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Old 04-23-2013, 02:14 PM   #1
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Asymmetry After 3 weeks in splint

Over the past week, I have begun to notice that my lower jaw has shifted to the left, so I look a bit lopsided now. Basically, I am noticing that my jaw is taking the shape of the splint which is shifting my jaw to the left.

Needless to say, this is disconcerting. I asked my dentist about it and she said that it is a temporary stage and that as the muscles get the chance to respond, it will go away. I already had some asymmetry going into this, but not in this manner. The dentist tells me that in the end I will look great.

I am so untrusting of doctors after getting burned by my orthodontist who kept insisting that I continue a treatment that was causing me pain.

The upside is that I am starting to feel better. But I want to look good too!

Anyone ever go though this bizarre stage of treatment?

 
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Old 04-23-2013, 02:19 PM   #2
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Re: Asymmetry After 3 weeks in splint

I think I will go through the same as you soon... my left has always looked a teeny bit lower-- not noticable but I can tell. And my dentist could tell by feeling the joints. He said the guard will help too. But I have a feeling it's going to shift many things before the change comes- and so I am expecting it. BUT if you receive any pain, like a pain that shouldn't be there or start getting more clicking or locking then I would call.
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Old 04-23-2013, 07:11 PM   #3
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Re: Asymmetry After 3 weeks in splint

It took me about 3 months to really get my muscles really loosened up after I started splint therapy.

My lower mandibular repositioning splint moved my jaw forward and a bit towards the right. After 3 years of treatment, that is still the positioning that my jaw is in. I've gone through a lot of phases in my bite over the last 3 years though. In fact, i still have a ways to go.
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Old 04-24-2013, 05:07 AM   #4
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Re: Asymmetry After 3 weeks in splint

Such a complex treatment. Mountain Reader, how did your dentist determine how your jaw should be positioned? Mine did impressions and made molds. Then she put them on a hinge, which represents the jaw. What that showed is that if my condyles were in the proper position, my bite is completely off (even though I appear to have a very good bite). So her splint was designed to compensate and get my jaw in a position that will get the condyles in place.

 
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Old 04-24-2013, 06:59 PM   #5
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Re: Asymmetry After 3 weeks in splint

Quote:
Originally Posted by clencher1 View Post
Such a complex treatment. Mountain Reader, how did your dentist determine how your jaw should be positioned? Mine did impressions and made molds. Then she put them on a hinge, which represents the jaw. What that showed is that if my condyles were in the proper position, my bite is completely off (even though I appear to have a very good bite). So her splint was designed to compensate and get my jaw in a position that will get the condyles in place.
I'm not sure it was determined by any one thing. I'd had 3 hours of testing an MRI and full molds prior to the records appointment. This included 3D CT scanning and jaw tracking as well. For the jaw tracking, they put magnets on the teeth and have you move around and it takes detailed measurements. I imagine that told him a lot about the positioning I needed.
At the records appointment when I decided I wanted to move forward with the splints, the dentist made a couple more sets of molds that were just of my bite. He had me talking, counting backwards in the 70's, etc... to check my bite placement. He then set the molds in place. He basically said the counting told him a lot about how to position things. We had the conversation about my jaw needing to come forward and a bit to the right even before the molds were made though. I did have another 3D scan with my final splint in that showed the positioning while I was wearing it.
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Old 04-25-2013, 09:51 AM   #6
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Re: Asymmetry After 3 weeks in splint

This condition is so confusing in that there doesn't seem to be a standard of care set up for it. There are so many different approaches (depending on the dentist's training)...it is almost like a Wild West of dental medicine. I think that is part of the problem with this condition. Everyone thinks they know how to treat it (even if they don't) and on top of everything else, insurance doesn't cover for most people. Very frustrating!

 
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Old 04-25-2013, 08:27 PM   #7
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Re: Asymmetry After 3 weeks in splint

I am finding that after wearing my acrylic custom guard for the past 3 nights my jaw pain is back and now I have headaches, but only in the evening... so I can't figure out if I just ate something too hard or chewed thinking I was fine because I felt fine and the headache is just from lack of caffeine or something....you would think I would WAKE UP with this type of pain. I noticed when I wore nothing and was taking valium every night my jaw started feeling better every day. Lol. I know that I cannot take valium every night. I do have Xanax and I take that but I'm not sure what to do as the guard feels right in my mouth, but I am thinking maybe it's making me clench because its in my mouth. The hardest thing to do is to determine if you will clench that night or not. Like maybe only wear the guard on nights you assume you will clench? I dunno...
I think I will give it a few more nights and if my headaches get worse I will call my dentist. I am suppose to have a cleaning next Friday (I had to keep putting it off because of jaw pain and not being able to open wide enough) Now I may have to put it off again which stinks because I get free cleanings through my insurance. This guard was SO expensive and every time I look at it I think "WHY is this so expensive, it looks like crap, honestly" I mean... it looks like it could crack or break anytime... but the mold is good... so
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Old 04-26-2013, 11:29 AM   #8
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Re: Asymmetry After 3 weeks in splint

Hi Mandolyn, you may need to have the night guard adjusted. I have had mine for 3 weeks and already had two adjustments and next week will have another.

