Starting Splint Therapy

04-14-2017, 10:32 AM

Hi friends,

I am getting my repositioning appliance at the end of this month. I am so very nervous!

My main symptoms are neck/shoulder/ back of head pain. I do also have a very limited jaw opening.

My tmj specialist only treats tmj patients and has been treating for over 30 years. X rays show that I have very little joint space in both sides, but no arthritis... which I believe has to do with the shape of the condyle. I did not get an mri to see disc involvement. I have a limited opening- my max is 23 mm and she said normal is around 50+. She considers this a lock, although I was surprised. I must just be so used to operating with a very limited opening.

My appliance will move my jaw down and forward and it sits on my lower teeth. I will wear it all day even while eating and also at night. I was surprised to not have a separate appliance for evening wear. I believe it is called a MORA splint.

PLEASE- anyone with splint experience, what are your thoughts? Should I expect to get worse at first? How long should I give this splint if it does make things worse?

I could use support now more than ever.

I struggle through every day, and cry every single day. I try to stay strong, but I fear I will never get better.. will never find a treatment that works. I honestly can't imagine dealing with this pain forever. As it stands now, I can barely focus at work and have very little motivation to go out. I fear this pain will ruin my life- job, independence, family, etc.

I need hope.. I need encouragement. Will I ever find peace?

Misty

04-18-2017, 08:44 AM

You may want to read my thread called, "Am I Ready for Phase II" where you can read through my experience with splint therapy, which I am still currently doing. My recommendation is to absolutely follow you dentists orders to wear it 24/7, even when eating. If you take it out for even one meal, your going to jeopardize your treatment, and treatment is expensive and takes a long time. Get used to wearing it, and it will become a part of you and your friends and family, and coworkers won't care or even notice it. I promise you I am telling the truth...I was extremely self-conscious and insecure about wearing my first splint, and I would take it out all the time and I literally wasted about $3500 and a year and a few months of my life and treatment....This new specialist told me to wear it 24/7 and never take it out unless to brush my teeth and clean it out (I have to keep my mouth ajar while doing this in order to prevent my teeth from touching)...plus I see a chiropractor...I believe after 2 months I am improving, and I see a light at the end of my tunnel. My appointments for TENS and adjustments take roughly an hour to an hour and a half but its crucial to do these steps. All of my treatment is meticulously monitored and determined through computer technology with EMGs (I think thats what they are) becuase my tmj specialist is trained in neuro-muscular treatment techniques, where my old TMJ specialist would just move my jaw with his hands and make determinations on adjustments based off of feel which in my opinion is ridiculous but I didn't know any better.

Again, read my post called Am I Ready for Phase II....I think everyone on this site would appreciate it if you routinely post your progress on your thread...That way we can learn from each others experiences and provide one another with hope and support. Good luck and I wish nothing but the best for you and your treatment.....WEAR THE SPLINT 24/7 as directed, don't deviate from that at all!

05-01-2017, 08:21 AM

Hello Friends,

Wanted to make sure I update everyone on my splint therapy. I have been wearing my splint for 6 days and I haven't noticed any improvement yet.

The real issue I have with this is that it is so very difficult to eat.. very uncomfortable to try and chew on the surface of it.. it sits on all of my lower teeth. I have been eating mush for days now and it is no fun. I still talk a little funny too. Hopefully things will continue to improve over the week as I continue to try and get used to it.

My entire treatment is supposed to last for 6-9 months but I suppose I was expecting to feel results- even if they were slight after the first week. No luck with that so far. This is so frustrating. I don't go back to see my doctor for another couple of weeks.... I guess I will just have to ride this out.

Some people I have read on this board noticed relief right away while others it took quite a bit of time. I just wish there was some way I could know if I was on the right path- to give me a little bit of hope. Right now, I don't see any light at the end of my very dark tunnel. So sick of the pain and tears because of it.

05-01-2017, 12:27 PM

You need to stop questioning whether or not its the right path, and now commit yourself to the splint therapy because you already invested yourself in it. If you keep questioning it, it will cause you to be tempted to take the splint out, and it will drive you mad with doubt...believe I went through that for a year and a half....Commit to it, and understand that its a slow process. Typically I feel better during the few days or so after an adjustment to my splint, then the symptoms slowly come back but at a lesser extent. Remember, that this is a slow process. The splint is literally reprograming your muscles, while at the same time allowing your joints to heal. It takes time......

As far as eating goes, the best I can say is to commit to it and own it. I eat steak with my splint in...Now obviously your teeth and jaw are in pain, but as you heal, eating normal food will become easier. Food will get stuck underneath the splint and it is very annoying but you learn to adapt and live with it....I have become a pro at chewing with my splint in, and when food goes underneath, I use my tongue to lift the splint up, and I take a drink of water and swish it underneath the splint to wash most of it out and then swallow it while I am in the middle of a dinner with other people around me and no one notices a thing. You will adapt to it and it will become easier, trust me...I was extremely upset at the idea of having to wear it, and now not the biggest deal in the world any more. I eat with it, I teach my classes with it in, I speak to people I never met before with it in, and I even take pictures smiling with it in....You just have to own it!

