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Starting Splint Therapy


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Old 05-15-2017, 08:45 AM   #16
tmjineedamiracl
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Re: Starting Splint Therapy

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Originally Posted by IndyGirl1 View Post
Hi Again,

Something occurred to me while I was waiting at my doctors office. You mention how you feel better after an adjustment and then it kind of wears off after a few good days. Could it be possible that you feel relief from the tens machine itself- that it relaxes the muscles for the time being and then after a few days the improvement "wears off". What if it is not the minor adjustments to the splint that are making you feel better- but simply the tens unit itself? I could be totally off base but wondered what your thoughts were....

My tmj appointment was a complete waste of time- she maybe looked at me for 5 minutes... no adjustments to my splint.. just said "give it more time". She said some people feel better right after putting it in for the first time while others it takes 5 months.. what!? This crap makes no freaking sense. I'm on a merry go round that I can never get off. lol

I'm sorry you aren't having a "good" day today... I hope tomorrow will be better : )

Indy
We haven't TENs'ed every single time I am there. It kind of depends what he is trying to do. If we are trying to find out what position my jaw is the most comfortable in, then we TENs for 45 min to relax the muscles and get a reading using the EMG machine. Then, once its established where my jaw wants to go, then we just keep altering the splint and monitoring the movement of my jaw. I don't think the effects of the TENs unit would make me feel that much better say after a few hours.

The reason why I would feel some relief after an adjustment is because my teeth naturally creates some pits in the splint and the movement of my teeth becomes inhibited by these pits or bumps on the splint. These irregularities need to be filed down in order to keep the surface of the splint perfect so that my teeth glide over the splint without obstruction when I am chewing food or grinding. These irregularities and bumps or pits on the splint can cause the teeth/jaw to become locked in a position and that can cause headaches and muscle issues...once those are grinded down and smoothed out, the jaw and muscles feel relieved and the jaw will begin moving a little bit further into the correct position. At least this is my understanding....

As a matter of fact, I have felt pretty good for the past two days! Headaches and neckaches and facial fatigue have been minimal over the past couple days....I see my doctor again tomorrow. He has even acknowledged that I need to see him every week or so now because I benefit more from having these adjustments more frequently, where other patients can get by seeing him once every 2 to 3 weeks or so...

If at one point I felt like 6 to a 7 of pain and discomfort throughout my entire day, then over the past few days it has come down to a 2-3...which is a big improvement, and I hope to continue to improve...

Your doctor is using the same approach my old doctor used which is more of a traditional method...Patients have had both success and set backs with both the traditional and neuromuscular approaches...However, I do feel like my new doctor has a precise spot in which he wants my jaw to be in, and he shows me my EMG readings which shows my muscle activity at rest position...3 months ago, my EMGs show that my muscles in my forehead were constantly firing even when my jaw was in a rest position, and my jaw muscles were so worn out that they barely had an activity indicating extreme muscular fatigue....Last week, he took another EMG reading now that my jaw has moved closer to the spot we want it at, and my readings in my muscles in my forehead and jaw are firing damn near exactly where they should be, so there is objective data that verifies improvement...

I will keep you guys posted on how I progress throughout the summer.

 
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Old 05-18-2017, 08:42 AM   #17
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Re: Starting Splint Therapy

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Originally Posted by MountainReader View Post
I just got used to the fact there were some foods that it wasn't worth trying to eat while I was in splint therapy. Things like lettuce/spinach, pickles, peppers, steak, etc. are tough since the acrylic splint isn't sharp like out teeth and it is hard to bite through. Although, I've been out of my splint treatment for almost 7 years and still cut my food up small to chew since it is easier on the jaw anyway. Eating does get better though. As for the spinach, my dentist told me to make smoothies to get the nutrition.

I actually went into bad spasm when I started my treatment and my ENT ended up giving me a couple weeks of muscle relaxers. I did have manual PT for myofascial pain/cervicalgia to help get the muscles relaxed. It is a critical part of the treatment. You need to address both the bite and the muscles. Also, if you can find somewhere to have oral triggerpoint work done, I highly recommend it. It can be very painful, but getting releases done of the masseters and pterygoids really is worth it.

