Crystal, after reading your response to me recently on another post about your treatment with Dr. R., I searched him on the net. The last time I did this was about 4-5 months ago and all I could find was about those "seminars" he gives. This time I found his website which details some of his TMJD treatment. It sounds much better than the previous info. Plus you and Marlene have both had success with him, so I'm revisiting this possibility, which brings me to a bunch of questions. I know you both have answered some of them before. Please excuse me, but with the drugs and the pain of TMJD, my focus is poor and I don't seem to retain much information.
Could you both give me an idea of the process of being treated by him. Like, how many appts did you have before you got your splints? How long did it take from initial appt until you got the splint? What was done at each appt? Kinds of testing, types of xrays? Marlene, I believe you saw him a couple of years back - do you still follow up with him, or have no reason to? Crystal, where are you in treatment, and will go be headed for ortho or reconstruction?
What is Dr. R. like? Can you ask him questions, or is he "one of those" who's egos get bent out of shape by enquiring minds. I ask because like many on the board I have had horrendous experiences with dentists and have seen WAY too many of them, being shuffled from one to the next. I want someone approachable who also knows their stuff.
I know Dr. R. spends a lot of his time lecturing these days. Does he care about his patients at all? Anyway, I would appreciate all the information you care to give me.
My situation is getting much worse and I need to do something right away.
It's been 7 years since I first saw Dr. Rondeau, so I'll do my best to recall my experience. Please remember that things may have changed in his office, since I was a patient. At my very first appointment, he walked into the cubicle, took one look at me and said "How long have you had that TMJ problem?" This was before he even touched me or did any testing! I began by filling out a LENGTHY TMJ Questionnaire (which I took home, completed, and brought back at my next appointment). Then he did Range of Motion - checking for how wide I could open, slide to left and right and whether or not there was deviation or deflection upon opening. All these motions were measured. Then he did Muscle Palpation - ie. excessive muscle contractions and trigger points. Then X-rays/tests were taken - Tomograms, Panoramic, Transcranials, Joint Vibration Analysis.
All this was done in the morning. I came back after lunch, and he showed me the X-rays, and had a consultation with my husband and I to explain his findings and proposed course of treatment (including costs and payment plan).
I believe I had my second appointment a few days later, and molds were taken for making my splint. About a week later, I was fitted for my splint. After that, I went for an appointment on a monthly basis. Sometimes my splint needed adjusting, and sometimes it didn't.
The last time I had an appointment was May 2002, and that was because my night guard that I'd been wearing for 3 years had "reached it's life expectancy". I've had no need to see him since then, but if I needed to, I could still call and make an appointment.
Dr. Rondeau does teach/lecture on TMJ more than he did when I was a patient, but he DOES care about his patients!! The last couple of times I was there, I believe he had an associate who had taken a large number of his (Dr. Rondeau's) courses, and was beginning to see patients when Dr. Rondeau was away teaching. Dr. Rondeau has an assistant (Janie), who is a Certified TMJ Assistant and also teaches/lectures. I believe she received her certification in Texas many years ago. She is VERY good at what she does, and is just as knowledgeable as he is.
Personally, I found Dr. Rondeau to be extremely approachable, and he listened to every word both my husband and I said. We both found him to "tell it like it is". If he can't help you, he'll say so.
Marlene's memory is impeccable! I'll try and recall my experience as well...
My treatment with Dr. Rondeau started out quite similar, but the timelines were a little different. On my initial appointment he did the physical testing, i.e. muscle palpation, questionnaire etc. I then made a second appointment for the x-rays, tomograms, joint vibration analysis. Two hours were set aside for that appointment, and Janie (Dr. R's amazing assistant) conducted all of those tests. They've just recently started using another device called a "trigger point gun", which is similar to the idea of tensing prior to the splint being constructed. The trigger point gun "confuses" the muscles into relaxing temporarily.
It was several weeks later when my husband and I had our consultation with Dr. Rondeau. This is when he went over the test results and the cost of treatment. My case appeared to be very straightforward. Both discs were displaced forward with reduction. My treatment plan was to last 5 months using a mandibular diagnostic splint (repositioning splint). I was to be re-evaluated after 5 months regarding the need for further treatment for a more permanent solution (orthodontics). The cost for the treatment was approximately $1,400.00. I believe the cost for diagnostic testing was about $650.00.
I decided to go ahead, and my impressions etc. were made that day. I got my splint approximately 2 weeks later.
Unfortunately, I didn't respond as well as Marlene did. After 5 months with very little change, it was believed that my right disc is displaced medially, or to the side, and locked there. This can't be confirmed without an MRI, which I'm still trying to schedule. Once I get the MRI, Dr. Rondeau will be receiving a copy of it.