Now with all that being said, I have good days and bad days... I have days where I am really strong about it, and days where I get down about it, I have days where my symptoms are gone and days where they come back, but I beleive with the passage of time things are getting beeter in generakl.

05-01-2017, 12:49 PM

Hi There,

It is good to hear from you again. I will have to wait a couple of weeks until I see my tmj doctor again. She is not neuromuscular so I am not exactly sure how they will adjust the splint or how they decide it is needed.. I guess I will have to see when I go there.

I am committed to the therapy and will definitely not take the splint out. I still have hope for it. I just get very scared when my symptoms crop up.

I would love to be able to eat a filet right now... there is just simply no way I could eat one. The doctor told me to make sure I chew food on both sides of my mouth yet I have never really done that- I usually chew on one side or the other.. it is hard to adjust to chewing on both sides.. especially with my very limited opening. 25 mm opening which is around where I am at is considered a lock : (

Did you have any other therapy while undergoing your splint therapy? How thick would you say your mouthpiece is? Mine is a heck of a lot bigger than I expected- and thicker on one side.

I believe you mentioned that for pain relief you would take advil- Did you have any issues with taking the advil on such a chronic basis? It does seem to help when I take 400 mg in the morning before I begin work but I worry it may cause me more harm than good. my doc tells me it is ok to take though and that I shouldn't worry. I am also on a muscle relaxer which may take the edge off the muscle spasms a bit.

You sound like a splint wearing pro- I just gotta get there!

Thanks for responding again to me... it definitely helps to have the support.

05-01-2017, 09:45 PM

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.

05-02-2017, 09:09 AM

I agree, eating salad or spinach is difficult to chew. However, I eat what I want when I want and if its a little difficult to do it, I just put up with it.

Every splint is going to vary in thickness depending on your needs, however I think we are dealing in millimeters in variance. The truth is no matte what thickness it is, you will adapt to it. Plus, any splint is going to freak you out in the beginning and you are going to believe its too thick because its a foreign object in your mouth, but you will get used to it.

I really don't know how different I sound with it in. My wife and students tell me that they don't really notice a difference. However, becuase I am the one who is wearing it, I sometimes get insecure and think I am speaking with a lisp even if my audience doesn't think so...I recorded my self reading a passage from a book and it did not strike me as though I was speaking with a lisp...

The only other thing I am doing besides splint therapy is seeing a chiropractor to make sure my neck and spine are in proper alignment while the adjustments to my jaw are happening.

05-03-2017, 08:00 AM

Quote:

Originally Posted by MountainReader

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,

It is so wonderful that after 7 years you still come on here to help people and offer support. I will make sure that I do the same when I get better.

I have now completed my first whole week with wearing my splint. Every day I hope to see some change, but nothing yet. My muscles are so so extremely tight on the entire left side from my shoulder up. I take a muscle relaxer called baclofen which I think helps slightly. I actually am going in for trigger point injections today for my neck and shoulder.. I am hoping for some relief from them....

My tmj specialist has referred me to a physical therapist who she believes really understands how to work with tmj muscular issues. I am waiting on a call back from her so I can begin treatment. Something has surely gotta give at some point! I have never been more frustrated in my entire life.

05-03-2017, 08:06 AM

Hey Miracle,

Thanks for your reply! I have made it a week without taking it out at all (except for teeth brushing). No improvement yet.. I think my muscles are really freaking out from the new position I have been put in. I am hoping by week 2 I may have some relief in symptoms. I am also going in for trigger point injections because my neck is also really out of whack.

Were you taking any pain medication? Did anything make a difference for you?

05-03-2017, 09:04 AM

Quote:

Originally Posted by IndyGirl1

Hey Miracle,

Thanks for your reply! I have made it a week without taking it out at all (except for teeth brushing). No improvement yet.. I think my muscles are really freaking out from the new position I have been put in. I am hoping by week 2 I may have some relief in symptoms. I am also going in for trigger point injections because my neck is also really out of whack.

Were you taking any pain medication? Did anything make a difference for you?

I take sertraline (its a knock off of Zoloft) which is an anti-depressant because I became so frustrated with my lack of progress with my first doctor and utter fear of not getting better made me extremely depressed and overwhelmed...I will say that this has helped me tremendously. I was so tense in my shoulders that my shoulders would rise up to the back of my skull and I would be breathing very shallow breathes and unable to relax....its insane what stress can do to your body...You may consider asking your doctor about this if you are experience high levels of anxiety that are tensing you up.

I also have a script for cyclobenzaprine which is a muscle relaxer, but I rarely take it...I dont take it during the day because I am under the impression it makes me tired...I thought it would be a good idea to take it at night (but I always forget to) in order to possibly help my face and jaw muscles relax instead of constantly being fatigued from clenching at night.....I know for a fact I clench at night, because I bit a small hole into my acrylic splint which my doctor says he has never seen that before...

