MORA Splint & Question Re: Internal Derangement
Well, I decided to try one last non-invasive therapy before having open-joint surgery with autogenous graft (cartilage from my ear to patch the holes in both discs). I got my MORA (mandibular orthopedic repositioning appliance) splint two weeks ago. It fits on my bottom teeth and is basically designed to position my jaw in its "ideal" place so that my jaw muscels can fully relax and to allow the displaced disc to slip back into its proper position. My doctor says it takes 3-6 months to see if it works. After two weeks, I haven't noticed any difference at all! Maybe I am being too impatient. I'm still waking up with sore jaw muscles from grinding. The headaches are pretty much constant and the tension in my neck, shoulders, back, and head is as bad as it's ever been. My muscles feel sore all over. The muscle relaxants don't seem to help and I think I'm immune to Tylenol and Advil now. It's really hard to function when you are in constant pain and discomfort and it's really starting to get me down. Has anyone had success with the MORA splint?
Also, I have a question about the five stages of internal derangement (displaced disc). I'm at stage 5, the worst, which my doctor says is rare for someone my age (31). But what I don't understand is what exactly does it mean to be at stage 5? Is it a distance thing? Like, how far away from the joint the displaced disc is located? Or do the stages have to do with levels of soft tissue degeneration? Because I'm at stage 5 plus have holes in both discs, I'm really skeptical that ANY splint (or other noninvasive) therapy is going to have any effect at all.
The weird thing about my case is that my opening is not limited at all and I don't have actual pain from the joint itself. My pain is all muscular. My jaw has never locked open. But it does click when I open really wide. My chief complaint is that my bruxism causes sore jaw muscles, which causes extreme tension and sore muscles in my neck, head, shoulders, and back, which, in turn, causes huge tension headaches that are almost debilitating. I am hoping that this splint helps me so that I can avoid open joint surgery. The surgeon says that b/c my condition is so bad (stage 5), that less invasive procedures like arthrocentesis or arthroscopy would not help at all.