I'm back and i need some answers - TMJ Disorder -TemporoMandibular Joint Message Board

navy2 · 07-04-2003, 10:30 AM

Hi again everyone!

I said I was going to stay off the computer, but, this is the only ploace that I can seem to get some experienced answers. I am also going back on meds today.

Here's the situation:

I've been to numerous dentists and specialists like you all have. I toted my pano's to every one and no one ever said there was a problem ...until i went to a Prostho and was told she thought there was some joint remodeling and less disc space, maybe flattening of something, and MAYBE bone to bone. These were speculations for the most part. As usual, I was anxious over this. Then I brought the pano's back to my general dentist and he showed them to an oral surgeon who said everything was fine.

So, now I went to the neuro. I thought my major problem was the facial pain amd a displaced disc. Maybe I'd need a splint and some dental work. On my second appointment, he said he heard crepitus in my right tmj (that I thought was the good one). Then he had the assistant set me up for sonography. They had me put discs over my tmj's and then I had to open and close a lot and the machine was recording my joint noises and the results showed up on the computer screen. I was told that there was a lot of noise in my joints. The assistant said there was more coming from the right tmj (the one I thought was good) than the left one (that pops). She said that I could have a displaced disc in the left tmj too. It doesn't make any noise, never has from what I can tell. Then she said because they are both connected, one comepensates for the other sometimes. Then the neuro comes in and says not to worry and he'll do the test again next week. So, of course I'm worrying. Crepitus means arthritis or disc degeneration right? The neuro gave me his home phone number, so, I called him yesterday to ask him about the sonography and the crepitus. He did call me back, but, I wasn't home when he called. We are playing phone tag.

So, if there is a problem with arthritis or something else and I just have a mild ache (which I think is muscular), do I just treat it like any other type of arthritis? I've read where after a couple of years the pain subsides and the joint remodels to accomodate. I have complete range of motion.

Also, now this seems possible to me. If I have extreme crackling in my neck & up the back of my head, is it possible for those noises to show up on the sonography tests? The tmj's are so close to the ear and neck anyway. Maybe this is just wishful thinking, but, I'm wondering if that's possible.

If there is a problem with my discs, I'm wondering if I should go through the neuro therapy. The cost of my treatment will be well over $4,000 and then there will be dental work as well. I do need the dental work done, but, I'm concerned that the splint may not be the best thing for the arthritis. It would help the other disc though (maybe).

What I've read is the best thing you can do for an arthritic tmj is to rest the jaw. I don't know if splint therapy is the best for it.

So, here I am again. I think I'm getting the right treatment and then something else comes up.

Do many of you have crepitus in your joints? What did it mean for you? Is it possible to just have it from the muscle inflamation? I can hardly hear what the doctor was talking about. My neck and head crackling are loud as ever though. I never asked anyone if they can hear it though.

Right now I can open and close just fine. I'm concerned that if an oral surgeon gets ahold of me he'll want to do surgery. I would think I would have to be on real strong pain medication and have a locking jaw or aomething before surgery was considered. I do have a tightness on the left side of my face. It's pretty uncomfortable at times. The jaw almost seems like it's fighting the muscles sometimes. I have had some crackig in there too. I was hoping this was muscular. But, i have had times over the past few months where it feels like my left tmj kind of locks up when I'm sleeping on it and then i hear a loud pop or shifting when I get up or roll over in bed. It almost feels like the whole left side of my face moves with me

So, who out there has had similar problems, concerns, or diagnoses?

Navy

Cymy Sue · 07-04-2003, 11:52 AM

Navy,
I believe grinding and crunching noises are called crepitus. ( I think this is right)I also think that the noises can be caused from several different things. I believe most people with TMJD problems have experienced these noises at one time or the other. It usually means that the joint is not functioning in perfect alignment. There are a lot of people whose joints make noise, but they do not develope real serious problems.

Cymy Sue

navy2 · 07-04-2003, 12:24 PM

Cymy Sue!

I could just reach through my computer and hug you to death! Thank-you so much for your post!

So, is that what splint therapy does, line everything up? I would think that the specialist would have to be really good to accomplish that. I know Marlene said they took x-rays before and after to show that her discs were put back in.

Every time I've do a search on crepitus I get information about how it's the final stage, bone to bone, arthritis, degeneration, surgery. It's made me very uneasy. All the info said that they try to treat you when things are in the early stages like popping and clicking,

But, I like your theory so much better. I'm going to hope that it's not bone to bone bad stuff. Besides, the oral surgeon here in town said my pano looked fine and bone to bone I think would have shown up on that. Also, maybe it has to do with the fact that my face was all swollen from that tmj massage work I had done on the muscles in my face. Could fluids cause crepitus? Also, my neck and back of my head crackles like crazy. Maybe that soudn vibrated and showed up on the test? Thank you for giving me some hope! Also, my noises are mostly crackling.

You are the greatest Cymy Sue!
Navy

[This message has been edited by navy2 (edited 07-04-2003).]

GenDen · 07-04-2003, 01:21 PM

The "pano" is just a simple panoramic x-ray. It does not show much detail. A tomogram (a CTscan) is the scan that shows the joint structure in more detail. Then if more detail of the soft tissues is necessary, the next test is an MRI. The function of the splint is to "line up" the bite or put it in the optimal position and also to rest the joint. If you have a specialist who successfully treats TMJ dysfunction on a regular basis, you should be fine with his treatment. If it eases your mind, there are lots of people with displaced discs who function normally. The body adapts quite well. It isn't necessary to capture the disc, though it is nice if it happens, if the joint is stabilized and is able to heal.

navy2 · 07-04-2003, 01:35 PM

Hi GenDen,

Thank-you for your post. I pretty much was cofortable with the line of treatment I chose. But, now something else has been thrown into the scenario.
Crepitus was heard in the right tmj during sonography. That could be arthritis or degeneration, right? I was also told that the right disc could be displaced too. I have never had a problem with that before. No noise, pain, anything in that joint. Just facial pain and tightness.

Navy