Has your speech gotten better yet? It took me a while to get the last part of a splint lisp adapted to.

The thickness of the splint really depends on where you need your bite to be. mine was several mm thick.

When I got my splint, I ended up at my dentist quite frequently for adjustments. As your bite adapts, your teeth will hit 'off' and the splint needs to be adjusted so you aren't in pain.

Make sure you wear it 24/7 like you are supposed to. It is a pain, but is necessary.

I would say I had some relief in my first month. By 3 months, I was doing significantly better. By 6 months, I was at least 90% better. I ended up in the splint over a year because I needed the time to come up with the money for my next steps.
Hi Mountain,

I have a quick question for you. My tmj dentist has referred me to a PT who is trained in craniofacial/tmjd pain.. I am still waiting to see her as she is in such high demand.. a few more weeks to go until I see her. I believe she will do the intra-oral massages for me.

Anyway, I am working with a regular PT on my neck- my muscles in both the front and back are all tight and sore... I was doing simple stretches and dry needling the first two days and felt ok, and then the third day I was doing some arm exercises with elastic bands and I could feel my neck muscles over-exerting and spasming while trying to do them. The goal of them was to strengthen the muscles that counter the SCMs etc. After the day of exercises I was in extreme spasm. Did you ever find that exersises made your muscle spasms worse? Was your PT more just stretch, trigger point, and massage? I just cant understand why simple strengthening exercises could set me back so much. What muscles did you find were in the most spasm? Perhaps mine are too injured and just simply cant handle the added pressure.

If you can tell me what you found in PT that helped and hurt that would be great. Also, what did your neck feel like... was it only one particular muscle or many muscles.. did it switch sides? Mine seems to be focused on my left side- both front and back... so tight I can barely turn my head. Did you have normal ROM?

Thanks! Indy

 
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Old 06-27-2017, 01:01 PM   #18
SallyA1013
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Re: Starting Splint Therapy

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Originally Posted by IndyGirl1 View Post
Hi Mountain,

I have a quick question for you. My tmj dentist has referred me to a PT who is trained in craniofacial/tmjd pain.. I am still waiting to see her as she is in such high demand.. a few more weeks to go until I see her. I believe she will do the intra-oral massages for me.

Anyway, I am working with a regular PT on my neck- my muscles in both the front and back are all tight and sore... I was doing simple stretches and dry needling the first two days and felt ok, and then the third day I was doing some arm exercises with elastic bands and I could feel my neck muscles over-exerting and spasming while trying to do them. The goal of them was to strengthen the muscles that counter the SCMs etc. After the day of exercises I was in extreme spasm. Did you ever find that exersises made your muscle spasms worse? Was your PT more just stretch, trigger point, and massage? I just cant understand why simple strengthening exercises could set me back so much. What muscles did you find were in the most spasm? Perhaps mine are too injured and just simply cant handle the added pressure.

If you can tell me what you found in PT that helped and hurt that would be great. Also, what did your neck feel like... was it only one particular muscle or many muscles.. did it switch sides? Mine seems to be focused on my left side- both front and back... so tight I can barely turn my head. Did you have normal ROM?

Thanks! Indy
I assume you are in Indy? I am in Greenwood. Did you ever get to see the physical therapist? I go to Athletico in Greenwood and see a great therapist that specializes in muscles and TMD. There is another therapist in the office that is in huge demand. Mine is new to the practice so not as busy.

Which dentist do you see? I found a neuromuscular dentist in Noblesville but he doesn't take insurance. I drive down to Louisville to see a neuromuscular/orofacial pain and TMD specialist. My insurance covers him.

I got an occlusal splint back in April but due to some other health issues I put off starting. I started wearing it last Friday.

 
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Old 06-28-2017, 09:23 AM   #19
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Re: Starting Splint Therapy

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Originally Posted by SallyA1013 View Post
I assume you are in Indy? I am in Greenwood. Did you ever get to see the physical therapist? I go to Athletico in Greenwood and see a great therapist that specializes in muscles and TMD. There is another therapist in the office that is in huge demand. Mine is new to the practice so not as busy.

