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TMJ Disorder -TemporoMandibular Joint Message Board
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Old 12-04-2012, 08:58 AM   #1
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Going for Braces?

I had TMJ for almost 2 years. After wearing the first soft night guard(mainly for grinding) for 5 months my bite opened in the front one day when I woke up, which made my symptoms worse. I then switched to Mora ( a lower day time splint) with a different dentist. I saw some improvement but my bite is still open - only the last molars are touching! My Dr said I should think about braces now.

I am afraid to get braces because my tmj discs are displaced and I was told dis recapature is almost impossible without surgery. Besides, I am still not 100% normal - I can still feels some symptoms if I talk too much during the day or grind too much at night. On the other hand I want to fix my bite desperately. My dentist said if the bite is close, I should be able to feel better, maybe even grind less.

On top of everthing, finding a good ortho is challenging.

 
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Old 12-04-2012, 09:44 PM   #2
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Re: Going for Braces?

I actually had my ortho do my splint therapy before I got braces. Your right, it was hard to find a good one trained in TMJD treatment.

I wore my lower mandibular repositioning splint for over a year before I got my braces. My Ortho did another 3D Cone Beam scan (CT scan) to check on the positioning of my discs/bite in it's 'new' position that I was comfortable with from the splint before we even discussed moving forward with the braces.

Your splint has helped you with the opportunity to get those TMJ and facial muscles loosened up and happier. It isn't a cure, it just helps get most of the symptoms under control. I used a lot of trigger point releases, ultrasound, and therapy throughout my treatment as well. I still use the occassional muscle relaxer if i get a flare as well. Splint therapy doesn't cause any permanant changes.

Phase II treatment, braces for some of us, permanent changes are what you are wanting as a result with your bite in a new 'happier' position.

My orthodontist did a lot of testing and discussion of options with me before I decided on the braces. There are other options available to you as well.

I started with getting my upper braces and continued to wear my lower repositioning splint for the first 11 months while my upper arch developed into better positioning before I moved on from the splint to my lower braces. That was 26 months total in the lower splint. I'm now about 15 months into my braces treatment and so far, very pleased.

While braces and permanent bite changes are very serious and not a good decision for everyone, I've found the decision to be very good in my case.

It might be worth at least finding a couple orthodontists to consult with. I'd make sure they have extra training in treating TMJD. At the least, they should be Functional Orthodontists trained in treating the bite and not just straightening the teeth.
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Old 12-05-2012, 05:31 AM   #3
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Re: Going for Braces?

Mountainreader,

You are right, splint therapy is not the cure. Do you have disc displacement? I am wondering how disc displacement will impact braces treatment or the other way around.

Jen

 
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Old 12-05-2012, 07:37 PM   #4
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Re: Going for Braces?

Jen,

Yes, my discs had slipped forward. That resulted in my lower jaw being pushed back towards my ear causing me some severe ear problems and hearing loss.
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Old 12-10-2012, 12:37 PM   #5
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Re: Going for Braces?

Did you recapture your discs? One dentist told me if the discs are displaced, the relationship between your upper and lower teeth might not be stable. He said even though braces can bring the bite to an ideal condition at some point, the bite and the lower jaw might shift again once the braces are removed. I was worried by his comments. I hope he is wrong!

It just seems so hard to find a nonsurgical permanent fix for disc displacement without reduction.

 
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