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Old 04-18-2010, 04:49 PM   #1
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macneil72 HB User
Any Recent Feedback RE; Dr Patrick Grossman in London

Hi

I am thinking of seeing Dr Patrick Grossman the TMJ dentist in London. All the feedback on him seems quite old on this forum and wondered if anyone here had seen him recently. Specifically what I want to know is:

1. Will he automatically push for a splint and surgery or will he help find the root cause and suggest conservative targeted solutions.

2. If you did go for the splint therapy did it work.

A million thanks in advance if you can provide me with any info on this.

Thanks


Mary

 
Old 04-19-2010, 04:02 AM   #2
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Amanda6 HB UserAmanda6 HB User
Re: Any Recent Feedback RE; Dr Patrick Grossman in London

Hi Mary,

I saw Patrick in London earlier this year, but just for one appointment, as it was for a second opinion on the TMJ treatment I a currently having by another dentist. Patrick would do an MRI scan of the TMJ to diagnose the problem first. After that he uses splints to help stabilise the jaw, and when the jaw is stabilised, he uses orthodontics so that the splint can be removed and the jaw remains stable. He explained to me that due to the displaced position of my discs, that it couldn't be fully corrected with a splint, and I would need surgery to reposition my disc at some stage, as well as the splint.

 
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Old 04-20-2010, 04:39 PM   #3
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Re: Any Recent Feedback RE; Dr Patrick Grossman in London

Thanks Amanda. How did this opinion compare with your first opinion. Did you feel confidence in what he was recommending for you?

 
Old 04-21-2010, 02:50 AM   #4
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Re: Any Recent Feedback RE; Dr Patrick Grossman in London

The first opinion is the one I started treatment with, no surgery has ever been mentioned by this dentist. He also arranged for me to have an MRI scan, and is using splint and orthodontics, and that part of the treatment is possibly very similar. Why one suggests surgery will be necessary to reposition the disc at some stage, and the other doesn't mention it, I have no idea. But the idea of the surgery doesn't sound very appealing to me, if it could be avoided. Patrick though did seem to explain very well, what is wrong with my TMJ.

 
Old 05-01-2010, 01:33 AM   #5
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pipdog HB Userpipdog HB User
Re: Any Recent Feedback RE; Dr Patrick Grossman in London

1. Will he automatically push for a splint and surgery or will he help find the root cause and suggest conservative targeted solutions.

If he sees a problem he will ask you to get an MRI and have it reported by a TMJ radiographer. The protocol is to first try a splint to recapture the disc and if that doesn't succeed disc plication surgery in Guys Hospital

2. If you did go for the splint therapy did it work.

Splint therapy can work if the disc / discs are not too badly displaced but beyond a certain point of displacement they are ineffective..

Last edited by pipdog; 05-01-2010 at 01:34 AM.

 
Old 05-01-2010, 05:44 AM   #6
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Re: Any Recent Feedback RE; Dr Patrick Grossman in London

Hi Pipdog,

After the splint has been worn for several months to try and recapture the disc, do you know how you can tell whether the disc has been recaptured? If the dentist says they are recaptured by examining jaw movement, is that sufficient?

 
Old 08-02-2010, 12:02 PM   #7
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pipdog HB Userpipdog HB User
Re: Any Recent Feedback RE; Dr Patrick Grossman in London

Yes I think it is because if say you had really limited opening prior to appliance therapy and then after a year or so wearing it your opening increased then this improvement in function is indicative of a correctly positioned disc.

I went from 44mm to 52mm so the specialists said another MRI would just be a waste of money. Also they have this torch with very high intensity light, and they shine it in your ear and it shows the outline of the condyle in the fossa. They can see if there is good joint space or not.

Other signs of a recaptured disc are that the clicking stops and if you had any deviation on opening beforehand this will stop as well.

Last edited by pipdog; 08-02-2010 at 12:04 PM.

 
Old 10-15-2011, 03:18 PM   #8
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pipdog HB Userpipdog HB User
Re: Any Recent Feedback RE; Dr Patrick Grossman in London

Quote:
Originally Posted by Amanda6 View Post
Hi Pipdog,

After the splint has been worn for several months to try and recapture the disc, do you know how you can tell whether the disc has been recaptured? If the dentist says they are recaptured by examining jaw movement, is that sufficient?
When the interincisal opening increases, the clicking stops and the mandible no longer deviates on opening: these are the signs that the disc has been recaptured. I was told another MRI would just be a waste of money

 
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