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TMJ Disorder -TemporoMandibular Joint Message Board
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Old 08-07-2009, 09:58 AM   #1
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jennck35 HB User
Your thoughts on treatment...confused

Hello....I am a TMJ sufferer. I've had symptoms for 3 years, but in the past 6mos my pain level has increased significantly and range of motion decreased quite a bit. I am actively searching for treatment and find myself very frustrated. I saw a dentist this week that claims to be an "expert" in TMJ disorder and treating it. After sitting with him for 5 minutes (without him doing an X-ray) and him looking at my bite and profile..he claimed that he could tell exactly what was wrong with me and then proceeded to lay out a 30 month-long, 4-phase treatment plan that would cost me almost $6000. It involves giving me 5 different appliances, each to be worn several months one or two at at a time, and then the last "phase" is to wear braces (which I already had as a child!!) which I'd have to wear for 12mos. He says that he is going to completely reposition my jaw and then move the teeth to where they need to be, and I will be cured. In a nutshell, he is telling me that the reason TMJ sufferers are in so much pain is because the damage to the joint and/or disc is causing the surrounding facial muscles to go into spasm and tense up. So its the jaw joint that is the root of the problem, that causes the muscle pain. If you fix the joint, then you fix the muscles, and then no pain.
I have also seen a chiroprator and done research on the web that tells me something completely different. I am learning another point of view that says its actually the MUSCLES that CAUSE the jaw joint problems. IN TMJ sufferers we have something called TRIGGER POINTS, tiny spots in our muscles that never release and are constantly tense, therefore causing pain which then affects the joint negatively. So its complete opposite of what a dentist tells us. Instead we need to release the tension, or trigger points, in our muscles, and then the jaw joint will go back to correct position, therefore curing a TMJ sufferers pain.
Instead of going ahead with the dentist's plan..i have decided to try a medical myofascial massage to see if it helps. I figure that a few massages at $50 a pop might be worth it instead of going through 2 1/2 years of painful, expensive dental therapy.
Does anyone have any info or comments regarding these 2 very different views on TMJ disorder? Thanks for feedback....

 
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Old 08-07-2009, 10:45 AM   #2
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Re: Your thoughts on treatment...confused

Quote:
Originally Posted by jennck35 View Post
Hello....I am a TMJ sufferer. I've had symptoms for 3 years, but in the past 6mos my pain level has increased significantly and range of motion decreased quite a bit. I am actively searching for treatment and find myself very frustrated. I saw a dentist this week that claims to be an "expert" in TMJ disorder and treating it. After sitting with him for 5 minutes (without him doing an X-ray) and him looking at my bite and profile..he claimed that he could tell exactly what was wrong with me and then proceeded to lay out a 30 month-long, 4-phase treatment plan that would cost me almost $6000. It involves giving me 5 different appliances, each to be worn several months one or two at at a time, and then the last "phase" is to wear braces (which I already had as a child!!) which I'd have to wear for 12mos. He says that he is going to completely reposition my jaw and then move the teeth to where they need to be, and I will be cured. In a nutshell, he is telling me that the reason TMJ sufferers are in so much pain is because the damage to the joint and/or disc is causing the surrounding facial muscles to go into spasm and tense up. So its the jaw joint that is the root of the problem, that causes the muscle pain. If you fix the joint, then you fix the muscles, and then no pain.
I have also seen a chiroprator and done research on the web that tells me something completely different. I am learning another point of view that says its actually the MUSCLES that CAUSE the jaw joint problems. IN TMJ sufferers we have something called TRIGGER POINTS, tiny spots in our muscles that never release and are constantly tense, therefore causing pain which then affects the joint negatively. So its complete opposite of what a dentist tells us. Instead we need to release the tension, or trigger points, in our muscles, and then the jaw joint will go back to correct position, therefore curing a TMJ sufferers pain.
Instead of going ahead with the dentist's plan..i have decided to try a medical myofascial massage to see if it helps. I figure that a few massages at $50 a pop might be worth it instead of going through 2 1/2 years of painful, expensive dental therapy.
Does anyone have any info or comments regarding these 2 very different views on TMJ disorder? Thanks for feedback....
HI there--I'm in splint therapy right now in phase 1 with a dentist, and have had tmj for 20yrs, so I'll put my 2 cents in. It is true, that with tmjd you will have muscular problems, and knots in your shoulders, neck, back area, but in my opinion, they are the symptom to a bite being "off" in some way, or another example may be some sort of trauma to the jaw area that dislocated a disc or both may contribute to this greatly as well. Some sort of teeth gearing problem or trauma, or bad dental or ortho work will definitely cause tmjd. With that said, the dentist's opinion you recieved I have a few problems with. Number one, how can he comment or give you an instant plan of attack without taking any tomograms, mri, or other tests to determine exactly what's wrong with your joints? I can understand if he sees something wrong with the bite, but I think he's jumping the gun on giving you a plan before thoroughly examining every angle of your case.
In my case, I had braces done wrong on me almost 20yrs. ago. This triggered major tmj symptoms starting with muscle spasms, periods of locking, and major pain. Present day I have a lot of damage to my discs, some arthritis, and bone loss--grating and popping of the joints, and major muscular problems. This all was caused by a bad bite that was done by orthodontal work. Just to give you an idea... I would seek out a professional who belongs to these 3 associations if you can..
1. American Academy of Craniofacial Pain
2. American Academy of Orofacial pain
3. American Academy Assoc. for Functional Orthodontics
Someone who uses Neuromuscular techniques as well as being thoroughly trained in orthodontics and Functional Jaw Appliances. Cross reference people on these associations and see who belongs to all three in your area. You have a better chance I believe going that route. Good Luck!!

