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Old 03-27-2012, 11:24 PM   #1
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Will a splint work instead of surgery?

My ortho said to correct my bite I would not only need braces but surgery too to move my jaw forward. I do not want surgery, but was wondering if a repositioning splint would put my jaw forward in the correct position? So that way if I did get braces later then I would have the correct bite?

I just cannot find the right dr for this. Good news is at least this dr has heard of my symptoms, but cannot help me. He says my jaw sits back too far blocking my ear, but that's my natural resting position. I always end up being referred to dr's that dont deal with tmjd, I keep thinking the one of them will finally help me. Now I'm referred to a physical therapist who says can help me and maybe know of a tmj dr. I feel like I've wasted so much time in just finding a diagnosis and now more time wasted in finding someone that can help me.

Mountain reader, I think it was you that posted something once about your ear finally popping after wearing a splint or was it from physically therapy...? Or a combination? I just want my ear to pop, whenever it does my symptoms including my balance is always back to normal.

I've tried to stay positive in all this, but today is one of those days that I just don't know what I do and give up. I'm afraid to go to some of these "tmj specialist" without a referrel that ive seen in the phone book not knowing if they are just going to rip me off.

 
Old 03-28-2012, 01:07 PM   #2
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Re: Will a splint work instead of surgery?

Quote:
Originally Posted by Lenore6 View Post
My ortho said to correct my bite I would not only need braces but surgery too to move my jaw forward. I do not want surgery, but was wondering if a repositioning splint would put my jaw forward in the correct position? So that way if I did get braces later then I would have the correct bite?

I just cannot find the right dr for this. Good news is at least this dr has heard of my symptoms, but cannot help me. He says my jaw sits back too far blocking my ear, but that's my natural resting position. I always end up being referred to dr's that dont deal with tmjd, I keep thinking the one of them will finally help me. Now I'm referred to a physical therapist who says can help me and maybe know of a tmj dr. I feel like I've wasted so much time in just finding a diagnosis and now more time wasted in finding someone that can help me.

Mountain reader, I think it was you that posted something once about your ear finally popping after wearing a splint or was it from physically therapy...? Or a combination? I just want my ear to pop, whenever it does my symptoms including my balance is always back to normal.

I've tried to stay positive in all this, but today is one of those days that I just don't know what I do and give up. I'm afraid to go to some of these "tmj specialist" without a referrel that ive seen in the phone book not knowing if they are just going to rip me off.

Hi I know exactly how you feel , my ears are stuffy its horrible ! I read on a health board that icing down your jaw , can help blocked ears , It helped me a lot , especially on the part at the front of your ear at the tmj joint ! Hope this helps keep going there's a answer for everyone

 
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Old 03-28-2012, 07:03 PM   #3
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Re: Will a splint work instead of surgery?

[QUOTE=Lenore6;4951717]
Mountain reader, I think it was you that posted something once about your ear finally popping after wearing a splint or was it from physically therapy...? Or a combination? I just want my ear to pop, whenever it does my symptoms including my balance is always back to normal.[QUOTE]

I think the question of surgery really depends on the severity of your jaw/bite issues.

I've had success with non-surgical treatments, but it is different for everyone.

When my tmj discs slipped forward, it pushed my lower jaw back towards my ear. The tmj and ear are only mm apart so it doesn't take much. That is what caused my ear stuffiness. Having things displaced eventually made my muscles unhappy and all the muscle spasms gave me some intense pain. The lower mandibular repositioning splint helped me find a "correct" bite with my lower jaw by bringing it forward and a bit to the right. The physical therapy helped ALOT in getting the muscles calmed down. My PT is specially trained in working with TMJD so I know I was in very capable hands. It took the combination because those muscles had to loosen and remain loosened in order to allow my bite to "naturally" stay in the new positioning which the splint was providing.

I learned a lot (and spent alot) in trying to get a diagnosis and find someone properly trained to treat TMJD. Please make sure your dentist is properly trained in creating TMJ splints and treating TMJD. Many dentist treat TMJ and don't have enough training which can lead to more problems. Find out what training your dentist has. Additional training in TMJD, functional orthodontics, neuromuscular dentistry, and orofacial pain treatment are indications you might be in good hands.

