? I've noticed that others on the board have had tomograms and MRI's that have shown their problems to be muscular also....but still wear repositioning splints.....???
Cheryl
I have a question that might sound silly. My Son has had several tests including an MRI and tomogram of the joints. (they all came out fine) His problem seems to be muscular in nature. Now, his current Neuromuscular dentist made him a repositioning splint that he's been wearing for about a month and a half. I guess what I'm wondering is, if your joints are in the right position, then why wear a repositioning splint?? I've noticed that others on the board have had tomograms and MRI's that have shown their problems to be muscular also....but still wear repositioning splints.....???
Cheryl
Sponsor
saaraah
10-16-2003, 09:23 AM
do you have copies of the mri or tomograms?
maybe the condyles, themselves, are fine - they dont have any articular changes [arthritis or osteophytes].
*but* maybe the condyle is still too far back in relation to the fossa. if you do have copies of the xrays, it's pretty easy to see for yourself if that's the problem.
- saaraah.
maybe the condyles, themselves, are fine - they dont have any articular changes [arthritis or osteophytes].
*but* maybe the condyle is still too far back in relation to the fossa. if you do have copies of the xrays, it's pretty easy to see for yourself if that's the problem.
- saaraah.
DianeTMJ
10-16-2003, 10:40 AM
Good morning Cheryl-
Cheryl, I know in my case, that the first splint I was put in was to stablize me. He really built up my splint to give my muscles the room to stretch, remember my opening was like 19mm, I am now up to 31mm, which I am thrilled with. But of course, as we all know my problems are not just muscular, I have some skeletal (sp) issues that helped bring on my TMJD as well.
Now, I do not know if that information helped at all, but I think the idea, especially for your son is to first get him stablized, it is not about repositioning him at all, it is about getting him out of pain and THEN working on correction through braces, palate expander. I do not think that a repo splint is in his future, I think it is about a stablizing one, then into correcting his problems.
Big hugs
Diane
Cheryl, I know in my case, that the first splint I was put in was to stablize me. He really built up my splint to give my muscles the room to stretch, remember my opening was like 19mm, I am now up to 31mm, which I am thrilled with. But of course, as we all know my problems are not just muscular, I have some skeletal (sp) issues that helped bring on my TMJD as well.
Now, I do not know if that information helped at all, but I think the idea, especially for your son is to first get him stablized, it is not about repositioning him at all, it is about getting him out of pain and THEN working on correction through braces, palate expander. I do not think that a repo splint is in his future, I think it is about a stablizing one, then into correcting his problems.
Big hugs
Diane
CherylLynn24
10-16-2003, 12:21 PM
Thank you both for responding.
Saaraah,
I did have copies of these, unfortunately they were mailed out recently. Once I get them back, I'll have to take a look at them.
Diane,
Do these tests mean that he shouldn't even be wearing a repositioning splint right now? He wore his splint for part of the tomograms. I just don't understand.
I hope that you both have a good day.
Take Care,
Cheryl
Saaraah,
I did have copies of these, unfortunately they were mailed out recently. Once I get them back, I'll have to take a look at them.
Diane,
Do these tests mean that he shouldn't even be wearing a repositioning splint right now? He wore his splint for part of the tomograms. I just don't understand.
I hope that you both have a good day.
Take Care,
Cheryl
DianeTMJ
10-16-2003, 12:42 PM
Good morning Cheryl-
Oh no, my thought is that since his condoyles are showing to be healthy and for the most part in a good position, that most likely what Mike needs is not repos splint but a stablizing one, that allows the muscle to stretch out, giving them more room to heal. I would not stop the repos splint unless his dentist says to. But I think the approach to Mike's treatment needs to change, you know the focus. It was being assumed that his joints were out of wack, but now the tomograms show other wise. It sounds like to me that the focus change is from repositioning the jaw to stablizing the muscles so that the next steps can take place.
Okay, my condoyles are flattened, displaced disc and derangement. But my muscles were so so bad, before my dentist could even think about repositioning my jaw, he had to first focus on me getting out pain, so he made me a stablizing splint that really opened my bite, gave my muscles happy space to stretch. Once I was symptom free... excluding the brain fog/exhaustion, then he put me in a repos. splint, that brings my jaw forward about 4mm.
