My Son's current dentist seems to be giving up on splint therapy at his time. (I'm scrambling to find someone new) He's suggesting seeing a 'friend' of his to use an upper palatal expander. I understand that you've used one in the past. I've VERY hesitant about this idea since he's still in pain. I don't want him any worse. What are your thoughts on something like this while still in pain?
From my own experience with an upper palatal expander, I had mine AFTER I completed my splint therapy to move my lower jaw into a more correct position. I wore the expander for a month with the braces. It was somewhat "painful" for me (it felt like my head was splitting in two for a few days after each time I had to "open" the expander), but I believe it was because I was 40 when I had to wear it and my palate wouldn't be as "moveable" as someone of your son's age! The pain wasn't nearly as excruciating as some of the pain I'd previously experienced with the TM joints themselves. It felt more like a really BAD headache, and usually settled down within a few days, once some palatal expansion had been achieved with each ajustment. I was supposed to "open" the expander 1 full turn with the key each week for 4 weeks - for a total of 4 full "openings". I was only able to achieve 3 & 1/2 turns, which fortunately, was sufficient expansion in my particular case.
Perhaps your son's dentist feels it's necessary to achieve some palatal expansion in order to facilitate the effectiveness of his splint therapy? I'd be interested to know what his rationale is behind palatal expansion at this particular point in his splint therapy.
I hope you don't mind me jumping in here but I was wondering is this dentist who seems to be giving up on your son's treatment at this point the one who did so much for him in the beginning of splint therapy? The one who went someplace and got further ideas on treatment for him? The one who called you right back and all.
Thanks for your reply. I understand the whole concept behind an expander but am leary of it's use while in pain. Your dentist's timing of the use of this appliance makes complete sense...when you hurt no more. His dentist seems to think that with his upper palate being somewhat buckled due to prior orthodontics, it's hindering splint therapy. Unfortunately, it seems that he's a severe case, and I don't think that he has the knowledge behind him to help anymore. I'll probably go in for a consult. with his 'friend' just to see what he has to say. Otherwise, I'm back to the drawing board so to speak. I believe that he has an appt. next week. I plan to get a more detailed response and will post what I find out. Thanks again for your thoughts on this matter.
Yes, this is the same dentist. The man has tried but I don't think that he's dealt with 'bad' cases in the past. Apparently, Neuromuscular dentists use one type of splint and if that fails....that's it. And Tiffany, feel free to jump in whenever you'd like!
Last edited by CherylLynn24; 11-02-2003 at 10:31 PM.
Im not an expert of course but it seems to me they should try to get his bottom in a favorable position first with the splint. I know my neuro has had some problems getting me exactly on target but she has been successful in moving my jaw forward I just need to get adjustments often, and my splint is built up high. Has he had any improvement with the splint in mobility?
Thanks for the response. Unfortunately, he's seen no improvement. I'm no expert either, but his lower jaw needs to come forward, just judging by appearance. It seems as though during the day, while wearing his splint, he can consciously remind himself where his teeth need to be on it, but at night....??? They're all over the place.
My FJO dentist has me wear what he calls a bionator at night. I am at a loss for words to describe it. It is quite cumbersome, but not uncomfortable. It is designed to do two things. It keeps my jaw in the forward position at night and also keeps me from clenching. He believes that without the bionator, the good that the day splint does would be undone at night. I think your assessment is probably correct about Mike's specialist. He is a caring provider, but doesn't have enough skill and information in his treatment bag of tricks to deal with difficult cases.
Thanks for bringing this to my attention. I had a bionator when I was a teenager. Unfortunately, I never wore it due to how uncomfortable it was for me. If I were in pain at the time, I'm sure that I would've worn it. I now wish that I had. I do know exactly what they look like and their purpose. This is why I've been checking into a FJO dentist for him. I think that a bionator would be very beneficial for him. It would hold his jaw in position while he sleeps, and then maybe, he'd see some improvement through whichever splint they supplied him with for daytime use.
I have to move on this idea soon. These Neuromuscular splints are made so thin that his developed a hairline crack in it last week. It finally broke off while asleep and clenching last night. I anticipated this happening, not quite this soon, though. Thanks again for bringing up a bionator. This appliance has been on my mind for quite some time now.
[This message has been edited by CherylLynn24 (edited 09-27-2003).]
Last edited by CherylLynn24; 11-02-2003 at 10:32 PM.
Sorry that it is taking time to find appropriate solutions for Mike. I just want to point out that not all neuromuscular splints are thin. Mine is not thin, but not extremely hard either. It has a little flexibility in it, so that if I press it in my hand with moderate force, it bends a little without breaking. I think that I also need something to stop me from clenching at night. I have not had much luck with day splints if I wear them at night. Alex
[This message has been edited by Al4 (edited 09-27-2003).]
How is your splint working out for you? Have you seen any improvement yet? Your splint and his sound completely different. If his fell on the kitchen floor, I'd be afraid that it would break, it's that thin. I do understand that your dentist uses various methods in treating TMJD versus the standard Neuromuscular method, which is a plus for you. Hopefully soon, I can find someone that uses a wide variety of techniques as well as splints. Good Luck to you and let me know how your splint is working for you.
Last edited by CherylLynn24; 11-02-2003 at 10:33 PM.
My day splint is a thin clear plastic. It has not broken yet. I am wearing a small hole in it that he will have to repair. My TMJ specialist has his own equipment to make splints so his lab person can have a splint for me in three or four days. He made my bionator as well.