Did your dentist give you a written recommended treatment plan for your course of TMJD treatment? If not, I'd ask for one. Treating tmjd typically involves a series of steps and most plans will involve Phase I (initially getting the jaw into proper positioning) and Phase II (establishing a new permanent bite in that positioning).

The splint therapy did take time to get me to a place my ear popped. If you can find someone trained in tmj/orofacial trigger point therapy, you can get some immediate relief. It isn't a cure and the trigger point treatments can be extremely painful, but really really help in the short term. Releases of the masseter and pterygoid helped me tons.

Can you share why your dentist said he wanted surgery as an option for you?

If you share the area in which you live, there are many people on this board who may be able to help you find a good tmj dentist or give other recommendations.

If you are interested in overall TMJ health and want a better understanding of what everything means, I recommend reading a book called The TMJ Healing Plan by Cynthia Peterson, PT. It is cheap, but is is new and very comprehensive. It also gives tons of strategies you can use at home as well.
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Old 03-28-2012, 11:02 PM   #4
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Re: Will a splint work instead of surgery?

thank you sarahblue and mountainreader for replying. Ive been having the worse couple of days, just been in tears and needed someone to talk to.

mountainreader, do you know how your discs slipped forward? I mean what cause it? Was a MRI done, or how did they find that? Im curious because when this started 14 yrs ago I had a MRI, cat scan, etc. found nothing, but Im not sure if its one of those stituations that if they arent looking for it they wont find it. Cause back then they thought my problems were sinus related. My situation has been off and on for 14 yrs. Been consistant for 1 yr this time since skydiving. Im wonder if skydiving caused some kind of whiplash (that I wasnt aware of) that sent my tmjd from mild to severe (if that makes any sense). I had a catscan done again last year but again they were looking at sinuses. It wasnt til everything else with the ear was ruled out that they came up with tmjd. Which makes the most sense.

To answer your questions, I have no treatment plan. When I made the appt to see the oral surgeon I thought he did sepcialize in tmjd. He did a xray and said my joint looked fine and recommended me to a ortho for braces but said that braces could make my condidtion worse. He just said my bite was so off, that it need to be fixed. Finally got into the ortho, who again I thought specialized in tmjd (I even ask them when making the appt). The ortho did tons of pics and xrays, said that my jaw sits too far back and is pressing on my ear which is causing all the proplems. For HIM to fix my bite he would need to do surgery to pull my jaw forward, that braces alone wouldnt correct my bite. (Surgery is not an option for me.) He said he would do it if I didnt have the tmjd problems, but since I do, that needs to be dealt with. So he isnt doing anything. He mentioned a splint that corrects the jaw but he doesnt do that either. And couldnt recommend anyone either except a PT that he knows that has done miracles with tmjd patients. I go to her in May, if she does deal with this Im hoping she knows of a doctor. It just seemed weird that he would say surgery when a splint could do the same thing...? But youre right, it does depend on the case. (But what worries me, his receptionist said braces caused her to have tmjd.) How do you decide btw for phase 2 on getting the braces or veneers? which is better?

So Im on my own again finding a specialist. I live in Las vegas, and from reading some of these posts Ive looked into DR Chan. But he looks way too expensive. Ive looked up neuromuscular dentist but dont know who is good and who just wants money. I say this because I recognize one of the DR's. I went to one of them many years ago for general denistry and he was one of those dr's that didnt care about the health of my teeth, just the appearance so I stopped seeing him, actually I hardly even saw him, it was always one of his assistants. Didnt realize he is actually a neuromuscular dentist tho.

