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Old 09-11-2009, 11:56 AM   #1
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Getting a new bite splint

Hi all. I'm getting a new bite splint and had some questions for those with experience.

When you see a tmj specialist, what sort of xrays and measurements do they do? They've got this machine hooked up to a computer and place a magnet in your teeth. The machine tracks your jaw motion and allows them to find the best place for your condyle to sit, and how to adjust the splint. Does anyone know what it's called?

I've had the consult, and next up is the xrays, then next visit is the tens to relax the muscles. Do you get it right after the tens treatment?

At what point do you get your splint?

Also, I'm concerned about speech impairment. For those who've had a MORA or Gelb type with the lower molar acrylic parts and the metal bar behind the lower incisors, how much does this affect your speech.

I know I don't have a lot of choice in doing this, as arthritis has developed and it's do it or get worse at this point. Mainly, I'm just looking for answers to help reduce the anxiety from the unknown.

 
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Old 09-11-2009, 02:27 PM   #2
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Re: Getting a new bite splint

Quote:
Originally Posted by bitefright View Post
Hi all. I'm getting a new bite splint and had some questions for those with experience.

When you see a tmj specialist, what sort of xrays and measurements do they do? They've got this machine hooked up to a computer and place a magnet in your teeth. The machine tracks your jaw motion and allows them to find the best place for your condyle to sit, and how to adjust the splint. Does anyone know what it's called?

I've had the consult, and next up is the xrays, then next visit is the tens to relax the muscles. Do you get it right after the tens treatment?

At what point do you get your splint?

Also, I'm concerned about speech impairment. For those who've had a MORA or Gelb type with the lower molar acrylic parts and the metal bar behind the lower incisors, how much does this affect your speech.

I know I don't have a lot of choice in doing this, as arthritis has developed and it's do it or get worse at this point. Mainly, I'm just looking for answers to help reduce the anxiety from the unknown.
Hi--I just got my repositional splint a few months ago. My dentist is a functional jaw orthodontist, and he does neuromuscular dentistry as well. Along with the jaw tracking machine, (which is called the K-7?) they also do a LOT of tomograms (x-rays) before fabricating the splint. After they take the jaw measurements and all the testing, (emg, cmg, etc.) they have you bite down on this extremely stinky blue material like playdough, and they actually use that to take some x-rays, and fabricate your repositional splint, or whatever splint you are getting. It sounds like if you have jaw arthritis, (like me) they are going to make a lower full arch hard acrylic repositional splint, so your mandible rests and pretty much stays in the bumps or grooves. Over time, the muscles usually relax, and thus the new mandible postition has developed. I'm not going to lie, it is horrendous to eat with it in, but after a few weeks, it was a piece of cake. As far as the muscular spasms though that I got from the splint bringing my jaw forward, it took 3 weeks for them to subside. (and they still get bad from stress) ..Good luck, and if you have any more questions, let me know!!

 
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Old 09-11-2009, 04:22 PM   #3
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Re: Getting a new bite splint

Thanks for the reply. He said from the initial consult visit which included palpation, opening, closing, lateral measurements and the panoramic that he was expecting to be choosing the Gelb type for repositioning. I do have a fairly large overjet and retruded jaw position. I was also concerned about being positioned too far forward. Is that possible? How do they choose where to position?

Were you able to speak well fairly early in the treatment? Does it start out thin and get thicker as they make the adjustments?

My condyle is flattened from the disk being anterior for so long. But I've read elsewhere that it can remodel and the cartilage heal in time with treatment. I'd be interested in anyone who's had that experience as well.

So much to think about. The current recommendations from the TMJ association and other large orgs are to start with a non-permanent splint first. I'm wondering why he would possibly skip that and go right into the forward positioning type.

 
Old 09-11-2009, 04:59 PM   #4
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Re: Getting a new bite splint

Quote:
Originally Posted by bitefright View Post
Thanks for the reply. He said from the initial consult visit which included palpation, opening, closing, lateral measurements and the panoramic that he was expecting to be choosing the Gelb type for repositioning. I do have a fairly large overjet and retruded jaw position. I was also concerned about being positioned too far forward. Is that possible? How do they choose where to position?

