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Old 06-27-2012, 08:20 AM   #1
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Braces for TMJ?

I've been going to the ortho for a looong time now (2 year process) to try and stop my TMJ pain of almost 10 years since nothing else worked.

I've gone through 5 different appliances with him, but now he wants to do braces as well. My face hurts all the time, it's like every muscle is pushed in a different direction and my eyes are swollen due to these appliances (although people say my face shape looks better)

Sorry such a long post but has anyone gone through braces to HELP TMJ and did it work? I already had braces as a teen years ago and I'm a little uncertain because of the amount of things my poor face has to go through, and now 2 more years of braces. Ugh. (and expensive).

 
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Old 07-08-2012, 03:57 PM   #2
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Re: Braces for TMJ?

I have been going to a TMJ specialist at the Univeristy of TN in Memphis. My TMJ started about 20 yrs ago after I got my first braces off...the popping and clicking. My ortho then sent me right to an oral surgeon who did two surgeries...one two put the disc back into place and after that did not work, a disc removal. I went about 15 yrs with no sympotoms..then about two yrs ago started clencing and night and had reocuance of pain. I went to the TMJ specialist and assume she knows what she is doing...as most othos and dentists refer to her for treatment....she did a full work up and said my bones were severely degenerated. Put me in a splint to wear during the day for like 6 weeks then weaned me off that one and also a splint to wear at night every night. We went to a Pumlmonigoist bc she has seen a high amout of pts with TMJ who also have sleep apnea. I am borderline. I have weaned from the daytime splint but now have new issues....pain behind my ears....which I never had before the splint. The night time splint I think helps me not clench at night it is just trying to get back from the weaning of the daytime appliance. I saw her last week and she explained that I may need ortho work done....she did not specififically say braces but more of a widening of my mouth (I have a tiny mouth to begin with) which she says will help correct the alignment problem with my new pain. She said in a small number of patients, she needs to do othro work...and I may then need braces once the mouth is wider to fix any bite issues.

I already had braces as a teen and really wonder if I should do this or not? I have been researching and have learned that "less is best"....and that surgery and braces are considered permenant therapies....anyone else with this situation?

I just don't want to wake up one day in the years to come and not be able to open or eat or talk or anyting...of course reading everythign online has freaked me out too.

I would love to go for a second opionon but don't know who to go see...my regular dentist does not see TMJ patients...I could go to my kids othrodontist....???? there is no other spcialists in memphis.....any suggestions.

 
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Old 07-09-2012, 10:40 AM   #3
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Re: Braces for TMJ?

Hi Cherylz,

What kind of ortho have you been seeing? Have they done a ton of post-grad education in neuromuscular dentistry for treating TMJD? I have to wonder how effective your doctor is if after two years and 5 applicances, you are no further ahead.

Regular dentists and ortho's don't have the expertise to treat TMJD effectively - it's a super tricky disorder to treat and you need the best nm dentist in the field to see results. Also, many people's situations worsen from seeing the wrong TMJD specialists - they are not created equal! They all have different training and levels of education/expertise.

I saw one of our city's TMJ specializing NM dentists and he just made things worse with appliances. I spent a ton of money and more time in pain because of this. Finally, i started doing research and looked for a modern nm dentist with (as a basis) LVI Global training and a proven, long-standing track record of treating TMJD successfully. So I started splint therapy with him.

Generally, splint therapy is phase one of treatment. It allows the muscles to relax and helps find the optimal position for your bite/jaw. Once these two things happen, you know that it's been successful because symptoms abate. At this point you need braces to permanently move the jaw into the optimal position that the splint found. I'd really hesitate to go directly into braces. It doesn't make a lot of sense.

I was a year in a permanent repositional splint. I went from being one of the most severe cases the doctors had seen to nearly symptom free. Now I'm two months into my braces to make the change permanent.

Hope this helps! All the best

 
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Old 07-09-2012, 08:14 PM   #4
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Re: Braces for TMJ?

I agree with the previous poster.

Typically the first step in treatment (Phase I) is to get the muscles out of the constant spasm they are in. For me, that was use of a lower mandibular repositioning splint. I combined that splint treatment with ultrasound and physical therapy to help with my neck and jaw muscles.

It took me about 6 months to get my muscles loosened. I didn't have money for my braces until over a year into my splint therapy. I'm now about 11 months into Phase II. So far, I've been only in upper braces to get my upper arch into position. I get my lower braces in a couple weeks. I'm in a very "in between" point of my treatment right now, but the goal is to get my bite into a permanently correct position.

