Hope we can benefit from all your experience out there. Our 15 year old daughter, still in braces, has been complaining of jaw locking and now real pain since about 4 months ago. She seems to have the typical symptoms and her orthodontist has diagnosed her without any x-rays.
His first course of treatment included building up her teeth with composites, but after a week of that not working, he has decided to stop all orthodontic care and work solely to alleviate this. She is being fitted for splints soon. Let me say that I do love this dentist. He is honest and caring. He seems to be very conservative in this approaches, which I like.
Of course I am worried. The more I read on forums like this, the more I worry. I want her to have the RIGHT treatment from the get go, but how do I know? What should I know about these splints? How do I know if they fit correctly? Someone here talked about checking splints on a machine to verify balance, please explain.
My husband and I want to see our daughter without pain. Any advice or knowledge/experience sharing would be great.
I'm sorry to hear about your daughter's problems. I know how you are feeling because my daughter's problems started when she was 15 also (she is 17 now).
Unfortunately I have to run out of here now and I probably won't get back on the computer until Monday, but you can do a search of this board for all the posts I've done and maybe it will give you some assurance. We are having positive results with treatment.
I will check back on Monday.
I am sorry your daughter is so young and dealing with this. Hopefully, she will be in for an easier time of it then some of us here. The most important thing to accomplish that is getting the right treatment from the start.
I am a little concerned about building up the teeth. You mean he permanently altered her bite with her teeth?? If so that is the WRONG way to start. Don't let anyone, no matter how nice they seem change her bite or alter her teeth. You never do something that can't be undone.
A good fitting splint is the proper way to start. However, a splint is only as good as the dentist who adjusts it. I have had splints balanced and although that is a nice thing to do, in the long run how it fits in MY mouth is what really cuts it.
The first thing to do is to find a dentist who knows what they are doing. Karen was right, don't let anyone do anything to change her bite. I have not seen anyone here have any success with that strategy. Braces have been known to cause these TMJ problems. There have been many threads here talking about the braces issue. There is a link here, up top, to the right hand side where you can search this board for "braces". Research for good dentists. Finding the right one is crucial. A splint is a good start. There are other conservative approaches your dentist may recommend. It is always better to go conservative first. You may want to start a new thread about where you live (what state) and see if anyone in your area has a good dentist they could recommend. Alot of dentist hang out a shingle saying they are TMJ dentists, but they may have just a weekend class on TMJ and call themselves a "specialist". Look for someone who devotes a good portion of their practice to treating TMJ.
The "build up" of composite on the teeth that I mentioned was only the first step. He will remove them right away and then make the splints. So he has not altered her bite, except, of course, with the braces. I am not sure if there will be upper and lower splints but I do know there will be splints for daytime and a different splint for nighttime.
He seems very concerned but is really saying this is due to her stress level. She is a top student, firstborn, and probably does hold stress. She does night grind and always has.
Please direct me on what to look for regarding the fit of the splints. Angel , you seem to have the experience, what exactly did your splints do to your bite or jaw placement? What do I direct my daughter to look for/feel for when these things are placed in her mouth?
Oldpal, I will ask the Doctor what training he has had with TMJ, thank you.
I'm going to check in to Mosmom's posts and do a search on braces.
I'm 24 and have had jaw problems since I was very little (I think since I had teeth), so I understand what your daughter is going through. For me it took a while to really get across, and understand the kind of pain I was feeling.
When I was a little younger than your daughter (13/14), the pain got pretty bad, and I finally got in to see a doctor. He referred me to a dentist who determined I had TMJ problems with panoramic x-rays, my symptoms, and how my jaw opened sideways like an L.
Long story short, I had a lower splint that I used for several years and never really had any flare-ups. Eventually it started bothering me more than helping me, so I stopped wearing it. Basically I was waking up in the morning with very sore teeth/jaw and headaches again, like I wasn't wearing the splint at all (I only wore it at night)
I gave up on fixing my jaw for a good while, came to college and was faced with massive amounts of stress, and it flared up again. Saw another dentist who again fitted me with a splint. I ended up cracking through that one. They fitted me with another which I again cracked through (I'm a clencher. I used to grind when I was young..) That dentist then referred me to an oral surgeon..
He immediatley ordered an MRI and we determined my jaw is displaced. Basically it's not straight in the joint - it's pushed slightly to the left, which causes the joint to slip, and to clench because my jaw is constantly trying to find a resting place. Imagine you're holding your foot an inch off the ground and can't rest it.. He fitted me with a completley rubber splint which helped for about 2 years. It too eventually started hurting as the others did, so I gave up on it..