 
Old 08-07-2009, 11:31 AM   #3
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jennck35 HB User
Re: Your thoughts on treatment...confused

Thanks for the quick feedback. I too don't understand how he can diagnose me without doing any kind of diagnostic Xrays, CT scan or MRI.
I also had braces 20 years ago....and this dentist also told me that it appears to him that my TMJ problems are a direct result of bad ortho work. He said the orthodontist put my jaw into incorrect positioning and it was only a matter of time before I started to have problems. But I'm not sure if I should believe that.

In addition to the massage therapy, I also have an appt set up with a different dentist that is supposed to be one of the best in the area (Cleveland suburbs). He specializes in TMJD treatment and I'm hoping to have better luck with him. He is a D.M.D. (doctor of dental medicine), and belongs to the following and does belong to The American Academy of Craniofacial Pain. Hopefully he'll be able to help me.

 
Old 08-07-2009, 11:39 AM   #4
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Re: Your thoughts on treatment...confused

HI Jennk35

I agree with everything JMitchell says. I believe that jaw problems and misalignments (TMD) cause muscle problems in the neck, head, shoulder and back rather than the other way round. I have suffered from severe TMJ for years and going to Osteopaths, Chiropractors, Physios and for massages didn't make an iota of difference to my tight and painful muscles until I started treatment to correct the position of the jaw. I now find these kind of treatments are very helpful as I am undergo splint therapy.

However before starting any treatment, you should do your research and be as confident as is possible for us patients that your dentist is knowledgable in this area and has done a number of tests so that he knows exactly what is wrong with your jaw.

Unfortunately, the reality is that getting the correct tests and treatment with a suitably qualified dentist is extremely expensive.

I was also told that my TMD was caused by bad ortho work I had 17 years ago. It makes sense to me, I had to wear head gear to push my teeth back into my head, now I've had an orthotic to push them back out again!

Good luck!

Last edited by canal19; 08-07-2009 at 11:41 AM.

 
Old 08-07-2009, 01:18 PM   #5
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bassclari HB User
Re: Your thoughts on treatment...confused

I agree with the others. If you are at all questioning diagnosis, then get a second opinion, and a third, and a fourth if you need to.

Funny, I haven't had any ortho work in my past, and still have tmjd. But, because I have heard that ortho can be the cause of tmjd, I am being very cautious about my kids ortho work now. I'm not allowing them to have any braces, etc until I get satisfactory answers regarding possible tmj effects. Even have orth assessments lined up with my tmj dentist to be sure they won't be taken down the wrong path.

 
Old 08-07-2009, 11:51 PM   #6
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pipdog HB Userpipdog HB User
Re: Your thoughts on treatment...confused

Hi Jennck35,

As others have said I think the dentist jumped the gun. You really need to have x-ray slices through your TMJs to see where the condyles are sitting and also MRI scans to show up any pathology with the soft tissue in there. They will be looking for signs of disc displacement, either to the front of the condyle or to either side.

From my experience this information is essential, otherwise you're proceeding on guess work.

About the muscular vs. jaw joint issue: If there is a disc displacement the muscles are going to go into 'guard' mode. The whole jaw apparatus is like a finely balanced mechanism where all parts have to act in unision. If one part is damaged other components i.e the muscles will attempt to compensate. This compensation puts them beyond their physiological capabilities and pain will result.

This is how the specialist I see has explained the condition. Furthermore something like 70% of the nerves in the body pass through the TMJ area so any advanced pathology there will cause a myriad of symptoms throughout the body.

I'm the third poster here who had earlier orthodontic work which must be more than a coincidence: had four healthy teeth removed and I'm pretty convinced if I had been left alone none of these TMJ problems would have arisen.

I've been through phase 1 and worn a pivot appliance but the disc hasn't been recaptured so I am scheduled for meniscoplasty surgery in Virginia next month

Last edited by pipdog; 08-08-2009 at 12:03 AM.

 
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