So I called my general dentist for a recommendation. I trust him a 100%. And Im even more confused after talking to him. He said he wouldnt even recommend a NM denist to his own family. Hes taken some of those courses and doesnt believe in it. That those dentist's charge way too much money. And that there is a different way to go about it. He doesnt specialize in tmjd but knows enough about it and has dealt with it and with other dr's to know. He said to continue wearing my NTI guard (for night grinding and clenching)that he made me in Jan. of this year and to wear it even in the day time and let him know next week if I see any changes. Then we will go on from there. He has seen this work before.
This is where Im stuck, I trust him completly. But I am tired of wasting my time. Ive read alot about tmjd to know about the phases, about the splint, about braces. And I feel like this is not the same direction. The NTI guard doesnt hold my jaw forward. You can even tell by my profile that my jaw doesnt sit right. I dont clench during the day. Ive read about neuromuscular dentist and what they do, it makes sense that what NM do would work, but to find a good one no one will help me. Ill try this other approach, but I cant take much more of this waiting. Im just confused.

I did get the book, I read one of your posts about it and got it, thank you! Im still stuck on how to sleep tho. I thought Ive read about sleeping on my back is best for tmjd, but in the book it said its the worst for grinding. Been sleeping on my side with about 5 pillows around me, its been interesting...

Thank you again for responding and being there!

 
Old 03-29-2012, 11:20 AM   #5
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Re: Will a splint work instead of surgery?

Lenore6
can you please tell us more about your examination by an orthodontist? Do you have a malocclusion? I suspect "jaw sitting too far back" means an overbite in your case (a class II bite). I.e. your upper teeth overlap your lower teeth too much. Your lower jaw may also be "retrusive", i.e. chin too far back/small chin. If this is the case, your ortho probably wanted to say that your lower jaw is too small to fit your upper jaw, and needs to be broken down and advanced (moved forward). This scenario is different from the MountainReader's, since her problems are mostly disc-related.

If you do have an overbite, it may or may not cause TMJD. Conversely, treatment with braces may or may not help with symptoms. However, there is a general agreement that correcting a malocclusion usually helps people with TMJD. If this is the case, I recommend getting a 2nd opinion from a different orthodontist. The whole surgery concept in orthodontics to fix a class II bite is kind of subjective. You may very well find an ortho who will treat you non-surgically. The surgery itself in this case is not to fix a TMJ but to increase the lower jaw and is related to TMJD only indirectly.

Last edited by TMJ82; 03-29-2012 at 11:24 AM.

 
Old 03-29-2012, 11:28 PM   #6
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Re: Will a splint work instead of surgery?

TMJ82,
thank you too for responding, lets see, yes on the malocclusion, my bite is so bad that only my back molars touch when I bite down. Depending on the day sometimes only my left or right side touch. Yes on the overbite too. And yes also my lower jaw is retrusive, it sits too far back, can really tell when looking at my profile. That is what Im told is the main problem with my tmjd and my symptoms, that my lower jaw in my natural resting postition is resting too far back (compared to a "normal" person) and is pushing on the auditory system causing my main symptoms relating to the ear. So its not just my teeth being out of alignment, its also the postition of my jaw that is causing the problems.
What im curious about is (Ive heard from others as well) that ortho's usually like to do surgery to bring the jaw forward because braces alone usually dont correct an overbite. But with my jaw retrusive, doesnt a repositioning splint do the same thing - bring the jaw forward?
Since this ortho didnt deal with tmjd he didnt want to do anything, he said I needed to find someone that specialized in it first before doing any braces which I understand. So now its a matter of finding someone.
Thanks for listening and being there!

 
Old 03-30-2012, 12:27 AM   #7
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Re: Will a splint work instead of surgery?

Just remembered, I forgot to add I also have a cross bite. (it's all a mess) :/

 
Old 04-02-2012, 04:56 PM   #8
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Re: Will a splint work instead of surgery?

Lenore, I feel for you. I was also in tears today because of my tmj. I also have a cross bite and 2mm open bite(the open bite was caused by the night guard my previous dentist made for my grinding). I'm also having a hard time finding a good orthordontist who really really knows how to treat tmj. I have seen a so called tmj specialist and he didn't help me. Today was one of my worse days where I didn't know what to do. Sorry I couldn't give you any advice...

 
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