I had to have an emergency root canal on one of my upper molars last June/July, I think partially because of the stress the tooth has received over the years, it wasn't a decay issue.. Since then my teeth haven't been sore as they used to be, but my jaw has been relentless - I have daily headaches regardless of how I sleep, and I know if I don't sleep well the next day I'll have an unforgiving headache that advil won't touch. I've found that taking half a dose of tylenol PM usually relaxes me enough that I sleep ok, and dont have a bad headache, but I try not to take that all the time. My oral surgeon prescribed me a muscle relaxer which would make me sleep a good 10+ hours, so I couldn't take that much at all with school and work everyday...
And as far as the fit of a splint? It's not the most comfortable thing to wear at first. It takes about a week or so for it to fit, and fit without problems. Your daughter shouldn't wake up (after a couple days) with one or two sore teeth, that means the splint isn't hitting her other teeth evenly. The splint is designed (to my understanding) to help your teeth to fit together, and all touch at the same time, so no one tooth is getting all the stress. It's also designed to help spread out the pressure from her clenching/grinding.
ANYWAY, wow this got long.. sorry
I'm not totally certain what to tell you as to do with your daughter, but I do think TMJ is something that's never going to correct itself. Your teeth will always shift, and while you might find relief for a while, eventually it will return in a different way. I have found some relief by seeing a really good chiropractor. He has at least relaxed my neck and shoulder area so I don't hold as much stress in my neck and jaw.. maybe you could explore that for your daughter. Maybe also look into massage treatments/physical therapy, that was my original goal, but I couldn't afford it..
Let me tell you, braces are a known cause of tmj, now, if you get an ortho to admit this, that is another story! Grinding, stress and braces all put together, I am sure, have given her a whopping case of tmj.
It is hard to tell you what type of splint will help her. Anyone who acts like they treat all cases of tmj the same way are the ones to be leary of. Tmj is as individual as the person who has it. Just because one person has good luck with a splint, the next patient maybe unable to tolerate that kind of spling.
Can you tell me a little more about all the symptoms she has? Maybe with a little info like that I can rell you what helped me with those certain symptoms.
I have had 9 splints. Only 2 have been a piece of junk. The others all served their purpose at the time. That is one reason you have to find a dentist who is willing to admit that you have to try different types of treatment.
I am in a full......soft splint as of now. It has been really wonderful in eliminating SO many of my symptoms.
Here is an example of how a splint can do damage while helping. My first splint was an NTI that I was given for clenching and grinding and severe dizziness and ear fullness. The NTI is a very small appliance that fits between the two front teeth. Only your bottom front teeth touch it. I wore this for well over 18 months and it did help those sympotoms but as a result of wearing that splint it caused me to develop an open back bite. because of this, I developed a "second tmj" my dentist calls it.
The one set of problems was treated but because of the open back bite, I developed a whole new set of MUCH worse symptoms.
It is my own experience that a dentist who is a DMD has proven to be the best at this. That does not mean that all of them are, but they are good. So called "tmj specialists" are usually a joke and orthos aren't that good at tmj. I would cringe at letting one of them treat me. It is kind of like an oral surgeon. Just be careful.
Any questions, please ask and try and post her list of symptoms and I can tell you what splint helped me with those symptoms.
Best of luck to your daughter. I can't imagine dealing with this at 15.
Sorry I couldn't post longer on Friday - I know you must be eager for input. So, here's my two cents...
First off, don't freak out from reading all the posts on this board. Keep in mind that many of these wonderful people are extreme cases. Most people who have mild cases of TMJD or who have been successfully treated don't visit here often. I like to keep visiting to be the encouraging voice of successful treatment.
The first thing you will learn here is that there are as many treatments for TMJD as there are causes. Everyone has an opinion and some are very strident in their opinions. The best thing you can do for your daughter is find a professional you feel comfortable with and whose plans make sense to you. This may be the doctor you are with now, but if he/she doesn't fit the bill...don't hesitate to seek other (multiple) opinions. You could call a variety of dentists/orthodontists in your area and ask them who they refer their TMJD patients too. If you leave near a University with a dental school, you could call them and ask for a reference. Let us know what area of the country you live in - someone here may have a reference.
As others have said here...start conservatively. Often symptoms will clear up with just the use of a nightime splint.
We started with a night splint, then a 24/7 flat splints, then a repositioning splint until we finally achieved positive results.
It broke my heart for my daughter to have to wear that "hockey puck" 24/7 at that age...high school is tough enough...but for the most part, she had a great attitude and got through it with very few emotional breakdowns.
One other thing...
I would like to respectfully disagree with the notion that you should NEVER do anything to alter the bite while treating TMJD symptoms. Although I agree that you should avoid it if possible, if a maloclussion or jaw placement is causing the problems it makes sense that the bite would need to change to attain results.
Our final splint was a repositioning splint - designed to reposition the jaw. This gave her the results we needed, but did leave her bite open. That is now being addressed with braces - the plan being to stabilize the bite in its new, correct position.
Hi--I know this was a really old post of yours, but I have a very similar case to your daughter. I was wondering if you've gotten her treated with anyone successfuly--please let me know~! Thanks-Jill M.