Vertical Dimension and Muscular TMJ
I went to the University of Pacific's Orofacial Pain Clinic in San Francisco last Friday and wanted to give an update and ask a couple questions.
During the appointment the dentist reviewed my MRI, pano and other xrays and listened to my story. He poked around in all the typical places and had me do the typical things to evaluate my bite. He was pretty personable and spent lots of time talking to me about my situation while doing a light examination.
At the end of it all, he said that he feels the dentists that I've seen up to this point haven't done anything to hurt me. He said that my current orthotic puts my bite in the correct position in regards to left / right and foward / backwards position. However, he thinks that the vertical dimension needs to be increased. He thinks that my mandible and maxilla have been too close together all my life and that is causing my muscle problems. He arrived at this in part from evaluating my "swallow bite". He had me bite down and swallow w/ the splint and also just swallow naturally. When I bite down and swallow - he noticed it is more labored than it should be. He also noticed that when I swallow by itself my teeth do not touch. According to him, this isn't normal - the teeth should meet when swallowing.
His treatment plan is to come in for the electromyography to measure the "correct" position of the jaw. Add vertical dimension to my current splint to be in accordance to this position. He said that after this point it would be good to continue to work w/ my osteo and NUCCA chiro to make sure the relationship w/ the neck stays correct also. In all it would cost me about $1500 for him to do the EMG and modify my existing splint. He also told me to get x-rays of my teeth because from the pano, it seems my teeth my be recessing into the gums in response to all the grinding I did (or do).
Does this sound familiar to anyone? My main hesitance is that I'm not convinced about more vertical dimension helping me. My current TMJ dentist added a lot more vertical on my splint than previous splints and I thought it might have caused an uptick in my symptoms if anything.
Has increased vertical dimension significantly helped anyone's symptoms?