| | Report - 1st visit to TMJ dentist
I spent about an hour and a half with my TMJ dentist this morning (in Lawrenceville, NJ)- a consultation only, which cost $85. I gave him a detailed medical history, written up ahead of time on my computer, besides filling out the usual forms, and I took my Brain/inner ear MRI's and my cervical spine X-Rays, which he asked for.
He listened carefully and seemed observant (noticed a tear from my right eye after testing my jaw opening and closing), and I tear easily under various conditions, even from my right nostril.
To make a long story short, he thinks TMJD may well be a part of my very complex problem, which started with labyrinthitis and sinusitis in March. But he would prefer to wait until I also consult with the neurologist my Ear Nose Throat doctor has sent me to (not until June 13!). He thinks there are multiple things going on and I need to be checked for facial pain syndrome related to the nerves in my face. (Possible neuro-muscular syndrome or atypical facial pain syndrome, with possible problems with or damage to my trigeminal or cranial nerves.) I am most affected by chewing, talking, laughing, smiling. I also have a neck problem, so it is unclear to him what caused what. However, I will get fitted with a splint of some kind in the near future (my dental insurance kicks up to a higher grade on July 1.) I have a misaligned jaw - it doesn't function right unless I use an abnormal bite. He said it is rubbing and moving too much. It is likely I had some jaw damage during a hard fall on my chin a couple of years ago.
He is obviously a conservative dentist. Says most TMJD problems can be managed with non-surgical treatment. 60% of his practice is TMJD related. He is a member of the Academy of Cranio-Facial pain and has worked as part of a university pain management clinic. He recommended going to one of these clinics, because he said many doctors work as a team to discuss each case also. He believes in a multi-disciplinary approach to facial pain, with him as just one part. Sounds logical and humble anyway. He admitted it isn't easy to hear this when you want an answer and a treatment right away.
At the moment, I am controlling most symptoms with resting my mouth and jaw - eating soft foods, taking Advil, applying heat or cold occasionally, sleeping on my back. And I use a very mild tranquilizer at night to relax my muscles (and stressed out nerves). My shrink also started me on 100 mg neurontin at night (along with my ususal Zoloft). I hate pills, but sometimes you need them.
I'll update you all after I see my neurologist.