Were you able to speak well fairly early in the treatment? Does it start out thin and get thicker as they make the adjustments?

My condyle is flattened from the disk being anterior for so long. But I've read elsewhere that it can remodel and the cartilage heal in time with treatment. I'd be interested in anyone who's had that experience as well.

So much to think about. The current recommendations from the TMJ association and other large orgs are to start with a non-permanent splint first. I'm wondering why he would possibly skip that and go right into the forward positioning type.
Hi there--I'm not familiar with the Gelb splint, but I would research it on the internet if you really want to get all the info about it. I've looked for it in the past, but can't remember too much, I think the creator's name was Harold gelb. Anyways, in my case, the x-rays, coupled with the "mock" splint material gave my dentist the measurements that they needed, supposedly down to a 10th of a millimeter, to the proper condyle position. I'm going to bump up a previous post of mine that lists all the tests my dentist does, and you will get a better idea. If you can't find it, send me a message and I'll help. It sounds like to me, from what you are saying , that if you have degeneration of your condyles, and arthritis, and an overjet with a mandible that is not in the right place, you need to go into something more aggressive, like me. I hope that your dentist explained what the next steps for you would be after he gets your mandible in the correct position. Usually it's braces, crowns, or equillibration, to get the bite to correspond with your new mandible position. Honestly, this is the part that is scary. You need to make sure your tmj specialist is highly skilled in orthodontics, preferrably a Functional Jaw Orthodontist, and also is excellent at crowning and stuff of that nature. In my opinion, any Tom or Dick off the street can put you in a splint, but it takes an expertly skilled dentist to finish the cases after phase 1 is completed. As far as your question about talking,,,it depends on how thick your splint will be. The thicker it is, the more lispy you will sound. You will get used to it, mine took about 3 weeks to really get used to. I'm not going to kid you, this is the toughest thing I've ever had to go through, and I've had 2 kids without drugs---if you know what I mean..
Look for the post with the list to ask the tmj doctors, I'll bump it up..it was to Silverwings from sometime in June.. Take care, and let me know if I answered everything ok..
Questions on the old post are on page 3

Last edited by Jill 227; 09-11-2009 at 05:06 PM. Reason: forgot

 
Old 09-11-2009, 05:29 PM   #5
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Re: Getting a new bite splint

He specifically brought up orthodontics for a phase II option. I also noticed a dental restoration wasn't mentioned. Lol. I think it would be impossible or cost as much as a new house to do it. He said that comes later, but hearing it won't be a shock to me. An ortho restoration is the least I'm expecting to hear.

Years ago they wanted to do orthognathic surgery. But as I understand now, mine is a borderline case, not a clear cut no other option case for the surgery.

I'm going to shoot you a pm. We're in the same state. I wonder how close. Your treatment does sound a lot like what they're going to do with mine. It will be nice to have someone to compare notes with.

He did tell me if the pain was joint related to expect the symptoms to clear up within the first week. I don't recall if the muscular symptoms were supposed to clear up on day one, or take longer.

 
Old 09-11-2009, 06:01 PM   #6
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Re: Getting a new bite splint

Quote:
Originally Posted by bitefright View Post
Hi all. I'm getting a new bite splint and had some questions for those with experience.

When you see a tmj specialist, what sort of xrays and measurements do they do? They've got this machine hooked up to a computer and place a magnet in your teeth. The machine tracks your jaw motion and allows them to find the best place for your condyle to sit, and how to adjust the splint. Does anyone know what it's called?

I've had the consult, and next up is the xrays, then next visit is the tens to relax the muscles. Do you get it right after the tens treatment?

At what point do you get your splint?

Also, I'm concerned about speech impairment. For those who've had a MORA or Gelb type with the lower molar acrylic parts and the metal bar behind the lower incisors, how much does this affect your speech.

I know I don't have a lot of choice in doing this, as arthritis has developed and it's do it or get worse at this point. Mainly, I'm just looking for answers to help reduce the anxiety from the unknown.
The x-ray you are referring to is a tomographic x-ray which is a giant machine that rotates around your head seeing how the teeth fit and where there might be a problem.

