Isobelj

I'm struggling with this too, some of my symptoms are similar to yours, muscle spasms in face and neck, apparant tinnitus and hyperacusis, incredible stiffness of neck. The first ENT I saw said get a nightguard as did the dentist, so I did that, though I've hardly worn it so far, I'm so scared it will worsen something. Anyway, it comprises a plastic mould with acrylic on it, shaped to my top teeth. The dentist told me it should 'train' my jaw not to grind and clench as it makes my bite a little higher than normal (I have bad malocclusion as well), after a few months, he said, my jaw will stop grinding without the guard as it will instinctively be expecting the teeth to touch at a higher point (i.e. the point the guard itself meets the lower teeth). This doesn't quite sound convincing to me.

The maxillo facial surgeon I saw told me something different, he said the guard should correct my bite (he worked on the guard too himself to reshape it a bit after the dentist made it), the acrylic and plastic filling in the spaces and making the bite equal on both sides and slightly higher. This achieved, he opined, my jaw will hopefully no longer feel it has to grind as grinding is frequently caused by some irregularity in the bite (higher teeth, badly aligned teeth heightwise), the jaw won't be attempting to flatten out some higher tooth point or whatever but will rest more comfortably and when it moves in my sleep it will remain relaxed, not grinding.

This sounds theoretically ok, but I'm afraid the guard is still allowing, or encouraging, grinding on one side as it is slightly lower there so the teeth seem to move instinctively to grind there when I'm asleep.

Does anyone have any opinion on either of the above theories?

I saw the NTI on the web, I'm interested to hear it doesn't really work, but how does it cause an open bite?

Looney, anyway I'm impressed by your thoroughness, you're not cutting corners and are rationally exploring the different professionals and confusing treatment options out there who could help TMJ, I feel you know more, at least than I do (!), and hope you find answers you need. I just took the advice of the first (and only so far) ENT I saw (about a month ago) and now I feel that he just prescribed 'fit all' solutions, with no real examinaton of what my history is or even what all of my symptoms are.

Isobel

[This message has been edited by Isobelj (edited 09-22-2003).]