It sounds like Mike only needs the stablizing then move forward with the braces and or palate expander.
Why use a repositional splint when the joints are healthy. Now, I do not know about the forward movement??? is that muscle related? did your dentist say?
Hugs Cheryl
Diane
Oh no, my thought is that since his condoyles are showing to be healthy and for the most part in a good position, that most likely what Mike needs is not repos splint but a stablizing one, that allows the muscle to stretch out, giving them more room to heal. I would not stop the repos splint unless his dentist says to. But I think the approach to Mike's treatment needs to change, you know the focus. It was being assumed that his joints were out of wack, but now the tomograms show other wise. It sounds like to me that the focus change is from repositioning the jaw to stablizing the muscles so that the next steps can take place.
Okay, my condoyles are flattened, displaced disc and derangement. But my muscles were so so bad, before my dentist could even think about repositioning my jaw, he had to first focus on me getting out pain, so he made me a stablizing splint that really opened my bite, gave my muscles happy space to stretch. Once I was symptom free... excluding the brain fog/exhaustion, then he put me in a repos. splint, that brings my jaw forward about 4mm.
It sounds like Mike only needs the stablizing then move forward with the braces and or palate expander.
Why use a repositional splint when the joints are healthy. Now, I do not know about the forward movement??? is that muscle related? did your dentist say?
Hugs Cheryl
Diane
Al4
10-16-2003, 03:18 PM
Cheryl,
It is terrific that Mike's problem is diagnosed as purely muscular. That is easier to treat. I have a question for you though. If it is purely muscular, it means he does not have any joint clicking or grating or popping. Is that the case with him? I hope so. As for the repos splint, I agree with Diane and saraah. It is needed only if the relative location of the condyles to the fossa is not normal (not adequate space left between the condyle and fossa). The doc can see that in the tomos. I have no idea how they determine what is adequate space, and how much to move the lower jaw with the repos splint to create adequate space. Alex
It is terrific that Mike's problem is diagnosed as purely muscular. That is easier to treat. I have a question for you though. If it is purely muscular, it means he does not have any joint clicking or grating or popping. Is that the case with him? I hope so. As for the repos splint, I agree with Diane and saraah. It is needed only if the relative location of the condyles to the fossa is not normal (not adequate space left between the condyle and fossa). The doc can see that in the tomos. I have no idea how they determine what is adequate space, and how much to move the lower jaw with the repos splint to create adequate space. Alex
totallyconfused
10-16-2003, 04:07 PM
Cheryl,
You said the splint was IN for the tomograms. I'm thinking that could have been why the condyles were in the correct position? It would be hard to know unless they did the test without the splint too. I would think if he is in the right position without the splint, then all he would need would be a splint to relax the muscles.
Take care and have a good day,
TC
[This message has been edited by totallyconfused (edited 10-30-2003).]
You said the splint was IN for the tomograms. I'm thinking that could have been why the condyles were in the correct position? It would be hard to know unless they did the test without the splint too. I would think if he is in the right position without the splint, then all he would need would be a splint to relax the muscles.
Take care and have a good day,
TC
[This message has been edited by totallyconfused (edited 10-30-2003).]
GenDen
10-16-2003, 04:21 PM
It is my understanding that moving the mandible forward in the repositioning splint relaxes the muscles. This would be temporary, for about three months or until all pain is gone, if the condyles are in the correct position without the splint. I suspect this is something you should discuss with your TMJ specialist. It is a very good question.
Puzzled
10-16-2003, 08:50 PM
Cheryl, my problems were determined to be strictly muscular. I have relatively little clicking and can open wide. I have now been told my bite is not good which is contributing to clenching, grinding and thus muscle spasm. I tried that thin lower splint like your son's sounds like. It did not help me either. My doctor called it a diagnostic splint and felt if you were not helped within 3 months then it was not the proper treatment. He did no tomograms either, just did this. Now I feel like he wasted three months of my time and should have done a tomogram and known I did not have joint issues. In layman's term he described it to me like this - "when the teeth and the muscles are in disagreement the teeth will always win in sending messages to the brain. The splint puts the teeth in neutral allowing the jaw to determine where it should be."
