Katie G
12-13-2004, 01:22 PM
:wave: Hi all - I hope you are having the best day possible with your TMD. I think of you often, and have been so busy at work I have not had a chance to be online. My kids monopolize the computer at home, so that doesn't work either for checking the postings.
Well a quick update on my situation - after 14 months of wearing an acrylic upper splint 24/7, my ortho feels that the jaw position is as good as it's going to be and stable at this point, so now we're on to Phase 2.
For me that means upper/lower braces for 22 months (!) to realign the teeth, followed by oral surgery to realign the jaws, and then braces continued for ???? (not sure on that one). Since wearing my splint, my bite has opened up so much that I cannot eat without the splint in. Because of that, the ortho said he may start with lower braces first and leave the splint in. I'll know more Wednesday this week when I go in to have the spacers inserted. I've been warned this may cause a lot of jaw achiness as the spacers are pushed in between certain teeth to provide anchors for the future wires of the braces. ICKKKK! I'll be popping the Motrin that day I'm sure. I've already planned to use an entire sick day from work.
Anyway, I'd like to hear how others are doing. As far as my pain from TMD, it is at a minimum - always there, but definitely tolerable. In fact, severe headaches/neck pain are rare for me anymore and make life so much more enjoyable. So I know the splint did what it was supposed to do - it allowed the muscles of the joints to relax, provided some healing to the area and realigned the jaw. However, I still grind my teeth at night (according to my husband; it doesn't wake me up), but the ortho thinks that will clear up as my teeth and jaws become more aligned over time. Even if I do still grind, at least I don't wake up with severe pains in the face, head, and teeth anymore.
Take care,
Katie G
Well a quick update on my situation - after 14 months of wearing an acrylic upper splint 24/7, my ortho feels that the jaw position is as good as it's going to be and stable at this point, so now we're on to Phase 2.
For me that means upper/lower braces for 22 months (!) to realign the teeth, followed by oral surgery to realign the jaws, and then braces continued for ???? (not sure on that one). Since wearing my splint, my bite has opened up so much that I cannot eat without the splint in. Because of that, the ortho said he may start with lower braces first and leave the splint in. I'll know more Wednesday this week when I go in to have the spacers inserted. I've been warned this may cause a lot of jaw achiness as the spacers are pushed in between certain teeth to provide anchors for the future wires of the braces. ICKKKK! I'll be popping the Motrin that day I'm sure. I've already planned to use an entire sick day from work.
Anyway, I'd like to hear how others are doing. As far as my pain from TMD, it is at a minimum - always there, but definitely tolerable. In fact, severe headaches/neck pain are rare for me anymore and make life so much more enjoyable. So I know the splint did what it was supposed to do - it allowed the muscles of the joints to relax, provided some healing to the area and realigned the jaw. However, I still grind my teeth at night (according to my husband; it doesn't wake me up), but the ortho thinks that will clear up as my teeth and jaws become more aligned over time. Even if I do still grind, at least I don't wake up with severe pains in the face, head, and teeth anymore.
Take care,
Katie G
Sponsor
oldpal
12-13-2004, 03:39 PM
For me that means upper/lower braces for 22 months (!) to realign the teeth, followed by oral surgery to realign the jaws, and then braces continued for ????
Hello Katie,
Why do you need surgery to realign the jaws? Something wrong with your lower jaw? abnormal growth?
oldpal
Hello Katie,
Why do you need surgery to realign the jaws? Something wrong with your lower jaw? abnormal growth?
oldpal
kikaida01
12-13-2004, 11:31 PM
I am also wondering why you need surgery to realign your jaw. The tmj dentist I went to see told me from looking at my jaw anatomy that more than likely my jaw always deviated to the right. I agree with him. I am 35 and I looked at my childhood pictures and my teeth always were not always straight. I am not willing to undergo any kind of surgery for tmj unless my jaw joints fail on me. He told me my joints are working smoothly and that I will be fine. I would suggest getting a second opinion before considering surgery.
oldpal
12-14-2004, 05:05 AM
Hello,
After reading your post over, it came to me. Brace to realign teeth, surgery, and then braces again? That really doesn't make any sense.
Functional Ortho basically will correct that in phase two with brace to pull the rear molars up. So your lower jaw can be sustained and not get pulled up again. Basically, in phase I using splints, your tm joint is moved to the "Gelb 4/7" vicinity. when it is there, your muscles are at rest. This can be proved by looking at the tm joint of the general population without "tmj."
So i definitely agree with Kikaida. Get a second opinion. But get one from a honest dentist. Surgery is not the solution, and often will cause more problems.
Take care,
oldpal
After reading your post over, it came to me. Brace to realign teeth, surgery, and then braces again? That really doesn't make any sense.
Functional Ortho basically will correct that in phase two with brace to pull the rear molars up. So your lower jaw can be sustained and not get pulled up again. Basically, in phase I using splints, your tm joint is moved to the "Gelb 4/7" vicinity. when it is there, your muscles are at rest. This can be proved by looking at the tm joint of the general population without "tmj."
