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TMJ Disorder -TemporoMandibular Joint Message Board
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Old 05-05-2005, 12:04 PM   #1
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Getting sick of yogurt and soup.

This is my first post. I've been having some serious troubles with my poor jaw. Does anyone else have this problem? Mobility is fine, it can open and close (with lots of noise, clicks and knocks,) but i can't close my teeth together the same way they used to. It's almost as if my left side of my mouth is slightly too far open, while the right is touching first and closing. It's causing alot of pain and i can't chew anything without severe aches and clicks so loud it hurts my ears. I haven't been able to eat anything but yogurt and soup for three days now and I fear it's getting worse.

I had an appointment with the oral surgeon for monday, only to find out my Insurance plan doesn't cover TMJ, only "Medically Necessary Procedures due to Degenerative joint disease or Injury." I don't get it. Isn't TMJ a disease? Isn't having a messed up jaw an injury? The insurance company gives me the run around while the oral surgeon wants 320$ (that I don't have) up front just for consultation. Is it just me, or does this seem totally wrong? Am I getting jerked around, or is this just the way it is?



[Please do not use characters that may be construed as being a cuss/slang word. See the substituted word "messed" above. You may edit that again, if that's not the correct meaning. Please see the board guidelines by clicking the "Posting Rules" for more details. Thanks - Well-come Moderator.]

Last edited by Well-come; 05-05-2005 at 09:44 PM. Reason: Removed characters suggestive of being a cuss/slang word.

 
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Old 05-05-2005, 07:43 PM   #2
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Re: Getting sick of yogurt and soup.

hi jennysaur,

i think you found the right board...we all have some type of problem with the jaw. if you are in the early stages, then going for consultations and tests is the right thing to do. most of these oral surgeons do charge alot ( i have paid what you have been quoted plus more) for the initial consult. the mri's, panoramics, etc... are extra too. if your insurance company does not cover tmj, then your dr.'s will have to specifically state what your condition is to your ins. co. That may be: dislocated jaw, internal derangement, degenerative joint disease... the dr. you see SHOULD know how to specifically state your problem to your ins. co. so he does not fall into the trap of just classifying your problem as "tmjd." this catch-all causes alot of people to be denied benefits. at the very least, he can state one of the above issues regarding your jaw and have an mri ordered. the insurance company may very well pay for it until further so-called tmj treatment is warranted. in the interim, it sounds as if your bite is off - one of the symptoms of tmjd - along with all the other symptoms you describe. please try to pursue splint therapy, a conservative path before resorting to anything invasive and non-reversible. it would be a wise choice. i know it is hard to hear when you don't have the $$ in the 1st place but - the price you pay now (if your tmjd) is in its early stages will be far less than if you do not pursue conservative therapy while you can.

 
Old 05-06-2005, 01:01 PM   #3
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Re: Getting sick of yogurt and soup.

Hey, PWC, thanks for your advice! I called my PCP doc and asked if she can put "Jaw Pain" on the referral instead of "TMJ". I hope this works! I miss carrots. ::sniff::

 
Old 05-08-2005, 07:04 AM   #4
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Re: Getting sick of yogurt and soup.

tell me about it...it makes me crazy to remember biting into a crunchy type of food. i really hope your insurance co. will pick up a good portion of the $$ of your treatment. good luck.

 
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