There are many people out there who developed TMJD after having had braces when they are younger. It is very important to have an orthodontist trained in functional orthodontics, not just one who straightens teeth since that can cause more problems.
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Old 07-10-2012, 07:04 AM   #5
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Re: Braces for TMJ?

arent you scared about doing braces? All of the research I have seen says to "do less"...."less is best" "avoid anything that is permenant". Which makes sense becasue if you do something like braces which would be permenent and then it doesn't help or casues other problems, you can't go back and undo the braces.....that's what scares me to death. And is all I can think about. Right now, after getting out of my day splint and just wearing my night splint I have good days and bad....the pain in my ear comes and goes and is not unbearable. But I can't get my mind to re-focus on anything other than "what if the pain comes back" "what if I can't afford braces" and all the other horrible "what ifs".....

 
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Old 07-10-2012, 10:27 AM   #6
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Re: Braces for TMJ?

You are very right to be afraid of surgery - it usually does more harm than good. The research reflects this reality. This, however, is not true for functional orthodontics.

Having successful splint therapy first lessens the fear because it proves that braces are needed to get successfully and permenently out of pain. First, you should have a splint that finally relaxes your muscles and creates and optimal jaw position in which your symptoms abate. This way you know that your jaw is happy in that bite position.

Then the braces permanently fix the jaw in the "happy" position. Done after successful splint therapy, by an expert in functional orthodontics, a lot of the fear is taken out of the braces equation.

I'd also be afraid if this site were full of people for whom functional orthodonics didn't work. There aren't people on this site in the situation you describe because, after functional orthodontics, they are mostly healthy and happy and don't need to come back here. Most of the people on this site who have issues due to orthodontics had straightening braces done by regular ortho's - not braces to heal TMJ. If functional orthodontics didn't work, this site would be full of very angry folks who are still in a lot of pain after the braces are taken off. This is not the case.

In my opinion, braces are risky unless you've first done successful splint therapy and know that a certain jaw position will stop your TMJD symptoms.

Last edited by judye; 07-10-2012 at 10:33 AM.

 
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Old 07-10-2012, 09:01 PM   #7
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Re: Braces for TMJ?

Many people have milder TMJD symptoms and are able to get relief through lifestyle changes and basic treatments.

I think many of us on this board seem to have the more severe TMJD issues. If you can get your symptoms under control without any permanent changes, that is great and as it should be. In my case, my bite was way off (even though my teeth were pretty straight) and I knew I wouldn't get the relief I needed without a permanent change to my bite. With my disc slipped, my lower jaw was pushing back into my ear and I'd lost quite a bit of hearing (moderate hearing loss and difficult to understand speech). It was necessary for me to be aggressive in my treatment in order to try to prevent any further hearing loss.

I fully understand your issues with worrying about cost. I work in a field that doesn't pay well and I had to make some hard financial decisions in order to find a way to pay for my treatment. So far, I'm happy with my treatment and progress. Ask me in about 14 months and I'll be able to answer you about my treatment in full.
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Old 07-02-2013, 04:27 PM   #8
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Re: Braces for TMJ?

Are braces covered as part of the treatment?
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Old 07-03-2013, 05:17 AM   #9
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Re: Braces for TMJ?

I agree with Mountain Reader. I happen to be one of those patients that should have approached my treatment with less is best. But I wore a repositioning splint for 7 weeks which made things worse. Before I started my treatment I had no jaw pain at all, just neck pain. After wearing the splint for 7 weeks, now I have limited opening (50 mm down to 26), and popping and crackling sounds. Thankfully, still no pain in the jaw area. Many of these dentists treat because it is a good flow of income for their practice. Mine told me to keep wearing the appliance despite the fact that it created more spasms in my neck and diminished my jaw function. Fortunately, I stopped sooner than later.

Regarding the braces, orthodontia is what flared up my TMJ issues. I never had TMJ, and after starting invisalign, I started getting the neck pain. It took a while for me to make the connection of the neck pain to the jaw.

Yesterday I had my first Rolfing session. I think this is going to be my solution!! Rolfing helps you to correct posture. One of the biggest barriers to correcting posture is your myofacia system. Your body gets stuck in a certain position because the facia doesn't let the bones move into the right position. A Rolfer works the facia so that the skeletal system can move properly. I am feeling so much better already!! Poor posture is one of the biggest contributors to TMJ disorder!

 
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