So i definitely agree with Kikaida. Get a second opinion. But get one from a honest dentist. Surgery is not the solution, and often will cause more problems.
Take care,
oldpal
Katie G
12-14-2004, 09:55 AM
Thank you all for your replies. I agree with you that surgery should never be entered into without a lot of soul searching and research. I really trust my ortho - he has been providing TMD services for over 15 years (in fact I first saw him 15 years ago for treatment, but had no insurance coverage at the time and couldn't afford it). I'm not real thrilled about the prospect of surgery in the future - first I'm going to see how well the braces realign my teeth - however my bite is so open now from splint therapy, that the only teeth that touch when my mouth is closed is the last molar on the right.
My ortho said that in realigning my teeth first that will help stablize the jaw more, but that since my maxilla is so far forward of the mandible now, I will never have a normal bite without surgery to realign the jaws. If the braces do what they're supposed to, my upper teeth will be "pulled back" somewhat to more closely align with the bottom ones, but will never be able to pulled back enough. However, I'm still hoping that the braces do a good enough job on their own, and maybe 2 years from now, surgery will not be needed.
I have talked to many others who have been treated (or had family members treated) by my ortho, and they said he's actually more conservative than most. Some orthos in this area jump right into surgery first before splint treatment and/or braces. My ortho has worked very closely with an excellent oral surgeon about an hour from my town, and they collaborate all the time on TMD cases.
Since I know surgery is a long time off, I'll have plenty of time to research my other options prior to the time surgery may be recommended. Maybe in 2 years time of wearing braces, another less invasive method may be available. My ortho keeps up on continuing education related to the jaws, teeth alignment, TMD, etc., and therefore I am confident of his abilities.
If I decided on a 2nd opinion, I'm not sure where I'd go here in central Michigan. There are not very many good orthos around here, and I just feel that right now, I'm seeing the best.
Thank you all for your concerns, and I will certainly keep you updated on my TMD process.
Take care,
Katie G
My ortho said that in realigning my teeth first that will help stablize the jaw more, but that since my maxilla is so far forward of the mandible now, I will never have a normal bite without surgery to realign the jaws. If the braces do what they're supposed to, my upper teeth will be "pulled back" somewhat to more closely align with the bottom ones, but will never be able to pulled back enough. However, I'm still hoping that the braces do a good enough job on their own, and maybe 2 years from now, surgery will not be needed.
I have talked to many others who have been treated (or had family members treated) by my ortho, and they said he's actually more conservative than most. Some orthos in this area jump right into surgery first before splint treatment and/or braces. My ortho has worked very closely with an excellent oral surgeon about an hour from my town, and they collaborate all the time on TMD cases.
Since I know surgery is a long time off, I'll have plenty of time to research my other options prior to the time surgery may be recommended. Maybe in 2 years time of wearing braces, another less invasive method may be available. My ortho keeps up on continuing education related to the jaws, teeth alignment, TMD, etc., and therefore I am confident of his abilities.
If I decided on a 2nd opinion, I'm not sure where I'd go here in central Michigan. There are not very many good orthos around here, and I just feel that right now, I'm seeing the best.
Thank you all for your concerns, and I will certainly keep you updated on my TMD process.
Take care,
Katie G
Mosmom
12-14-2004, 11:04 AM
Good Morning, Katie -
You're absolutely right...you have two years to research methods for closing your bite and who knows how far the braces will take you.
Maybe it will turn out that you ARE a candidate for the skeletal anchorage. Keep that option in the back of your mind. We are continuing to have great results.
Mosmom
You're absolutely right...you have two years to research methods for closing your bite and who knows how far the braces will take you.
Maybe it will turn out that you ARE a candidate for the skeletal anchorage. Keep that option in the back of your mind. We are continuing to have great results.
Mosmom
Katie G
12-14-2004, 11:18 AM
Hi again Mosmom. I will definitely keep the skeletal anchorage in mind - I'm so glad it's working so well for your daughter.
Someday, I hope all on this board can find some relief and recovery from their symptoms.
Katie G
Someday, I hope all on this board can find some relief and recovery from their symptoms.
Katie G
oldpal
12-16-2004, 04:18 AM
My ortho said that in realigning my teeth first that will help stablize the jaw more, but that since my maxilla is so far forward of the mandible now, I will never have a normal bite without surgery to realign the jaws.
Hello Katie,
Your mandible should be pulled down and forward in Phase I of splint therapy so that it will have a good relationship with the maxilla. Your maxilla should never be way forward relative to the mandible after Phase I.
I understand that you really trust your current ortho, but i have a bad feeling about his treatment.
Good luck to you.
oldpal
Hello Katie,
Your mandible should be pulled down and forward in Phase I of splint therapy so that it will have a good relationship with the maxilla. Your maxilla should never be way forward relative to the mandible after Phase I.
I understand that you really trust your current ortho, but i have a bad feeling about his treatment.
