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Old 01-11-2012, 01:41 PM   #1
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Splint or Braces?

Symptoms:Right Jaw popping a year ago but stopped 3 month later. Minor left jaw popping currently. Grinding/Clenching sometimes at night. Discomfort and tight jaw muscles when chewing and talking for two months now. Open bite (only the back right teeth are contacting) which was developed in the last few months while I was wear a soft night guard. Partially impacted lower wisdom teeth. Had braces when I was a teen, for which 4 teeth were pulled.

One TMJ specialist recommends long term hard splint/night guard for grinding because he believes his splint will relax the muscles and jaw joints at night. Another dentist who also treats some TMJ disorders recommends ONLY braces to correct my open bite, which she said was probably caused by the previous night guard.

I'm so confused by the totally different solutions offered by those two doctors. What should I do?!

 
Old 01-11-2012, 10:11 PM   #2
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Re: Splint or Braces?

I agree that a previous nightguard could have cause you problems. That was what happened to me.

Every dentist seems to take different approaches to treating TMJ problems. I'd ask about what specific training your dentists have for treating TMJD and functional orthodontics. That may help you decide who you feel more confident in treating you. You need someone who will help you ensure your jaw in functional order. Many good TMJ dentists also have neuromuscular training as well.

If you do some internet research you will see that many typical TMJD treatments have 2 phases. Phase I typically involves use of a repositioning splint 24/7. This splint is typically worn until your muscles relax and your bite is in correct positioning. This typically takes at least 6 months. Phase II involves "permanant" changes in your bite. Sometimes it involves crowns or other tooth adjustments, but frequently it involves braces. During this phase, they are establishing a "permanently" correct bite for you.

I've worn a lower repositioning splint since June of 2010. I was very unusual in that until recently I wore the repositioning splint during the day and a special customized upper splint at night that addressed my bruxism and jaw positioning issues both while I was sleeping. It took me about a year, but my muscles became "happy" and I was ready for Phase II. I'm now 4 months into treatment with self-ligating braces on my upper teeth and the repositioning splint on my lower teeth. When my upper teeth are in correct position in about 3 months, I'll be getting my lower braces. At the end of treatment, I'll be evaluated to see if I need some caps on my molars since they are worn down from bruxing for so many years.

I highly recommend doing some more internet research on the phases of TMJD treatment. I think you might actually want to explore treatment that involves a combination of what has been recommended to you.

I also highly recommend having some physical therapy to help you loosen those jaw and probably neck muscles as part of your therapy as well.

Good luck,
MountianReader
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Old 01-12-2012, 03:26 PM   #3
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Re: Splint or Braces?

Hi mountainreader,

Thanks for your reply! Was your joint disc displaced? Did your phase one recapture the disc? How is your mouth opening situation?

Are you seeing a orthodontist for your TMJ?

 
Old 01-12-2012, 08:38 PM   #4
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Re: Splint or Braces?

Hi,

Yes. My discs had slipped forward causing my lower jaw to be pushed back towards my ears causing muscle spasms and ear problems.

Phase I got my bite into a correct position comfortably. I haven't had a repeat MRI to see if the disc was captured though. I do know my last 3-D CT looked good for my jaw positioning.

I'm a bit unusual compared to many on this board. My problems have actually been related to having a hypermobile jaw joint. Opening my mouth has never been a problem. The extra movement has caused some major muscle problems for me though.

I'm seeing a functional orthodontist for my treatment. He also has additional training in dental surgery, a fellowship in general dentistry, a fellowship in craniofacial pain, training in advanced TMJ studies, training in treating sleep disorders through dental appliances.
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