Even though I'm not YET a success story, I would highly recommend Dr. Rondeau's office. After my initial 5 months of splint therapy, they've continued to see me at no charge whenever I need a splint adjustment. While it's true that Dr. Rondeau spends a lot of his time doing seminars, he does still care about his patients. I'm not going to say he doesn't have an ego, but with his success rate, why wouldn't he. He is still very approachable and open-minded. As Marlene mentioned, there is another dentist in his practice who has started treating TMJ patients as well. I've seen him, but his name isn't coming to mind right now. Also, Dr. R's assistant, Janie, is absolutely wonderful. I would almost say that she knows more than Dr. Rondeau does about TMJD. They have tried everything in their power to help me out.
When I told Dr. R and Janie that I'd learned of them through the internet (Marlene) they were quite impressed by all the research that I had done.
Anyway, this is starting to sound like a paid ad!
I don't think you'd have anything to lose by having a consultation with Dr. Rondeau.
Best of luck.
i hope that you dont mind me butting in here, but i've just started the process with seeing dr. rondeau.
in the middle of august, i saw dr. rondeau for the first consultation. it involved medical history, range of motion, joint vibration analysis, etc [a pretty much typical consultation]. however, janie did all of this, and she was truly a very competent and kind person.
after janie spent a considerable amount of time with me, dr. rondeau came in, and they went over my case together. he did a muscle palpatation, and did a strange exercise where i stood against the wall and pushed against his hands. my left side was weaker - anyone know what this test was for?
dr. rondeau seems to be straight to the point, and is fairly approachable especially when you know what you're talking about concerning TMJD. he seemed to brighten up when i mentioned that i found out about him online and mentioned marlene's name to him.
the appointment cost $75, btw.
on thursday, im going for my 2nd appointment, which includes a multitude of diagnostic testing. it costs $650.
i noticed [and liked] the fact that he wasnt jumping to conclusions about my problems. he said that it could be my neck causing the problems or back. it made me comfortable to know that he's following a scientific approach to rule out other problems that could be causing my TMJ symptoms.
after thursday's appointment, dr. rondeau will go over the results with me and suggest different courses of treatment.
when i get back from my appointment, i'll let you know how it goes. it's wonderful knowing what to expect at appointments, eh? it helps to qwell the nerves.
Marlene & Crystal - thank you as always for answering my questions and trying to help. Do your splints include your wisdom teeth (if you have any)? Is it one of these lower splints where the front teeth aren't covered, but the rest are? Do you splints have indents where the upper teeth fit, or is it a flat plane?
When Dr. R. has discussed the options beyond the splint, has he mentioned wearing a permanent splint? Marlene, is that what you're doing?
Crystal, I hope you can get in for an MRI soon, and start getting some relief.
Saaraah, thanks for jumping in here. I posted to you on another topic, asking questions, before I saw your post here. Do you know how long your second appt is?
I'll probably call Dr. R.'s office to discuss my situation.
Thank you all for your help, and take care,
he did a muscle palpatation, and did a strange exercise where i stood against the wall and pushed against his hands. my left side was weaker - anyone know what this test was for?
There seem to be a few 'Kitchenerites' popping out of the woodwork. I lived there for 10 years myself, and my parents still do :-)
About that test you mentioned....I saw a dentist this summer for a t-scan evaluation. He's received some training by Dr. Rondeau, so maybe that's where he learned this arm strength test from. I think basically what this test shows is how your strength goes up when your jaw joints are in the 'ideal position'. This dentist showed me that when we did the arm strength test as he had me say the 'sssssss' sound (like snake ;-) )...then my arm strength went up. Apparently making that sound puts your jaw in a good position. But when he got me to wear my splint (which wasn't properly adjusted at the time)...or when he got me to bite on my back teeth...then you could tell that my strength went down, indicating that my jaw wasn't in the correct position.
I think it's a 'rough test' but the dentist I saw seemed think it was a pretty useful one :-)
i had my 2nd appointment yesterday, and im still feeling fairly sore.
it was supposed to be 2-3 hours, but it only lasted 1.5 hours for me, and a very kind woman, mary, did all of the testing. i cant believe how friendly and kind the staff are at dr. rondeau's office. it's truly a great feeling to go there.
anyway, the appointment consisted of:
- photos of my teeth [a retractor was used to pull the lips out of way] for at least 3 angles, roof of mouth, floor of mouth, face & shoulders from side, front, and back, in front of a posture chart from side, front, and back, and range of motion of neck from side to side, down, and up
- upper and lower teeth impressions [almost initiated my gag reflex especially with the lower impression, but it was only in for less than 1 min]
- at least 9 xrays: sinus, skull & 7 vertebra, tomograms, panoramic, etc [i asked for copies of the xrays because they are so interesting and cool to look at]
and i think that's it.. they were also supposed to do a mouth exam, but the woman who was supposed to do it was ill.
the appointment included a lot of clenching and opening wide, which has not made my jaw happy. my opening, tho, was 46 mm, which makes me feel good. also, the only other uncomfortable thing apart from the impressions was the xray machine, since huge ear plug things had to go in really far into the ears. it wasnt necessarily painful, but very uncomfortable and weird.. but that's probably because i have a phobia of putting things in my ears. hehehe.
my next appointment is on september 24th, so we'll see what dr. rondeau says.