Also they are wanting to see where your teeth should be in order for pain not to occur which is why they may have you do exercises during the process.

The splints you have mentioned I have never heard of and I would be careful because many are outdated. I have very little speech impediment with mine and most splints shouldn't affect the way you talk after a week of wearing them.

You get your splint after they do impressions of your teeth (upper/lower) and then however long it takes for that office to complete it. I've had one in 2 days and I've had one in 12; it's different for every office.

Medical treatment for TMJ is getting better and better so I wouldn't lose hope. Generally the pain is muscle spasms from the bite being off and those muscles compensating (as would any other place in the body would do, it also affects the areas around it).

Any modern splint should not make you lisp or have speech impediments.

 
Old 09-11-2009, 07:15 PM   #7
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Re: Getting a new bite splint

He didn't call it a gelb, but it looks just like one with the two acrylic bite pads which cover the mandibular molars and the lingual bar that runs behind the lower incisors. It looked fairly easy to deal with, and not very thick. Maybe a couple of mms, but I guess the thickness you get depends more on your own anatomy and function rather than some standardized measurement. Esthetically, I can handle a little more vertical which would actually approve my appearance. But too much forward is going to make me look a little witchypoo.

What are the chances of things progressing if I don't do this treatment? It's been 20 years since I was first diagnosed. I don't have too many functional problems yet, just lots of pain that waxes and wanes. The pain in my ear and jaw just started a few months ago. Prior to that my symptoms were severe headaches, and have gotten to be a couple times per week or more during the worst spells which can last for months at a time.

If there is condylar flattening, is that a pretty good indication this is a progressive problem and will continue to get worse?

I'd ask the doc these questions, but their office was closed before I thought of them. Of course. Lol.

 
Old 09-11-2009, 07:34 PM   #8
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Re: Getting a new bite splint

Quote:
Originally Posted by bitefright View Post
He didn't call it a gelb, but it looks just like one with the two acrylic bite pads which cover the mandibular molars and the lingual bar that runs behind the lower incisors. It looked fairly easy to deal with, and not very thick. Maybe a couple of mms, but I guess the thickness you get depends more on your own anatomy and function rather than some standardized measurement. Esthetically, I can handle a little more vertical which would actually approve my appearance. But too much forward is going to make me look a little witchypoo.

What are the chances of things progressing if I don't do this treatment? It's been 20 years since I was first diagnosed. I don't have too many functional problems yet, just lots of pain that waxes and wanes. The pain in my ear and jaw just started a few months ago. Prior to that my symptoms were severe headaches, and have gotten to be a couple times per week or more during the worst spells which can last for months at a time.

If there is condylar flattening, is that a pretty good indication this is a progressive problem and will continue to get worse?

I'd ask the doc these questions, but their office was closed before I thought of them. Of course. Lol.

that sounds something like my daytime splint wherein is does not cover the incisors but rather the back molars because that is where tooth alignment occurs.

by condylar flattening do you mean the bone wearing down? if so, then yes, that's a huge problem. the disc would slip out and there would be no meniscus type padding in your jaw. it would be incredibly painful.

if the problems are getting worse see a doctor immediately and see a specialist. mine happened all of the sudden and started with vertigo, dizziness, and disorientation. mine left me feeling insane. part of me wishes it started off with pain so people would have taken me way more seriously.

 
Old 09-11-2009, 07:41 PM   #9
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Re: Getting a new bite splint

It is the bone wearing down. He commented that my disc has been anteriorly displaced for a very long time, and that's how determined it. He walked right in after looking at my xray and said "you have tmj". I kind of raised an eyebrow and looked at him like, "well, yeah!" I wish someone had told me 20 years ago this could happen. At the time I thought it was no big deal. It didn't matter anyway. I never had the money or insurance to take care of it. So it is what it is, I guess.

Can you tell I'm trying to weasel out of this treatment process? Lol. I'm still trying to find a way to minimize it. "Oh, I'm not in that much pain." or "What if the treatment makes it worse." Or "I usually only have headaches, so why should I do this?"

