Hi,
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.
yogi
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.
hi Laura,
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
Yogi
Yoga G.,
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
Yogi
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!!
Jill
Thanks!,
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!
Yogi
Laura
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
yogi
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
yogi
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....
Jill,
Thanks for the reply!
The minimal opening has been with me for several months! Dec? and it has been getting progressively worse and now it is so minimal I can barely speak
I have been unable to work for the past month and half and now my leave is coming to an end- I am desperate for relief and wonder how I could even get into a splint- one of my DDs/TMJ univ specialists doesn't even think I need a splint- I am SOOO confused!Time is of the essence- but I don't want to do anything else stupid that will make it worse! I am soo scared.Mine was not caused by trauma such as accident, but by opening mouth too wide I guess on several; occasions during sinus condition. Is it too late for me? This TMJ specialst also wants to try jaw mobilization while I am sedated. Have you heard of that?
The way my jaw is feeling soo not wanting to move at all- I am thinking I need to do something quick!
I hope you read this today and respond.
Thanks for your input!
Yogi
HI---I am actually traveling up to see my tmj specialist on Mon. for my appt., so I will ask him how he would go about starting treatment on someone like yourself, with a very minimal opening. I am familiar with the joint mobilization under sedation, and to be honest with you, that is risky as well. Think about it...someone is going to manipulate the delicate workings of your tmj, not really knowing if they are causing further damage to the ligaments, discs, etc. I have heard of some tmj specialists injecting lidocaine (sp) into the joint, to cause pressure and possibly shift the disc back into it's place...and then giving the patient a soft splint until the joint has time to rest, and until the neuromuscular testing can be completed....but I would have to ask him about how he would handle your case right off the bat, to get a better idea. Did you try the gag reflex trick yet? If it has been dislocated since Dec...you may still be able to recapture the discs...time is of the essence though. I will get back to you on what my dentist says on mon. afternoon. Take care, J.
Hi Jill,
I tried to search for some nueromuscular DDS's yesterday and left a message with one- many are not open on Fri
My opening has been so minimal for awhile and it did happen gradually- I am wondering if the gag will work- or anything? Do you think my jaw will still function? I need to do something NOW and it's so frustrating because there aren't any clear answers it seems. The other bad thing is that I already put a deposit down fro WED
It adds another level of difficulty that I live on an island and travel to other places is challenging.
This is making me crazy!
I am not going to be able to go back to my job if I don't get some resolution in the next few weeks and then I will lose my health insurance which leaves me with a mouth that is not functioning- I guess they convinced me that the surgery would get me open and I would be able to get on with a normal life. What if they sedated me and got me open to get impressions? Would my mouth stay opened?
I know they are going to be upset if I cancel and then they may not treat me and they are considered one of the top tmj places here-
I regret so many decisions I have made about this and don't want to regret more- also- I will not be able to pay my bills if I can't work- and I don't think my insurance will be there either-then what?
I am in a tight place and now it seems like the surgery is
not the way to go- does it really only work for trauma or structural damage?
How could they tell me that this will work for me and is the best option and then everything I read here warns me against it? It sounds so promising when they talk to me about it- aside from the fact that this piece of equipment is new Although I have read that some cases of a locked jaw get better with arthocentrisis- I am just scared because so much time has gone by and I WILL be doomed if much more goes by -
Help- need further guidance
thanks and take care
yogi
Hi again,
I know this seems like an impossible situation. Also, I fully understand that you need to get back to work, and that money is an issue...This past Wed...my family claimed
20K on my medical deductions from my tmj specialist, other doctors, and my last dentist's attempt to help me, that failed miserably.(He was not NM or a FJO) It took me 4 mo. of straight research to find the new tmj specialist to help me. I know exactly how desperate and frustrated you are. If you do call NM dentists, make sure that when you are calling and interviewing them that you ask if they practice Functional Jaw Orthodontics. If they don't, I would move on. IMO, it's better to find a dentist that can do both phase 1, and phase 2 treatments. I can't really comment on your surgeon or dentist wanting to do this procedure, and the outcome you would have. If you were my daughter, I would not go this route. I would consult with a tmj specialist like I was saying.
Look on the top of the tmj page at the great tmj doctors thread....maybe there is a NM dentist in your area on it.....? hang in there...J.
Thanks Jill!
I am just wondering how long I will be able to open my mouth and speak like I am- I feel as if I have NO TIME and I mean NO TIME to fudge around (what could I do if my jaw totally locked/closed?!)and definitely don't want to do a procedure that may make it worse- but I also know that so many around me think I should do it and AM going to do it and they will be more than p.o'ed if I change my plans.
Is it possible for someone who has been locked up for soo long with such minimal opening to get help?!!! and be functional???
Any other input highly appreciated!
Panicked yogi
Good luck.....J.
Although I have read that some cases of a locked jaw get better with arthocentrisis- I am just scared because so much time has gone by and I WILL be doomed if much more goes by -