 
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Old 04-26-2013, 12:02 PM   #9
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Re: Asymmetry After 3 weeks in splint

It feels like it fits perfect though- that is what is strange. I actually wake up with it in the middle of the night forgetting it's even on. It feels way better than any of my over the counter ones. I am going to try and eat softer foods until my cleaning on Friday and if I am still having jaw pain or head aches at night I will take the guard in then and have it adjusted. I have already been billed too much for all these visits. They did deduct some visits due to the guard not fitting and having to send it back to the lab but if I were to go in before my cleaning I would be charged for that visit I am sure. So I am trying to plan wisely. LOL. If my head aches get worse throughout the day I may just not wear the guard until I go in on Friday and take the extra Valium I have only at night. Honestly, muscle relaxers have helped SO MUCH in me not clenching at night and with my RLS. My RLS has gotten worse. I see my regular doc at the end of May and may need something other than Xanax because it seemed to help at first but now it's not. I feel like my entire body is trying to rebel!!

But I will definitely take the guard in next Friday when I go. I just hope I can open wide enough for the cleaning. Right now I can but my left side is tight and I keep yawning and that ear will feel clogged like it did before. When I wasn't wearing any guard and taking a muscle relaxer at night all of this went away....it was wonderful. Lol.

Do you find yourself yawning a lot throughout the day? I don't open my mouth wide when I yawn anymore either. I try to yawn with it slightly open.
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Old 04-26-2013, 12:37 PM   #10
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Re: Asymmetry After 3 weeks in splint

I haven't taken a full yawn in forever.

I am way overdue for my cleaning. I was originally scheduled last month with my regular dentist. I am waiting for a while...no hurry. The dentist I am using now works with lots of TMJ patients, so their hygienist is specially trained for patients who can't open wide. They also have smaller instruments to help in keeping mouth opening to minimum.

 
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Old 04-26-2013, 01:32 PM   #11
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Re: Asymmetry After 3 weeks in splint

I am way over due too. My last cleaning was in July! And there is NO WAY I can do x rays and by the time I go in I am sure it will be time for annual x rays again. But I will have to put them off unless a tooth really starts to hurt or something. I keep my teeth in good shape, use an electric tooth brush, the Braun one with the small circle tip. Works great. And I floss every night so I'm not worried about missing a cleaning... but I would like to get it in because it's free. I didn't ask about the hygienist working with TMJ patients. I should call and ask what they would rather me do.

How are you doing today Clencher?
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Old 04-26-2013, 02:06 PM   #12
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Re: Asymmetry After 3 weeks in splint

I've been gradually improving...the key word being gradually. This is by no means a quick fix therapy lol!! I took my first yoga class on Sunday and have done a couple since then. Today, I am afraid I may have overdone it...so I just popped a muscle relaxer before it gets too bad. If I compare myself to how I was a month ago, I am definitely better...but it happens very slowly.

I got some reassurance today in my yoga class. A woman in my class told me I should go to the University of Maryland in Baltimore and work with the dentists who train over there as they are the best in TMJ treatments in this area. Well my dentist had her 3 year prosthodontist training there and also teaches there once a week, so I found that to be very reassuring. And this is not the first time I have heard this...someone on this board had mentioned this before.

 
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Old 04-26-2013, 04:01 PM   #13
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Re: Asymmetry After 3 weeks in splint

Mandolyn,

Can you refresh things for me? You're only wearing your guard at night right?

If that is the case, it could be that you need a splint 24/7 for a while. That was what I found I really needed after years in a night guard.

If your jaw is in 'good' positioning at night and you don't have anything during the day, then your positioning will be different. It could be you are going to continue having the muscle issues since you are going back and forth with the jaw positioning.
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Old 04-26-2013, 05:26 PM   #14
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Re: Asymmetry After 3 weeks in splint

I can't afford a day splint. I can't afford anything anymore!
I do only wear it at night. I honestly think sometimes I never had a problem to begin with- and the guard made me clench. When I wasn't wearing anything a few weeks ago all this went away. Even the ear thing.

Now when I massage the muscles on the left I can feel weirdness in my left ear when I push up on the massater muscles on that side. It feels like it's also pushing something into my left ear, or something in my left ear is being "hit" or affected. I wish I could get some muscle relaxers. I have Xanax but that's it. Flexeril worked GREAT when I had it. But I wasn't given much. I also have bad RLS so the muscle relaxers would be nice but can one take one every night?? I mean is it ok to do that? Maybe that is why docs don't prescribe them like other meds.
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Old 04-26-2013, 05:28 PM   #15
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Re: Asymmetry After 3 weeks in splint

Also, I can't wear the one I have now in the day as I would talk funny and wouldn't be able to function normally at work with it. It's like a guard- it goes on the top teeth but it's not like invisalign - it's thicker
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