Later today I'm going to the dentist for him to fit a nightguard (recommended by the ENT who diagnosed my TMJD). The dentist told me this will be a plastic mould fitted to my top teeth with acrylic placed on it which will be initially shaped by my bottom teeth as I bite on it when it's soft. The idea, he said (as I understood him) is to trick the jaw muscles (sorry, this is a very unscientific explanation!) into habitually biting/clenching in a higher position so that when I stop using the nightguard (dentist said wear it for 6 months) they will not clench so hard and strain will be reduced.
However, I've read that this kind of guard can actually cause the jaw to clench harder when you are wearing it as it is trying to get into its normal position. So the guard can even cause more clenching and stress to the jaw, and more pain. This is worrying to read, I'm wondering if this kind of nightguard had actually worked for anybody?
I know I do have new and significant bite problems, some of my molars went lower when a bad dentist worked on them at the beginning of this year and I lost my normal 'bite'. What I hope is that if I can correct this my TMJD will reduce or go away. I am wondering if I should just try to make the dentist create the nighguard so that it helps me recover my natural bite height rather than going higher, if I can?
Does anyone have any opinions, if so I'd really appreciate it. I'm sorry I'm describing all this so badly, TMJD is so new to me I'm having trouble grasping or conveying all the issues related to the condition.
I do have one more question, I've realized (basically from reading on the internet as my dr explained very little to me when he gave me the TMJD diagnosis, my problems are added to by the fact that all this has developed when I am away from home - that is the UK - and in Mexico presently seeing drs who speak a different language to mine) that the temporal mandibular joint is the small joint joining the jawbone to the skull. I see some referring to 'discs', is the tempororal mandibular joint also referred to as a disc, or is this disc something else?
[This message has been edited by Isobelj (edited 09-01-2003).]
The disc is a "shock absorber" that provides gliding action between your lower and upper jaw when you open and close your mouth.
The condyle is the round end ("the ball") of the mandible, which moves in and out of your TMJ socket.
Muscles attached directly to your TMJ help control its movement and position.
Ligaments hold your disc to your condyle, helping to stabilize your jaw.
Connective tissue attaches your disc to the back of your joint and contains blodd vessels and nerves.
Like you I had TMJD from bad fillings. I then had 4 of them redone with 3 partial crowns and 1 inlay. Unfortunately, the dentist got very close to "fixing my bite after he did 2, but when he did the 2 on the other side something went horribly wrong. I now have worse pain than ever and the prosthodontist is refusing to replace the one crown that is causing me trouble because it's a permanent. If I had it to do over, I just would have done just one at a time(he did 2 on one side, 2 on the other), and when he got close to having it where I could live with it I would have stopped after the first two. In a nutsehll to have permanent changes done to the vertical dimension is RISKY as you are dealing with a human being that can make mistakes, get it wrong and then you'll be stuck like me.
I just put my tongue between top and bottom arch to prevent the back molars from touching. But the jaw moves as it does and it's going against the teeth so I get this continuing pain/discomfort. Hope this helps. The other thing is an occlusal device where they try to get your bite to the comfortable position, but this has had it success and failures(check other posts). I can't go this route at this time.
Thanks Marlen and Antoni. Something I want to know is, if someone has vibration, drumming, extreme sensitivity etc. in the ear, does this definitely mean the condoyle or TM joint are displaced? If so then are hearing problems and sensitivity not really and early sign of TMJD being present, but actually a symptom showing it has already been present for a while?
Antoni, I'm really sorry you've had these teeth problems too, do you mean the dentist placed the permanent crown and it is impossible to remove without damage to the tooth, or he just doesn't want to remove it because he put it there as a long lasting crown and he would charge you again to redo it? I would have thought, especially given what you are suffering,that it is absolutely his obligation to get the crown right, grrr.
I've been wondering about the teeth heightening process also, yesterday my dentist told me it would be better to do the work all at once (one top onlay, two bottom crowns on one side and one crown on theother side) but I am so reluctant and anxious re this, having had such a bad experience with the other dentist who caused my terible bite doing a lot in one go that it just greatly scares me to think of being in that vulnerable situation of hoping they will get it right and not being sure. I can understand that when the lab creates the onlay and crowns they maybe can fit them better if they do it all together, but just any change in my mouth panics me utterly now. After what you've said I'm thinking of asking for the work to be done bit by bit. I do think my present dentist seems trustworthy and professional, he talked for an hour and a half yesterday free of charge about my problems, he even said he would not do the work himself because its so important to get it right but would recommend I go to a specialist in the same clinic for the crowns etc. He also told me they can do the work first in acrylic, putting temporary stuff on the teeth, and then I can try to judge how it feels and if they are too high or too low or whatever they will alter it till they get it right and then fit the permanents. I am concerned re cost though.
Anyway, the nightguard was made, I thought I'd be able to bring it home yesterday but apparantly it needed to dry (the acrylic) and then I need to try it in the next appointment and see if adjustments need to be made. I was trying to bite the way I think my jaw needs to go (more to the left as now it is low on the left and slides to the right when I bite which I'm convinced caused the TMJD) but the dentist said just bite comfortably, so I got confused. I've decided to ask if I can just walk around with it on my own for five mins or so when I got back, to see how it feels, it's so hard to assess that lying in a chair with people staring at you! The dentist also suggested I see a maxillofacial surgeon to try to see what is going on exactly with my joint and disc, I'm getting very anxious to about that now and scared really to find out.
In the meantime I'm trying keeping my tongue between my teeth too when awake, but eating and sleeping are times you can't control so well and always after waking my jaw aches like mad. Good luck to you also and much sympathy, thank you again for trying to help.
[This message has been edited by Isobelj (edited 09-03-2003).]
I have a nightguard. It is not helping with the clenching. For me it seems a temporary fix. I clench and spasm at night (can not control it). I wear it to protect my teeth from grinding (at night too) until I can get this clenching neck spasm thing under control.