Which dentist do you see? I found a neuromuscular dentist in Noblesville but he doesn't take insurance. I drive down to Louisville to see a neuromuscular/orofacial pain and TMD specialist. My insurance covers him.

I got an occlusal splint back in April but due to some other health issues I put off starting. I started wearing it last Friday.

Hi Sally,

Yes, I live in Indianapolis. I bet you went to see Dr. Mike Deldar in Noblesville. I went for a consult with him but felt better about Dr. Pam Steed who I am currently in treatment with. My PT is also at an athletico by my home but I have not had much luck yet. I was working with someone for my neck and then have been working with a new lady who specializes in craniofacial pain and does intraoral massage... she also has been trying to dry needle my SCM, Trap, and Scalene muscles. So far, I can't seem to find anything to get the muscle spasms to stop. The tension and stiffness is just horrible. Louisville is such a long way to go for treatment! I sure hope your new splint helps you!

Are you in a repo splint? Does it try to reposition your jaw?

Indy

 
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Old 06-28-2017, 01:59 PM   #20
SallyA1013
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Re: Starting Splint Therapy

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Originally Posted by IndyGirl1 View Post
Hi Sally,

Yes, I live in Indianapolis. I bet you went to see Dr. Mike Deldar in Noblesville. I went for a consult with him but felt better about Dr. Pam Steed who I am currently in treatment with. My PT is also at an athletico by my home but I have not had much luck yet. I was working with someone for my neck and then have been working with a new lady who specializes in craniofacial pain and does intraoral massage... she also has been trying to dry needle my SCM, Trap, and Scalene muscles. So far, I can't seem to find anything to get the muscle spasms to stop. The tension and stiffness is just horrible. Louisville is such a long way to go for treatment! I sure hope your new splint helps you!

Are you in a repo splint? Does it try to reposition your jaw?

Indy
I have emailed with Dr. Deldar but haven't been to his office. He doesn't take insurance. Dr. Steed isn't on my insurance either. I wish I could find someone closer! To have my insurance cover it is worth the drive to Louisville but it's such a pain.

I don't know what type of splint I have. I posted a link to a picture in another thread. When I googled I came up with occlusal splint. It's clear and covers all of my top teeth at least part of the way up. It's tight and uncomfortable but I am getting used to it. I just wish I could get my tongue to stop pushing it up. I wish I had paid more attention but I wasn't feeling good that day and really thought it was only for grinding.

I have such tight muscles too. They've done the needling a few times and it seems to help.

Are you taking muscle relaxers? I know it sounds crazy but my spasms actually got better when I stopped taking them. It might have been a coincidence but I am definitely better. My therapist said she could feel a difference too. I also started taking magnesium, tumeric and glucosamine so maybe that helped too. The most annoying spasms I have right now are on the sides of my neck on both sides of my throat. That is such an odd feeling.

 
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Old 06-29-2017, 06:03 AM   #21
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Re: Starting Splint Therapy

Hi Sally,

Do you wear your splint all day or just at night? I have never had an upper splint.... I have heard of a nighttime upper appliance that fits on the front teeth which helps stop grinding- I think it is called an NTI. Do you believe you grind your teeth at night? Sometimes the grinding can cause muscle spasms and pain. My TMJ was caused by a blow to the side of my face... I don't believe I clench or grind at all.

Most insurances do not cover TMJ treatment by dentists as they consider it experimental. There is no standard for treatment for tmjd unfortunately. My insurance will only cover an oral surgeon and I have heard surgery is very risky and a last resort so I did not go consult with one. Hopefully I wont have to down the road either.

I have tried multiple muscle relaxers- baclofen, skelaxin, robaxin lol. I can't tell a huge difference while I am on them. I have not taken them today and I feel the same. I have considered starting the exact same supplements you list below.. also heard that omega 3 supplements are good. You could also try a muscle/pain gel- I like biofreeze. You can find it and other products like it at Walgreens/CVS.

How does your jaw feel today? I hope a little better!

Indy

 
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