I am scheduled for an arthroscopy in my tmj speciaists office and am wondering if anyone can give me advise on if they would recommend this.
He assures me that he knows what he is doing and that no patients have had complications from this procedure. I am VERY scared- but since my situation is worsening daily I am thinking about doing it. My speech is becoming impaired and my health is bad. I REALLY would like people's views and experiences- it's scary to think that the outcome is irreversible-if it is not a good one- I have also read that sometimes the benefits don't last? Have others experienced that?My situation has been going on for about 6 months with worsening as it goes- as I have tried the just relax treament and it hasn't worked~nobody seems to have straight answers for what to do- except for this specialist who wants to do the procedure. ANY thoughts helpful. and thanks! PS- he has done several arthrocentrisis procedures but not arthroscopys.
Hi there--sorry to hear that you are in pain too...What other conservative treatments have you tried? I have had tmd for a very long time, with muscular pain, joint pain, etc...and recently started treatment from a neuromuscular dentist who practices Functional Jaw Orthodontics as well. I am in an orthodic, 24/7, that was designed from a neuromuscular standpoint, taking into consideration the muscles, and jaw function...It has brought my pain levels down by 50%. There are other avenues of treatment you can try, aside from the invasive procedure you are scheduled to have. Also, I would be very cautious having someone perform this if they haven't done it a ton of times. IMO, please get a second opinion from a tmjd specialist who practices NM dentistry, and Functional Jaw Orthodontics. Mainly, these dentists do non-invasive treatment for tmd pain, whether you've had it for 4 weeks, to 10yrs....it can help. Good luck.....J.
Thanks for the reply.
What is the orthodic? I did have braces before but this sounds different? Also, my situation is that my opening is SOOO minimal probably less than 10m
I need something quick and I DO appreciate your input! How quickly do you think that would work for someone in my position? Thanks again for your input!
Hope you are well
I'm really surprised you haven't had more conservative treatments, especially an orthotic (splint typically worn for severe cases 24 hrs a day). Most insurance companies won't approve surgery without this. I would ask your doctor why he/she hasn't tried this and I would get a second opinion. Try an ICCMO doctor or if insurance doesn't work with them try another oral surgeon who specializes in TMJD. I am scheduled for open joint surgery but it wasn't until we tried many, many other conservative treatments first. This includes but is not limited to physcial therapy, medicinal treatment, chiropractic, several different types of splints, massage therapy, etc.
If you do end up needing arthroscopic surgery, know that these have proven to be very successful for many people. It is the most conservative form of surgery and it can work, but you should try all conservative forms of treatment prior to surgery. Surgery only works if there is true structural damage to the joints. Best of luck to you and please don't hesitate to come forward with more questions.
THANKS for your reply
I have tried massage and am doing cold laser-also have tried acupuncture and tried to do small front splint and did not work, I did not tolerate meds for other splint and went to UnivDDs/TMJ for help and spent the last month trying their relax therapy which did not work-so I went to this DDD/TMJ and I don't know if procedure is the right thing, but I feel that my jaw is trying to close up completely and that I have very little time
I am not sure I have time for another consultation before that happens and I need to go back to work or I will lose my job and my health benefits- I am in a bad spot! I know my discs are displaced and that my jaw has become so much worse over time. I am VERY scared-what can anyone do when your jaw is closed? I need to be able to talk! My job requires a lot of talking!
Thanks for your reply! and encouragement.
please give more thoughts
What a Neuromuscular dentist who practices Functional Jaw orthopedics, and orthodontics can do for you is this....They will do a thorough exam of the muscles in your head, neck, jaw area. They will take the appropriate x-rays, and do NM testing like EMG, CMS, K-7 unit testing, and use a tens unit which relaxes the muscles, (uses prior, and during the testing..) and then make an orthodic for you if need be. What a neuromuscular orthodic does is bring your condyle bones out from the joint a bit, in a down and forward position, to relieve pressure on nerves, and put them in a more favorable position. IT can eliminate muscular constriction around the joint, and in the neck and face....(probably what is causing you to have such a restricted opening right now...along with possible disk problems...)..It is a hard, acrylic , bumpy orthodic that fits over the bottom teeth, worn 24/7, even while eating. Over time, this can eliminate muscular pain, dizziness, and many other symptoms. I have been in a new orthodic since Dec. 30th of 09, and my pain levels went from a 10 and off the charts....to around a 5 within months....I hope that helps! .....Also, an orthodic alone will not get you 100% well. You will need to find a good OMT.....Orthopedic Manipulative Therapist, for physical therapy, and probably a massotherapist to alleviate muscular tension in the upper back, neck areas.. Take care, J.
I am glad you have tried so many other types of therapy. I understand the fear and frustration that comes with a continual decline in your health. My jaw too is tightening up. In January I could open 32mm, today I am between 13-17mm on average. I continue to go to physical therapy and use a therabite to exercise my jaw but it isn't increasing my opening much, but at least it seems to have stopped the decline some or at least slowed it down.
It sounds to me like you are in a position where you need intervention. Please do not fear the arthroscopy too much. I know many people for whom this helped at least on a temporary basis (years). Just remember that after surgery you must continue with physical therapy, and when that is done you need to continue to exercise your jaw. This is what will help you keep the benefits you gain from surgery.
If you have any more questions or concerns that I may be able to help with please don't hesitate. Do you know yet when your surgery will be?
