HI---LIke I stated before, with acute locks, (less than 6 mo..) sometimes tmj specialists will inject lidocaine (sp) into the joint, to cause pressure and hopefully move the disc back into place..this is just one procedure that can be done in the dentists' office....but it's invasive, so that's why I want to ask my tmj doc. what he would do in that situation. Yes, you can be unlocked, and Yes, you definitely can function afterwards, regardless if your discs are recaptured or NOT. The posterior ligament will act as the disc, in its place in some cases, and a normal opening will return. It is not a hopeless situation by any means. Take care, j.
I guess I am just freaking out because my lock has been that long- not this severe, but that long and I am finding it very difficult to eat, etc!
Thanks so much for all of your input! I right need support right now.
Hope you are well
Is this TMJ specialist who is proposing to do the arthroscopy a Maxillofacial surgeon Ė if not then I wouldnít want him to carry out the procedure, especially as he hasnít done that before.
The reason they might be telling you itís the best treatment for you, and not suggesting neuromuscular dentistry is because the method they are suggesting to you is the mainstream treatment option. The neuromuscular dentistry is not considered to be mainstream, but I believe itís actually better and less invasive than the more standard mainstream options.
I see you mention you had an MRI. What did that tell you is wrong with your TMJ?
I have TMD but have not experience closed lock. But from things I have read, I understand that if you are not able to open your mouth wide enough for a neuromuscular dentist to make impressions for a splint, then they can make you a different sort of temporary splint to start without impressions. Have you also tried looking on the AACFP group of dentists?
Hi, Thanks for your reply. Yes it is a tmj specialist using a new piece of equipment. He has done the procedure before with older equipment is my understanding. I wish I would've heard of the nueromuscular DDs earlier I feel like I don't have time to find one and get an appt, due to my work deadlines and my situation. My opening is EXTREMELY limited and seems to be getting worse.
My MRI showed anteriorly displaced disks with linear fluid signal through middle of one, with a tear/perforation- if that means anything to you. No osteophytes.
My main problem has been my opening that is really locked down and scary-impeding my speech now and I feel like this is an issue that has to be resolved in a very timely fashion. They are planning the arthroscopy/arthocentrisis for this week.
Any other thoughts?
yogi-ps what is the other dental assoc you mentioned, I am not familiar with the initials.
Thanks- peaceful thoughts to you
The group AACFP is the American Academy of CranioFacial Pain. My TMJ dentist who I see in the UK is a member of that group. The neuromuscular dentists use splints to change the position of the jaw, as an incorrectly positioned jaw is what could have caused the anterior displaced disc in the first place. They would be able to tell you if it’s the position of your jaw that is the problem. If you have surgery and the jaw is still incorrectly positioned, then the surgery wouldn’t be addressing the route cause of the problem, although it might ease the symptoms for a period of time. The trouble with the neuromuscular dental treatment is that it’s not normally covered by medical insurance.
Thanks for the reply.
I don't think my jaw is in bad position- just disks are displaced and my opening is minimal. I don't know if that is seen as structural damage which Laura sia was the thing surgery would help. I am wondering if the procedure will help with my opening mainly and how much?
If it can, that is what I am looking for- because it has been so long that this has been going on. I need help! If my mouth closes any more it will be totally locked
I didn't know my jaw was incorrectly positioned until the TMJ dentist told me. I have anteriorly displaced discs, and if my lower jaw is moved forward my a few mm's with a lower splint, they can be recaptured. Apparently as my jaw was slightly too far back, this caused my discs to become squeezed out of position. It caused me clicking and cracking in my TMJs on opening and closing, and facial and neck pain, but not severely limited mouth opening.
I tried to see if I could send you a private message but you don't seem to have that facility switched on. Is there a neuromusular dentist near to you who you could see for a second opinion? I'm not sure where abouts you are. I wish you all the best with what you choose to do.
Hi Jill Any thoughts from your specialist?
I am due for my procedure manana and I am VERY apprehensive- wondering ahwt else could be done to get me back to work by end of next week- wondering if this will be the greatest thing or something else.
Hope u are well
Have you talked with your doctor some more? I really recommend sitting down with him and sharing your concerns and questions prior to the procedure. It really is best to work through your fears and hesitations and I doubt he would mind. It is imperative that you not go into this with such heavy anxiety. It will not help you any as you go through the surgery and recovery. Please, please, set up a time to talk with him. It won't hurt anything and really, the only effect on you it could have would be positive. It will give you a more definite sense of whether or not you want to pursue it.
Hi, Laura, I am new to this site but not to TMJ. I have had it about 25 years. I am wondering if you could give me the doctor's name you are scheduled to have surgery with. I have seen a dr. in Dallas and he has diagnosed me with degenerative jaw joints and recommended surgery. I need a second or third opinion before I make a decision. I appreciate any names you might have. I am willing to travel. Please also explain what an ICCMO dr. is. Thanks so much.