Good luck to you.
oldpal
Katie G
12-16-2004, 09:54 AM
Thanks for your concern oldpal. However, my mandible was actually pulled forward over the last several years to match up to the maxilla and "align" the teeth. Therefore, it was completely out of the socket for several years. I've had TMD symptoms of pain, jaw popping, limited oral opening, tinnitus, etc., etc., for at least 15 y ears. It wasn't until my husband complained so much about my bruxism keeping him awake at night that I decided to do something about my TMD. I was so used to the chronic pain, that I didn't really believe that I could feel any better.
However, my ortho took X-rays at the beginning of treatment and noticed that I've had joint and bone deterioration from years of TMD, my teeth are worn down abnormally, and that the alignment of my teeth (which are crowded/crooked, but at least my bite was closed) indicated continued misalignment of the mandible in relation to the maxilla.
Since starting splint therapy back in Oct. '03, my pain levels have improved remarkedly, my oral opening has increased from 26 mm to 41 mm, and as the jaw muscles and joints were allowed to relax and realign properly in the fossa, my bite opened anteriorly. Without the splint in, the only teeth that touch when my mouth is closed is the last molar on the right. According to my ortho, my bite has opened up so much because the mandible was allowed to move back into the "best" physiologic position for me, and since the maxilla is unmovable, the bite would become more open as the mandible moved back and up to the socket/fossa.
Therefore, the braces I will be wearing starting next week will realign the teeth and start to close my open bite. However, I will still probably require surgery about 2 years down the road to actually ensure the maxilla and mandible stablize in the right position; following surgery, I will continue to wear braces for another year to finalize the process.
I know it sounds weird that my bite is so open now from splint therapy, but there are others on this board who also found the same thing happening to them. It's actually a sign of progress that my bite opened so much while the mandible moved back and up to its proper position. I know my TMD is much improved since the pain levels are minimal and my oral opening is close to "normal." My ortho told me yesterday that splint therapy is really more of a diagnostic procedure to see if allowing the mandible to relax and reposition itself will benefit the person with TMD. In my case, it did work. My mandibular position is now considered "stable."
I hope this all makes sense. I'm not really looking forward to surgery in the future, and am hoping after 2 years of braces that other alternatives may be available. However, I do trust this ortho very much, but also will seek a 2nd opinion if I don't believe he is treating me correctly. However, my ortho also has had orthodontia and surgery to correct his TMD so he understands TMD from an academic and personal view, and works very closely with the oral surgeon I will be referred to. I was also assured by the tech yesterday that if my TMD pain and other symptoms recur, my braces will be pulled and I will return to splint therapy.
I truly believe they have my best interests at heart and will progress slowly as needed.
Thank you so much for your concern and posting. I really appreciate all the care shown on this board.
Katie G
However, my ortho took X-rays at the beginning of treatment and noticed that I've had joint and bone deterioration from years of TMD, my teeth are worn down abnormally, and that the alignment of my teeth (which are crowded/crooked, but at least my bite was closed) indicated continued misalignment of the mandible in relation to the maxilla.
Since starting splint therapy back in Oct. '03, my pain levels have improved remarkedly, my oral opening has increased from 26 mm to 41 mm, and as the jaw muscles and joints were allowed to relax and realign properly in the fossa, my bite opened anteriorly. Without the splint in, the only teeth that touch when my mouth is closed is the last molar on the right. According to my ortho, my bite has opened up so much because the mandible was allowed to move back into the "best" physiologic position for me, and since the maxilla is unmovable, the bite would become more open as the mandible moved back and up to the socket/fossa.
Therefore, the braces I will be wearing starting next week will realign the teeth and start to close my open bite. However, I will still probably require surgery about 2 years down the road to actually ensure the maxilla and mandible stablize in the right position; following surgery, I will continue to wear braces for another year to finalize the process.
I know it sounds weird that my bite is so open now from splint therapy, but there are others on this board who also found the same thing happening to them. It's actually a sign of progress that my bite opened so much while the mandible moved back and up to its proper position. I know my TMD is much improved since the pain levels are minimal and my oral opening is close to "normal." My ortho told me yesterday that splint therapy is really more of a diagnostic procedure to see if allowing the mandible to relax and reposition itself will benefit the person with TMD. In my case, it did work. My mandibular position is now considered "stable."
I hope this all makes sense. I'm not really looking forward to surgery in the future, and am hoping after 2 years of braces that other alternatives may be available. However, I do trust this ortho very much, but also will seek a 2nd opinion if I don't believe he is treating me correctly. However, my ortho also has had orthodontia and surgery to correct his TMD so he understands TMD from an academic and personal view, and works very closely with the oral surgeon I will be referred to. I was also assured by the tech yesterday that if my TMD pain and other symptoms recur, my braces will be pulled and I will return to splint therapy.
I truly believe they have my best interests at heart and will progress slowly as needed.
Thank you so much for your concern and posting. I really appreciate all the care shown on this board.
Katie G