I've been putting this off so long because other things were more important. But I don't want to end up with a worse problem than it is today.

Last edited by bitefright; 09-11-2009 at 07:43 PM.

 
Old 09-12-2009, 11:19 AM   #10
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Re: Getting a new bite splint

this could be a big wake up call for a lot of people. there are so many problems we have that actually ORIGINATE with the jaw out of balance and can create other disorders to mask it. for example i was seeing a neurologist for a short few months and he did a brain scam, no tumor, so he sent me away with a migraine diagnosis. it felt more like he couldn't figure it out so he just stamped something on it.

ear problems, sinus problems, cramps in the neck, eye pain, vertigo, all these things could be TMJ masking itself and I think more people have some strain of it to a degree.

Now there are some people I've run into who claim to have TMJ and have none of the symptoms but rather take poor care of themselves and carry a lot of stress. Sometimes, depending on the severity, people can live with very mild TMJ and make a few lifestyle changes. But I think the people on here have had it to where they have seriously considered chopping their head off. These people irritate the hell out of me because they are in no way hindered and know nothing of TMJ.

I have a very large soapbox.

 
Old 09-12-2009, 01:24 PM   #11
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Re: Getting a new bite splint

Funny, Velvet. I've had almost all of the tmj symptoms since my teenage years. I was diagnosed with chronic fatigue first over 20 years ago. Then myofascial pain disorder over 15 years ago. I've been put on antidepressents 3 times over the last 20 years and they never help. The cymbalta helped because it decreased my anxiety problem considerably, but I never felt clear headed or energized and lost interest in everything. I so admire people who can go, go, go, and only drop when it's time to hit the bed. Since my teenage years, I've never been able to do that again.

If doing this could get me my brain and energy back, I suppose that would be a very worthwhile endeavor.

But in my mind, I still try to minimize things. Maybe that's how I've been able to deal with it so long, other than only recently the pain has been going from the moderate to severe category more frequently and lasting longer.

 
Old 09-15-2009, 07:21 AM   #12
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Re: Getting a new bite splint

Well, I had the tomo's done yesterday it they showed marked degeneration of both condyles. Judging by the presentation on the films, I was told it looked like I'd be wearing the splint for the rest of my life to prevent further damage.

Apparently, they can't tell from the xrays if there is arthritis or not. But mind does look like an advanced case.

So glad I'm not severely affected by it like some here, and hoping we caught it in time and can stop the damage in it's tracks.

I feel like I could just cry at this point.

 
Old 10-06-2009, 07:54 AM   #13
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Re: Getting a new bite splint

oh yes, me too, but crying only makes my jaw hurt worse. I have to interject that when I had my tomo, and he saw the degeneration of both condoyles, he only told me to go to PT, thats it and sent me on my way.........................so frustrating!!!!

as a side note, he also said that some people have the degeneration and never have pain?? can you believe that?

 
Old 01-17-2010, 08:14 AM   #14
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Re: Getting a new bite splint

wondering if you ever got the bite splint? How did it work out for you?

 
Old 01-18-2010, 04:29 PM   #15
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Re: Getting a new bite splint

Hi.

I did get it, and got some relief but not 100%. I have had a few pain free weeks. The headaches are much, much better. The earache took quite a while to clear up, and is the first thing to come back with a flare up. It still feels a little off, like when you feel like you need to crack your knuckles, if that makes sense? And in some ways there is more persistent discomfort in a different area than before the treatment began.

I will likely be looking for a second opinion in the short term, as it doesn't seem like things are progressing as originally promised, and it doesn't seem like there is a whole lot of concern about the symptoms I continue to have, almost as if it's getting perceived I'm making it up. Or maybe I've used up my allotment of office visits on the contract and now won't be getting any more consideration until the contract is expired and I have to pay more money.

Whatever it is, I'd like additional input. It's not a nice feeling to continually get the brush off, especially after making such a big investment of time and money.



I'm happy with the results so far, but feel like it could be better than it is now. And why not go for 100% relief if it's at all possible?

 
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