I also take Ibprophin occasionally, about 600mg to just deal with headaches and facial aches because its not that invasive of a medication and a lot of the problems we have in our joints is caused by inflamation and Ibprophin is an anti-inflammatory.

Plus, I bought a small TENs unit that I will occasionally have my wife attach to my temples, jaw, neck, and shoulders and let the pulsating relax my muscles...

05-09-2017, 09:38 AM

tmj friends,

I am now at my two week mark with my splint therapy. My symptoms seem to have maybe moved around a little. I feel a lot of pressure in my forehead and in between my eyes on the bridge of my nose. I never used to get this type of pressure before. I also have my usual symptoms. I keep hoping my opening will improve but at this time I am not sure that has happened yet.

I just feel absolutely horrible..not to mention hopeless. If this splint was creating what my body needed- my body should be reacting favorably to it.. I just don't understand. How unfair that some people receive help from their first splint or from more simpler therapies and while the rest of us seem to suffer forever. I just cant take this pain forever... it is totally not worth it. This is not life, I am not me anymore.

05-11-2017, 07:40 AM

How ya feeling today IndyGirl? Splint therapy is a slow process, just stick with it and continue to wear the splint 24/7. I am in my third month with my new splint and new doctor and I have had my ups and downs. I kind of feel like it's 1 step forward, 1 step backwards, 2 forward, 1 backward, 2 backward, 4 forward, 1 backward...but overall I am making some progress...and over time I think the steps forward will outweigh the steps backwards.

One week I literally felt horrible, and then my specialist adjusted the splint and within three days I felt the best I ever did, but then I began declining again. He adjusted my splint on Monday, and Tuesday I felt like crap, Wednesday I felt a little better, and today I feel the same as Tuesday...

Keep in mind, that your muscles have to adjust to keeping your jaw in a new position and that doesn't happen overnight. Plus the muscles that affect your jaw movement are in your cheeks, forehead, sides of head, front and back of neck...they are al working together so all of them have to adjust...plus any ligament or joint damage needs time heal.

I agree that this ailment has a huge impact on my overal happiness, social life, and job, but know that there is a light at the end of the tunnel...stick with the therapy and accept that you will feel good and bad throughout the process for a while, but eventually you will start feeling better as you heal. once you accept the fact that it's a slow process, it will take some of the stress off youself.

Again, remember that you are not alone, we are all in this together! Keep updating us on how your progressing

05-11-2017, 08:22 AM

Hi Miracle,

I began PT for my neck yesterday.. doing stretches and dry needling etc since all my muscles are rocks. Do you feel that too? Like you cant turn your neck? I try so hard to relax and lower the tension but they are always so tight. I use a neck massager I bought from brookstone too. Hopefully this will begin to help soon. I will stick with the PT for a couple months and see what happens. I will also be seeing a PT who focuses on craniofacial pain and the jaw- but she has a waiting list so I have to wait a month to see her.

I began taking the advil regularly again- I sure hate doing it but if it helps even the slightest bit I have to get through the day.

I have a follow up appointment with my tmj specialist today. I am not sure how much regular adjustments she makes to my type of MORA splint- they aren't like neuromuscular where you get completely moved from appointment to appointment. I wish that I could notice improvement like you have said you notice- In all the past 8 months with this I have never once noticed any real improvement. That is the discouraging part... : (

Thank you for checking up!

Indy

05-11-2017, 08:51 AM

Quote:

Originally Posted by IndyGirl1

Hi Miracle,

I began PT for my neck yesterday.. doing stretches and dry needling etc since all my muscles are rocks. Do you feel that too? Like you cant turn your neck? I try so hard to relax and lower the tension but they are always so tight. I use a neck massager I bought from brookstone too. Hopefully this will begin to help soon. I will stick with the PT for a couple months and see what happens. I will also be seeing a PT who focuses on craniofacial pain and the jaw- but she has a waiting list so I have to wait a month to see her.

I began taking the advil regularly again- I sure hate doing it but if it helps even the slightest bit I have to get through the day.

I have a follow up appointment with my tmj specialist today. I am not sure how much regular adjustments she makes to my type of MORA splint- they aren't like neuromuscular where you get completely moved from appointment to appointment. I wish that I could notice improvement like you have said you notice- In all the past 8 months with this I have never once noticed any real improvement. That is the discouraging part... : (

Thank you for checking up!

Indy

I have my wife rub/massage my neck during the evenings often. I also had her rub the joints of my jaw as well, that was kind of intense because my muslces are so tight and sore there. My neck has loosened up a lot over the past month, but yes, I had an extremely tight neck muscles for a while. As a matter of fact, my neck feels tight today, but no where near as tight as it once was. I think the chiropractor and splint has helped with that. In addition, my anti anxiety medication was a life saver for this...it really helped relax me. I also try to take a muscle relaxer in the evening as well.

05-11-2017, 10:00 AM

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

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