I will copy below a section from the informational pamphlet they email patients in case it helps you to understand what they hope to accomplish by treating muscular pain with repo splints. Here it is:
This is a diagnostic phase to detemine the extent of muscle and/or joint problems that may be involved and to determine the extent of improvement in pain. The mode of action of the splint is to restore proper physiologic resting length to the muscles of mastication and to provide a platform of support which allows the lower jaw to reposition itself. It is this auto-repostioning of the mandible that results in a correction of altered head/neck posture. Since the chronic pain can be caused by dysfuntion of the muscles that support and balance the head/neck/facial complex, the restoration of proper balance and posture to these structures can result in decrease and/or elimination of pain syndromes associated with the muscle groups.
I am looking at it like this - well, I have eliminated that as the solution to my problem, now I need to try something else. Which is what your new doctor will do for your son.
Deb
I will copy below a section from the informational pamphlet they email patients in case it helps you to understand what they hope to accomplish by treating muscular pain with repo splints. Here it is:
This is a diagnostic phase to detemine the extent of muscle and/or joint problems that may be involved and to determine the extent of improvement in pain. The mode of action of the splint is to restore proper physiologic resting length to the muscles of mastication and to provide a platform of support which allows the lower jaw to reposition itself. It is this auto-repostioning of the mandible that results in a correction of altered head/neck posture. Since the chronic pain can be caused by dysfuntion of the muscles that support and balance the head/neck/facial complex, the restoration of proper balance and posture to these structures can result in decrease and/or elimination of pain syndromes associated with the muscle groups.
I am looking at it like this - well, I have eliminated that as the solution to my problem, now I need to try something else. Which is what your new doctor will do for your son.
Deb
CherylLynn24
10-17-2003, 03:03 AM
Thank you all for responding. The knowledge that all of you provide has really helped me out this whole time.
Diane,
The dentist did say that the 'forward' movement was muscle-related. His previous 3 splints were stabilizing splints....nothing. ???
Alex,
He does have a lot of joint noise. I can hear it when he eats and he had some type of test (I'm sorry, the name of it escapes me right now) where the dentist 'listened' to the sound from his joints. He even said that he had quite a bit. How is your splint working out for you, Alex?
TC,
Funny, you mentioned this. Half of the tomograms were taken with the splint in....the other half without. ??? How could everything look the same?
GenDen,
It sounds like you and I had the same understanding. I will indeed speak to his dentist about this.
Deb,
What you've said makes a great deal of sense. This is his 6th splint since February!! 2 were NTI's, 3 were stabilizing splints...and now this repositioning splint and nothing. What a mess this is to try and sort out! I hope this new dentist feels he can help and has a plan.
Thank you all again for writing. I always appreciate your helpful advice. So far, the hospital has been the only one to read these tomograms. I'd rather have someone who is familar with this problem looking them over vs. a hospital that doesn't see these day after day.
I hope you all have a good day tomorrow, as well as a wonderful weekend.
Take Care,
Cheryl
Diane,
The dentist did say that the 'forward' movement was muscle-related. His previous 3 splints were stabilizing splints....nothing. ???
Alex,
He does have a lot of joint noise. I can hear it when he eats and he had some type of test (I'm sorry, the name of it escapes me right now) where the dentist 'listened' to the sound from his joints. He even said that he had quite a bit. How is your splint working out for you, Alex?
TC,
Funny, you mentioned this. Half of the tomograms were taken with the splint in....the other half without. ??? How could everything look the same?
GenDen,
It sounds like you and I had the same understanding. I will indeed speak to his dentist about this.
Deb,
What you've said makes a great deal of sense. This is his 6th splint since February!! 2 were NTI's, 3 were stabilizing splints...and now this repositioning splint and nothing. What a mess this is to try and sort out! I hope this new dentist feels he can help and has a plan.
Thank you all again for writing. I always appreciate your helpful advice. So far, the hospital has been the only one to read these tomograms. I'd rather have someone who is familar with this problem looking them over vs. a hospital that doesn't see these day after day.
I hope you all have a good day tomorrow, as well as a wonderful weekend.
Take Care,
Cheryl