Q's on Splints & Bioesthetic Dentistry - TMJ Disorder -TemporoMandibular Joint Message Board

Thelma-Louise · 07-02-2004, 06:49 PM

I have been told my many dentists now that my tmj is caused by an improper bite. All my teeth are crowned or bridged. I started with a dentist 8 weeks ago and my bite is even worse so I have started to look for another dentist. The one I met yesterday says that my crowns are not contoured correctly to induce proper jaw and condyle movement - it appears I rely on my canines to do this and the current crowns have repositioned them. He also said the angling of the front upper and lower crowns does not match each other which is why my jaw feels unbalanced or off center. Has anyone ever used a dentist that practices "bioesthetic dentistry" which is described as contouring teeth for functionality?

Also, are bite guards also called splints? What are the pros and cons between the acrylic bite guards that can be fitted for top or bottom and the rubber splint that looks like a trampoline and clips on to the molars to prevent your mouth from fully closing? The dentist I am now considering uses the acrylic bite guards and said the tmj specialist I was seeing who uses the rubber splint would not approve of the treatment he is recommending. I am confused as to what to do.

Also - is anyone else been on medical disability for this? I can not work due to all the pain & my doctor refuses to extend my leave since he really is not treating me other than with pain meds. I was wondering what other options I had?

Ann123 · 07-03-2004, 08:40 AM

Hi Thelma,

I have to wonder, what the bioesthetic dentist is proposing to do- how is that different than what a prosthodontist does? And isn't that what a prosthodontist specializes in whereas a bioestheic dentist does a lot of cosmetic too? Or is your bioesthetic dentist a trained prosthodontist? The thing with prosthodontists is you have to find a really good one from what I understand. Is the biosthetic dentist going to make models of your teeth and determine your best bite from that? That is the correct way to do it. Are you by any chance near Chicago? We have some top notch prosthodontists here.
Regardless, your bioesthetic dentist sounds knowledgeable to me. Any chance you could get prior tmj patient recommendations?

I have an upper acrylic mouthpiece that is considered a splint. It a new material which when rinsed in warm water softens slightly so that you get a really good fit when you put it on then it hardens to acrylic. I don't know anything about the rubber splint though, sorry.

Can't help with the disability question either.

Good luck to you.

Ann

Thelma-Louise · 07-03-2004, 08:44 PM

I have tried going to prosthodontists but none have wanted to take my case once they hear I have tmj - they all refer me to tmj specialists before they will are willing to correct my bite but when I go to the specialists they refer me to they tell me to first get the crowns corrected and then return. I keep going in circles with this. The bioesthetic dentist I met with is a supposed expert in correcting occulsion problems ...the only difference I can see from other dentists is that he spoke of the positioning and contouring of teeth to send the correct messages to facial muscles and to align the teeth to allow for proper condyle positioning which seems to be a problem for me on the left side. All other dentists are just copying crowns done by previous dentists so I have not seen any improvement in my symtoms. I am so frustrated with this I am ready to pull all my teeth out. Do people who wear dentures get tmj as well?

TiffanyAnn · 07-03-2004, 08:59 PM

Quote:

Originally Posted by Thelma-Louise

I am so frustrated with this I am ready to pull all my teeth out. Do people who wear dentures get tmj as well?

Yes, people with dentures can have problems with TMJ because TMJ is not a teeth problem, TMJ is a JOINT problem.
Tiffany

Arleen · 07-03-2004, 09:13 PM

Hi Thelma-Louise:

You'll excuse me for being cynical, but your latest dentist just sounds like he's using all the right jargon but his suggestions may ending up hurting you more in the end.

Usually tmd is treated first by putting the joints in proper position - normally done with a splint. Once your symptoms are relieved and the joints are healed, you move to phase II, which can involve restorative work like crowns, or ortho, or even a permanent splint. Phase II recreates the bite created with splint therapy, so your jaw joints remain in proper position. What if your dentist doesn't contour your teeth properly. Then you've got an even worse bite and your teeth have been irreversibly changed. Contouring also weakens the teeth, depending how much is done.

Contouring can diminish your vertical dimension, which may put additional force on the joints. I'd get another opinion before proceeding with contouring. I came very close to having equilibration done a year ago, before I knew much about tmd. I'm so thankful I didn't proceed as I'd probably be in much worse shape now than I am.

Good luck.