A ICCMO doctor is one who specializes in cranio-mandibular orthopedics, such as a neuromuscular dentist. I have not seen one as my insurance does not cover it and I do not have $6,000 to spend on an alternative treatment. I have heard they can help wonderfully for some people though.
I am currently seeing an oral surgeon from Johns Hopkins. I have started seeing him at his private practice in Catonsville, MD. His name is Dr. David C. Bastacky. He has been awesome so far and likes to take things as conservatively as possible. I have had many people tell me he is one of the best and so far I agree.
Yogi gal----Since my appt. Mon. was very brief...I'm going to email him now, and post what he says about your case. I know for a fact that he would say NO surgery. Can you postpone the surgery til next week, til you have more time to think about it and get more feedback? I will post more asap. Take care, J.
YogaG.----Here's his opinion on your case....."I've never had a patient, that I've not been able to at least fit with a soft splint...(he's been doing tmd for 20yrs.)....How he would open your bite a bit first off would be: Ice, Heat, ptyerygoid massage, tens unit therapy, muscle relaxers if need be...No surgery. Also, if your mandible is in the incorrect position, any amount of surgery will not correct the fact that your condyle placement is not good...Hope this helped.....
Wish I had gotten that sooner. What if someone did an arthrocentesis? has anyone benefitted? How long would the positive results last? I am in splints now and must get back to work next week- but /i am SCARED because I have to do so much talking AND I HAVE to pay back all my health bills. Need to stay calm and looking for answers. Any thoughts/ideas?
Thanks for your quick reply.
Yoga Gal- I have been following your posts bc I to am scheduled for the surgery and am nervous as well. Did you have the arthroscopy or did you post pone? I was wondering if your better if you did have it?
Hope you are doing ok.
I would advise against it! I did not do it-but did something else I regret and think you should be very cautious! Get lots of expert opinions and chose surgeon carefully if you do decide to do it.
I have had arthrocentesis done. According to the Mayo Clinic and Hopkins, arthrocentesis has positive, long lasting results for most people (95% success rate). My surgeon said a lot of times that is all his patients need (if the splint doesn't work which most cases it does). It is extremely rare anyone ever needs intervention beyond a splint, let alone arthrocentesis.
I had it done along with cortisone injections. It only helped me minimally for a couple weeks. The reason this is, however, is the majority of my problem is structural and the result of a trauma. Like Jill has said, the only people who ever really need surgery are those who have had a trauma to the jaw. Mine was the result of a 2.5 story fall onto the gym floor, landing directly on my jaw. I was 7yrs old at the time.
I hope this helps you. The arthrocentesis was minimally invasive (just needles) and I went home about 10-15 minutes after I woke up. You do not have to be put under IV sedation but my doctor advised to do it since my opening is so small and he needed to move my jaw open/closed a lot. I was feeling fine after two days, though many people say they feel better the moment it is done. So it really is a person by person basis.
Yogi- Thanks for the advice. I have done quite of bit of research about my doctor, he does specialize in TMJ, and have read some of his patients results. He is a haughty doctor but he does know his stuff. I feel similar to you when you said you were worried that it would get worse if nothing was done. The doctor said this is best option to try and fix the issue. My right disc is stuck and i can't open fully nor move my jaw to the left side at all which he says shows more that the disc is in the wrong position. He says without the surgery and leaving disc in that spot could cause more damage.So right now I am scheduled for arthroscopy in June when he will go in move disc back and suture in place, He says the suture will fall away in a few months, so hopefully its the right thing to do. Im sorry to babble on, but its hard when your not sure if your starting to go down this road where there is no return. The only thing that gives me a little hope is that with my TMJ I didnt always have this problem, its only been like this for 3-4 months. So Im hoping seeming its still semi recent with the stuck disc it can be undone. Sry for not knowing alot of the proper words in regards to everything.
You said you were thinking arthrocentesis and I had that done about a month ago and for me it didnt work. the day of the procedure my opening had increased greatly but within a day it was just about back to where it was, stuck. I hope for you, yours works, everyones different.
Hi Laura and Chicklett,
Your responses have been very helpful.
I am sad about my situationas I think the arthocentesis was a mistake- I am wondering Laura, if you or Jill could address the next question- will splints work AFTER the procedure-as my tmj says they will and that is what his path for me is- my opening varies between almost two fingers to more toward one and since the proc.(which I regret but friend scared me into- different long story) so I am just wondering if things can STILL get better ? (I HOPE) or if I will go back to the tiny unlivable opening I had before? I am hoping I can at least maintain the somewhat larger opening. My person said I could should start to chew soft foods by now too.
I am just needing to tell my boss if I will return to work and I HAVE TOO!!!! Will I be able to talk a lot as I need too? Thoughts and wisdom ASAP very appreciated from Laura or Jill.THANKS!!! wish things were very different.
Have a great day- So Laura, I just read your last post- do you think there is still hope for me?!! Please be honest- in the mean time I am wearing splints and doing my pt. I have a follow up appt Thurs.