[This message has been edited by saaraah (edited 09-05-2003).]
Thank you for posting about your appt. It's always so helpful to hear about other's appointments. Gives me an idea what to expect, expecially since I'm considering Dr. Rondeau.
Did Dr. Rondeau do any of the testing? Is Mary a dental assistant who's been trained in TMJD and testing?
When they did your impressions, did they use any kind of machines? Or was it just those trays filled with goop that were put in your mouth. Guess I'm wondering how they know how your teeth line up, or if you're way off midline (like I am). I've had impressions done by several dentists, who made nightguards from them. Because the impressions were done from my off bite, and nobody checked how it SHOULD be, or what was happening with my jaw, my nightguards are way off kilter too, just like my teeth.
Did they charge you extra for the copies of all your xrays? If so, would you mind telling me how much?
I'm curious too if they were able to let you know in advance that you wouldn't be having your mouth exam. I realize this may not have been possible because people get sick at the last minute. I'm just thinking that if I go to Dr. Rondeau, and it's a 3 hour drive, I wouldn't be too happy to arrive there and find out I'd have to come back again for the mouth exam. Or maybe Dr. Rondeau will do this at your next appt?
I've spoken to his office and I would guess your next appt is the one where he tells you his diagnosis, discusses his treatment plan and $$$. Is that right? How much of Dr. Rondeau have you seen during your appts? Did they give you any idea of when, after your next appt, you might expect to get your splint (if that's what he suggests), or schedule your next appt?
Sorry to flood you with questions, but it's so difficult finding the right dentist. I hope you're doing well.
One more question. Did they do any tensing of your muscles? I believe they have something - it may not be a tensing machine - but something that's supposed to zap or relax the muscles. Did you have this? What were the results?
arleen - dr. rondeau was not present for the entire appointment. i believe that mary has been there 1 year, and she said it takes about a year to get comfortable/know all of the testing procedures along with diagnosing TMJD. im not sure of what her specific credentials are - im assuming, tho, that she's a dental assistant with radiology [?] background, too.
for the impressions, they used the metal trays with the pink goop in them. also, i had to bite down on a wax thin block.
to get copies of the x-rays, i have to talk to dr. rondeau, but mary said it shouldnt be a problem. i dont see why i cant get copies, since i paid so much for the initial ones, eh?
no, they didnt tell me in advance that i wouldnt be getting the mouth exam because the women called in sick that morning, and my appointment was quite early, too.
instead, they're going to stick in the mouth exam right before my next appointment. ie, 15 minutes of my next appointment will be for the mouth exam, and then i'll see dr. rondeau right after.
you're right - the next appointment is where dr. rondeau will go over the x-rays, give my a diagnosis, and suggest various types of treatment.
they havent said anything about when to expect a splint because it seems like they do not want to jump to conclusions about my problem - they're not getting ahead of themselves before seeing the xrays and whatnot.
honestly, i have seen very little of dr. rondeau so far. in the first appointment, i saw him for maybe 10-15 minutes [if that], and i didnt see him at all for the second.
they did not do any tensing of muscles. my guess is when and/or if i get a splint, they'd probably do it.. you'll have to ask crystall or marlene.
anyway, i enjoy answering your questions - dont hesitate to ask more.
Just thought I'd jump in here.
Impressions are made of your teeth for several reasons, one of which being to reproduce a "model" of your original bite. They also require impressions of your teeth in order to make the splints. At Dr. Rondeau's office, the lower splint does not originally have indentations for your top teeth to fit into. Once they find a good position for your jaw, then they add acrylic to the top of the splint and have you bite down, thereby creating the indentations for your top teeth. You can rest assured that they won't put you back to your incorrect bite.
Also, Dr. Rondeau's office doesn't do "tensing". They're always updating their equipment, but the last time I was there they were using a "trigger point gun". It would probably be used before your initial splint fitting, and at each appointment for adjustments. The trigger point gun uses soundwaves to "scramble" messages within your muscles, which is supposed to break any muscle spasms. It's really tough to explain, but if you contact their office they should be able to explain it better.
I'm getting a run-around with the whole MRI thing. My doctor's office keeps telling me they sent the request, but the MRI centre hasn't received anything. I finally spoke to someone at the MRI centre who advised me she would personally call my doctor's office to find out what's going on. They're now booking into November/December. It's really getting to be ridiculous. Thanks for asking anyway.
November or December? That is ridiculous. Maybe there's a different centre or hospital you could check? You've probably done that already. I hope they manage to schedule you an earlier appointment than that.
Dr. Rondeau's office led me to believe that the MRI centre won't take a referral from a D.D.S. But now I'm thinking they just don't bother referring their patients because of the long waiting time. Splint therapy normally takes about 4-6 months, so by the time an MRI is done it's probably not needed. But there's an exception to every rule....