Thanks for your quick reply
Yes- I am in a VERY tight situation with my jaw and hope that the procedure will help!
One DDS says it is muscular and this guy says he can help me open by flushing the joints etc. I hope he is right! I wonder how long the effects will last?
the procedure is scheduled for WED this coming-
Thanks for your thoughts and support- I need it.
Any other thoughts?
I will check in later.
Have a good day
I would plan to be down and at home for about a week after surgery. Surgeons will always say you'll be up and running in a few days, but anyone who has gone through surgery will tell you different. For mine, since it is more invasive, I will be taking two weeks off.
Plan for a no chew type diet for a while. I found a great cookbook called "dinner through a straw without the straw". If you google it you will find the website. The book is only about $5 and is very helpful with recipes and tips for recovery.
Buy yourself a child size toothbrush in case your opening is very limited for a while. Also get yourself a baby spoon for the same reason. Make sure you have a good blender and someone to help you out for a bit. I'm having my aunt stay with me for the first few days after i'm discharged from the hospital. With your procedure it is outpatient I would assume, correct? I think you said it would even be done in the doctors office.
I hope this helps. If I think of anything else I will let you know. Just remember to take deeps breaths and remind yourself often that this will hopefully help you feel a thousand times better for years to come!
thanks for your reply!
I am wondering and hoping I am doing the right thing.
Dose it seem like this is an approp measure for someone whose jaw has been locked up for about 6 months?
I am not sure what else would help in a timely fashion or at all at this point.
Do the poss benefits outweigh the risks?
Or am I just making a hasty and horrible decision?
I have been eating pureed foods for several months.
I am scared to do this- but scared NOT to!
How does anyone live with a closed jaw?
Thanks for your thoughts!!
what kind of opening do you have? That all sounds GREAT, but my opening is sooo minimal that I don't thing I could get into any of that asap and feel like I have no time!
I wish I would've talked to you sooner!
Thanks for all your thoughts- I don't know if I have true structural damage-but should I trust that the DDs read my MRI and knows what to do?He is also suggesting this because I am so locked down and it has been going on for awhile-he assures me that this will be the best way to open me up-but I am LEERY because he has not used this equipment before- even though he has done the procedure- or similar before- many times he says.
Does this seem reassuring?There are not too many tmj specialists in my area and I am running out of time! Do I go ahead and do it and hope for the best? Scared of all options!!
Thanks for more info and thoughts
I'm sorry it took so long to get back to you; long night at work!
My suggestion to you is go by your gut. If you don't feel comfortable with this doctor and the procedure, you need to either sit down and talk to him in greater detail, sharing your thoughts, or you need to find a different doctor.
I would never allow a doctor to do surgery on me unless I felt I could trust him. I need to know what exactly he is doing and why it is being done. The doctor must have great experience in doing the procedure for me to feel reassured. I also need to know everything has been done that can reasonably be done. I say reasonably because for me I know there were a couple more things I could have done, such as acupuncture. My doctor and I agreed though that there was nothing else out there that could prove to bring me healing.
You need to be sure you have structural damage before going through with the surgery. Any good, solid surgeon will tell you this is the only way surgery will prove effective. Due to your limited opening, I would believe there is structural damage but you need to be sure.
So really in summary, I recommend going with your gut. If you are not comfortable with what is ahead, don't do it. Take time to really find out what is going on. Talk to you doctor and get another opinion. It will be worth it in the long run. I wouldn't worry too much about your opening totally closing down. Another couple weeks will not make much of a difference.
Keep us posted and please, if you have any more questions or just need to talk, I am here to listen.
Thanks so much Laura,
I really appreciate your input.
I am going to talk to him some more and see if we can do some less invasive stuff-although I have put down a deposit-because I am thinking I could do some mobilization technique that he wanted to do as well.
Have you heard of that? I wonder if he could get impressions for splints if he gets my mouth open enough- or ho long that would take?
I need more opening so I can do my job in 2weeks! I really can't imagine that at this point and I am so freaked because my speech is impaired- it DOES seem to be getting worse each day I am having a hard time eating enough etc.This sucks!
I just wonder if my jaw is still functioning I don't want it to be permanently damaged- or is it already I wonder- what a mess!
Thanks so much for your thoughtful replies- J will check in tomorrow.
I need to figure SOMETHING out now!
Peaceful thoughts to you
Yoga G.---How long have you had the minimal opening? Was it something that came on sudden? or was it progressive? Did you research to find a neuromuscular dentist who practices functional jaw orthodontics yet? Please try and consult with one of these docs before entering into surgery. There are things less invasive that they can do without the risks of surgery. Since i can't post where to find these guys anymore, you will have to research under Neuromuscular dentistry, and Functional Jaw Orthodontics. If the closed lock was something that happened rather recently, you may be able to gag yourself to recapture the discs...I've done this many times myself, and it worked. The position the gag puts the mandible in will sometimes move the disc back into place. I know it sounds strange..but it's non-invasive. It needs to be a hard gag though. (I know it sounds gross... ) Good luck with everything...J.
Also, do not limit yourself in the area that you live---for finding a good specialist. I travel 2 hours to see mine, and I've also traveled 11 hours for a consult before. It's worth the time and money. Surgery is always left as an absolute last option, and usually it's with patients with trauma cases....