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-   -   PLEASE HELP - 2 different diagnostics/treatments (http://www.healthboards.com/boards/tmj-disorder-temporomandibular-joint/901628-please-help-2-different-diagnostics-treatments.html)

TMJproblemX 05-20-2012 11:46 AM

PLEASE HELP - 2 different diagnostics/treatments
 
Hello,
I have an unilateral crossbite, and my bite shifted over the years so that my lower jaw goes to the left and my midlines are c. 3 mm apart. I also have difficulties opening my mouth wide, and my teeth have become unaligned so that I have 2 large spaces between my teeth that are 1/2 tooth wide. My jaw joints are often sore as well because I grind/clench my teeth at night. Needless to say, my face is not symmetrical, which is not attractive! actually, my jaw is lower on one side of my face that on the other, so that my profile pictures on either side look quite different.
I went to see 2 different TMJ experts, who made 2 different diagnostics and recommended 2 different treatments, and I am now totally confused!
The first dentist recommended an upper jaw extension, a splint to bring my lower jaw right and forward, and veneers to close the gaps in my teeth. He said that the treatment would take a total of 6 months.
The second dentist recommended that I wear a splint for 1 year to bring my lower jaw to the right, followed by braces for 1 additional year to realign my teeth.
What do you think? How do I figure out whether my lower jaw really needs to be brought forward? Should I get a 3rd opinion? Obviously, the perspective of a treatment that would take only 6 months and would not require braces is quite enticing. At the same time, I am concerned that it may be less sustainable over the long run.
Please advise. Thank you so much!

judye 05-23-2012 08:20 AM

Re: PLEASE HELP - 2 different diagnostics/treatments
 
Hi there,

I'm no expert but here's my take on it. They are both essentially the same treatment. The repositional splint will start the process of bringing your jaw into a healthier position. The first expert is using veneers to close the gap, fixing the vertical dimension. The second expert is doing this same thing using your own teeth, with braces. Braces should pull your own teeth high enough that you do not need veneers (although in rare cases, veneers are used after braces). I think you are right that number one is a bit of a short cut - but will it be as effective in terms of addressing pain issues? I really don't know. What are the long term effects of having veneers? Most people I've heard of have the splint followed by braces, rather than going into veneers right away, so braces are the more comon method - perhaps there's a reason most dentists go that route?

I imagine that braces might also help with straightening your teeth and dealing with the space issues you have, so this may be another good reason for choosing braces.

By the way, I had very severe TMJ symptoms and was in a splint for almost a year. Things were tough for the first few months but finally improved (pain relief for the first time in years) about 5 months in. I'm now in my braces and although it's a royal pain in the tushy, I'm glad I'm finally resolving my pain issues properly, once and for all. I, like so many others here, went for far too long, mired in pain, seeing the wrong dentists and getting the wrong treatments.

TMJ is a tricky one to treat - there are no agreed-upon best practices in this field as yet, so you have to do a ton of research to find the right dentist and get the right treatment. Also, the right treatments are often still not covered by medical, so people often opt for the wrong treatments, such as surgery (covered) to save money and that makes their issues worse. If people don't know all of this, they can wind up in pain for far too long with the wrong treatments and an untreated or worsened condition. If I were you, I wouldn't take any short cuts - TMJ is very debilitating - think long term results, a life of good health...

Sounds like you are on the right path - I hope this helps!

Best of luck in your recovery :)


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