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TMJ Disorder -TemporoMandibular Joint Message Board
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Old 05-30-2005, 08:30 AM   #1
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Join Date: Dec 2004
Posts: 42
chloebell HB User

It has been awhile since I have posted on here because I have given up on ever getting my tmj fixed. Mine is structural from being hit in the mouth with a softball. Neither my dental or my regular insurance will pay for it. Both policies deny tmj coverage. I am beginning to feel like the pain I go through on a daily basis is driving me crazy. I am irritable and sometimes I break down and cry because I feel so helpless. I just want one day where I don't feel pain of some kind. My husband and I are ttc so there are very few pain medications I can take. Tylenol just does not cut it, but I do not want to give up my chances of having a healthy child by taking other medicines. The worst part is now this is invading my dreams. I dream about being in pain from my jaw. I dream that I go to the dr in horrible pain and they tell me I am faking or a drug seeker. I don't know why I am posting this. I guess I just wanted feedback from people who understand how I feel. My husband is as supportive as someone who does not truly know what I am going through can be, but I am tired of feeling like this is taking over my life. Any suggestions from someone who has been where I am now?

Old 05-30-2005, 10:15 AM   #2
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Join Date: May 2005
Posts: 14
tanglefoot HB User
Re: venting...

You say your problem is structural, can you be a little more specific? Have you ever worn a splin? Proper made splints can really ease the pain. I was hit in the face by a ball also and was never treated for 15 years. Now, I have all sorts of problems. I don't know where you live but I know if I go to my TMJ specialist, the splint costs around $500 plus the cost of M.D. visits and adjustments. Check out what is available in your area for splint therapy. Invasive proceedures can make the entire situation worse. I know from experience. Have you tried heat or Ice? A lot of people get help from chiropractic therapy.....I haven't, my insurance will not cover it. I hope all goes well.

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Old 05-30-2005, 11:22 AM   #3
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Join Date: Dec 2004
Posts: 42
chloebell HB User
Re: venting...

My jaw shifts to the right before opening and closing. It is not possible for me to open it smoothly. Regardless of how careful I am or how much I try, the shifting happens along with a popping sound that is so loud it can be heard ten feet away. My insurance refuses to pay for anything related to my tmj treatment, and treating tmj is not cheap. Consultation fees, splints, etc. I have never worn a splint because I can not afford to pay out of pocket to get one made. You say that a splint is only 500 dollars, but x-rays and doctor's fees are much more than that. I would love if my insurance would pay for me to have an mri done because I think that would show something was wrong that even my insurance company would not deny. This is the most frustrating thing that I have ever been through.

Old 05-30-2005, 02:18 PM   #4
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Join Date: May 2005
Posts: 14
tanglefoot HB User
Re: venting...

Even if you had an MRI and it did show something wrong, it would be your TMJ. Your insurance wouldn't cover it. Do you clench your teeth during the day or at night? It makes the pain greatly increase. I know that you are in a lot of pain, but you will have to try to focus on the positive things in your life to get you through this right now. I would try to reseach all the M.D.'s in your area and try to find a TMJ specialist. Ask about the cost and all the proceedures involved. My doc doesn't need to run a slew of tests to tell me that I have TMJ. General dentists can also make splints....I know this is not want you want to hear but that is the best treatment. Have you had an x-ray to make sure that your jaw wasn't broken??? Just to let you jaw does the exact same thing....but now it is much worse over the many years of grinding it away without therapy. I encourage you to get a splint.

Old 05-30-2005, 08:12 PM   #5
Join Date: Aug 2003
Location: MO
Posts: 489
Michelle W HB User
Re: venting...

I understand how you feel. I live in a state where they deny tmj coverage. It doesn't matter that I can prove with a MRI that I need treatment. It is not considered medically necessary by my insurance.

I did manage to borrow the money for the needed surgery, but it didn't work on both sides for me. It lasted about six weeks. You think the doctor would redo the procedure for free? Wrong. Now I am stuck. I can do nothing but take medication for my pain.

I am looking for second opinions to see what I might need done, but I will not have the money or ability to borrow it for years. I am still paying for the first surgery. I think I understand how you feel.

I filed a complaint with the insurance commision in my state against my insurance company. I am also writing my govenor to see if he might be interested in changing the law to where it is mandated that the State of Missouri requires insurance companies to cover tmj. Nothing may come of any of this, but it still makes me feel better.

Right now I am just trying to keep as busy as I can doing other stuff, and I visit several support boards daily.

Old 05-31-2005, 03:19 AM   #6
Senior Veteran
Join Date: May 2004
Location: USA
Posts: 1,409
luvtocamp HB Userluvtocamp HB User
Re: venting...

I think medical ins should pay for all things related for TMJ and dental should pay for the teeth only. The TMJ is a joint like all other joints and should be considered medical. We should all write to our congressmen. TMJ should also be studied in medical school so at least MD's can diagnose it and then send you to a TMJ specialist. Somehow TMJ just fell through the cracks.

Old 05-31-2005, 06:38 AM   #7
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Join Date: Dec 2004
Posts: 42
chloebell HB User
Re: venting...

The worst part about this is that before my husband and I were dating he was in a position where he was one of the head people negotiating his work's new contract and the subjuect of tmj came up. No one knew what it was and the insurance ppl acted as if it were a fake syndrome, so they did not even fight for it to be covered under their new contract. My dh always says that if he knew then what he knows now, he would have fought to the end for it to be covered. Also, I do clench my teeth at night and any time during the day that I am stressed out.

Old 06-03-2005, 02:42 PM   #8
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Join Date: Jun 2005
Posts: 19
Pablo2079 HB User
Re: venting...

If you snore, you might want to get tested for Sleep Apnea. The reason I say that is that my medical is covering a splint/night guard to reposition my jaw for apnea. Fortunately, the doctor that is making the splint for me is also aware of my TMJ. We're treating both, but billing insurance for the apnea.

If your insurance covers apnea, it might be the way to go!

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