Moving on to Phase 2 - TMJ Disorder -TemporoMandibular Joint Message Board

Katie G · 12-13-2004, 10:22 AM

Hi all - I hope you are having the best day possible with your TMD. I think of you often, and have been so busy at work I have not had a chance to be online. My kids monopolize the computer at home, so that doesn't work either for checking the postings.

Well a quick update on my situation - after 14 months of wearing an acrylic upper splint 24/7, my ortho feels that the jaw position is as good as it's going to be and stable at this point, so now we're on to Phase 2.

For me that means upper/lower braces for 22 months (!) to realign the teeth, followed by oral surgery to realign the jaws, and then braces continued for ???? (not sure on that one). Since wearing my splint, my bite has opened up so much that I cannot eat without the splint in. Because of that, the ortho said he may start with lower braces first and leave the splint in. I'll know more Wednesday this week when I go in to have the spacers inserted. I've been warned this may cause a lot of jaw achiness as the spacers are pushed in between certain teeth to provide anchors for the future wires of the braces. ICKKKK! I'll be popping the Motrin that day I'm sure. I've already planned to use an entire sick day from work.

Anyway, I'd like to hear how others are doing. As far as my pain from TMD, it is at a minimum - always there, but definitely tolerable. In fact, severe headaches/neck pain are rare for me anymore and make life so much more enjoyable. So I know the splint did what it was supposed to do - it allowed the muscles of the joints to relax, provided some healing to the area and realigned the jaw. However, I still grind my teeth at night (according to my husband; it doesn't wake me up), but the ortho thinks that will clear up as my teeth and jaws become more aligned over time. Even if I do still grind, at least I don't wake up with severe pains in the face, head, and teeth anymore.

Take care,
Katie G

oldpal · 12-13-2004, 12:39 PM

Quote:

Originally Posted by Katie G

For me that means upper/lower braces for 22 months (!) to realign the teeth, followed by oral surgery to realign the jaws, and then braces continued for ????

Hello Katie,
Why do you need surgery to realign the jaws? Something wrong with your lower jaw? abnormal growth?

oldpal

kikaida01 · 12-13-2004, 08:31 PM

I am also wondering why you need surgery to realign your jaw. The tmj dentist I went to see told me from looking at my jaw anatomy that more than likely my jaw always deviated to the right. I agree with him. I am 35 and I looked at my childhood pictures and my teeth always were not always straight. I am not willing to undergo any kind of surgery for tmj unless my jaw joints fail on me. He told me my joints are working smoothly and that I will be fine. I would suggest getting a second opinion before considering surgery.

oldpal · 12-14-2004, 02:05 AM

Hello,
After reading your post over, it came to me. Brace to realign teeth, surgery, and then braces again? That really doesn't make any sense.
Functional Ortho basically will correct that in phase two with brace to pull the rear molars up. So your lower jaw can be sustained and not get pulled up again. Basically, in phase I using splints, your tm joint is moved to the "Gelb 4/7" vicinity. when it is there, your muscles are at rest. This can be proved by looking at the tm joint of the general population without "tmj."
So i definitely agree with Kikaida. Get a second opinion. But get one from a honest dentist. Surgery is not the solution, and often will cause more problems.

Take care,
oldpal

Katie G · 12-14-2004, 06:55 AM

Thank you all for your replies. I agree with you that surgery should never be entered into without a lot of soul searching and research. I really trust my ortho - he has been providing TMD services for over 15 years (in fact I first saw him 15 years ago for treatment, but had no insurance coverage at the time and couldn't afford it). I'm not real thrilled about the prospect of surgery in the future - first I'm going to see how well the braces realign my teeth - however my bite is so open now from splint therapy, that the only teeth that touch when my mouth is closed is the last molar on the right.

My ortho said that in realigning my teeth first that will help stablize the jaw more, but that since my maxilla is so far forward of the mandible now, I will never have a normal bite without surgery to realign the jaws. If the braces do what they're supposed to, my upper teeth will be "pulled back" somewhat to more closely align with the bottom ones, but will never be able to pulled back enough. However, I'm still hoping that the braces do a good enough job on their own, and maybe 2 years from now, surgery will not be needed.

I have talked to many others who have been treated (or had family members treated) by my ortho, and they said he's actually more conservative than most. Some orthos in this area jump right into surgery first before splint treatment and/or braces. My ortho has worked very closely with an excellent oral surgeon about an hour from my town, and they collaborate all the time on TMD cases.

Since I know surgery is a long time off, I'll have plenty of time to research my other options prior to the time surgery may be recommended. Maybe in 2 years time of wearing braces, another less invasive method may be available. My ortho keeps up on continuing education related to the jaws, teeth alignment, TMD, etc., and therefore I am confident of his abilities.

If I decided on a 2nd opinion, I'm not sure where I'd go here in central Michigan. There are not very many good orthos around here, and I just feel that right now, I'm seeing the best.

Thank you all for your concerns, and I will certainly keep you updated on my TMD process.

Take care,
Katie G