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  • Has anyone gotten braces after their TMJ splint and seen improvement?

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    Old 10-13-2016, 07:45 PM   #1
    sharma408
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    Has anyone gotten braces after their TMJ splint and seen improvement?

    Hi guys,

    I have been wearing my night time splint since march 23rd and day time splint since June 30 of this year. My main issues with TMJ have been headaches and nerve pain. The nerve pain is like electric shocks throughout the day that happen on the face, scalp, legs and arms. I used to get 200 shocks a day, but with medication it has gone down to 50. When I told my TMJ specialist about my headaches, he recommended prolotherapy. I did 2 sessions, which mildly improved my headaches, but left me with a terrible side effect of soreness in the neck. He recommended seeing a chiropractor for the neck soreness, which has been very helpful. And I now believe the reason for my nerve pain is being caused by my neck and back because my nerve pain improved after my back and neck adjustment. Also, I have decided to see a neurologist to see if this true.

    My main question is that I saw my dentist today and he said we are going to start weaning you off the daytime splint if you are getting better. But I told him that without the medication amytripline, the pain comes back instantly. He said we really don’t know then if this is helping you or not. Though I assured him the adjustments from the chiropractor are helping my headaches and nerve pain. So he is going to let me know if we are going to start weaning me off the daytime splint or not. Because he said, long term wise the daytime splint will change my bite by a lot. And during the period of weaning off the splint, if the symptoms come back we can put you back on the daytime splint for a short period of time. But will have to go to phase 2 eventually, which will be braces. At the time I’m thinking shouldn’t I have been put on braces in the first place instead of the splint? Anyways now I am just frustrated and need other peoples advice on whether or not if this is the route to go or if anyone has followed this phase and seen improvement.

    Last edited by sharma408; 10-13-2016 at 07:47 PM.

     
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    Old 10-16-2016, 09:26 AM   #2
    austinbobcat
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    Re: Has anyone gotten braces after their TMJ splint and seen improvement?

    Hi, I've been wearing my orthotic for almost 7 months now. I've seen improvements with my back, upper shoulders and neck. I also had pressure behind my eyes and the pressure is gone. But I'm still dealing with ear issues. I went to an ENT last year and hearing doctor and both said my ears were fine. I have another appointment with a different ENT in a couple of weeks and another hearing test this Tuesday. I also did prolotherapy (one session), but did not continue because I was going to start splint therapy. I told my TMJ specialist about my improvements, but also my concern about my ears. He thinks I have an inflamed eardrum. But he thinks I should be ready for phase II soon. I only wear one orthotic 24/7 and it wraps all of my upper teeth. I start a new job in a couple of weeks, and I'm really nervous. I hope my ear starts healing soon! I'll let you know when I'm ready for phase II. Have a blessed day!

    Last edited by austinbobcat; 10-16-2016 at 09:28 AM.

     
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    Old 10-16-2016, 08:36 PM   #3
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    Re: Has anyone gotten braces after their TMJ splint and seen improvement?

    My TMJD manifested itself as intense ear pain/stuffiness. While some strategies are similar for each TMJD patient, I think that in the end, you need to make decisions based upon your underlying issues.

    In my case, I traced my problems back to intubation with a surgery. Evidently, my discs slipped which resulted in my jaw 'pushed' back into my ear. The muscles in that area went into constant spasm. I also had lost 30% of the bones in my condyles by the time I was diagnosed too. (I was told a 100% chance of arthritis as I get older.) My phase I was a re-positioning splint I wore during the day and a night splint with a wedge that kept my lower jaw forward when I slept and at the same height bite as my re-positioning splint. I did use some muscle relaxers when my pain was at it's worst. I also had regular PT. Manual work on my jaw, neck, and shoulders with some adjustment of ribs and hips that were thrown out of alignment as a result. The manual work/massage done on my neck and jaw helped my muscles slowly relax. I also found tons of relief from oral trigger point releases. This included inside the mouth work with release of the pterygoid and masseter muscles. It was intensely painful at first, but totally worth it. I also found another PT who is an ergonomics specialist. She gave me exercises to build the small muscles and to teach proper tongue placement.

    After the pain diminished during the splint therapy, my TMJ Orthodontist reviewed options with me. 1. wean from the splints 2. continue to wear the splints 3. caps/crowns to even out my bite since I'd worn down my molars before my diagnosis 5. braces. Because my bite was off, I chose self-ligating braces. I started my braces treatment with upper braces only. For about 11 months, I wore the lower splint with regular adjustments as my bite changes. He cut the back off the splint to allow my lower back molars to 'erupt'. I had brackets put on the lower molars during this time so that I could use them with elastics at night to help me hold my lower jaw forward when sleeping. I literally cried having to give up the upper night splint since the jaw falling back cause pain again. The elastics were a strategy to help. I had some times early with the braces that my ENT prescribed muscle relaxers while I was adjusting to some changes. After 11 mos, I had my lower braces added since my upper arch had developed to a nice "U" shape instead of a more "V" shape I started with. With both the upper and lower braces, I had a series of elastics that helped my erupt those back molars and to still hold my lower jaw forward. Throughout braces treatment, I still had manual PT work done on my jaw, neck, and shoulder to keep the muscles from going back into spasm again. In my opinion, PT or trained massage can make a huge difference in treatment. The muscle part of the TMJD pain needs to be addressed at the same time as the physical bite part. Posture work is also important because most people with TMJD develop a head forward positioning.

    To learn more about some of the ergonomic strategies, trigger points, and small muscle exercises, I recommend the book The TMJ Healing Plan by Cynthia Peterson. I had some Jaw School sessions with her, but the book didn't come out until I was completing my TMJD treatment. That was when I found her about an hour away. The book is affordable and well worth it.

    I've had my braces off for several years now. I still need to do some muscle work/PT periodically, but I am about 95-100% better on most days. The treatments were well worth it, but super expensive. My treatment took a long time because I couldn't afford the steps as quickly as I wanted.

    Honestly, it is not recommended to have any permanent changes in your bite for TMJD treatment. I chose them because it allowed me a more natural approach to getting my bite settled since my back teeth weren't touching where I had ground the molars down. If you choose braces, I highly recommend the self-ligating type. The brackets have 'trap doors' on them that pop open and closed instead of needing to have ligs/small rubber bands holding the wire in place. I know I would have had much more pain with the pressure that would have resulted from the regular adjustments when they press on the tooth to get the lig into place.
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    Old 10-16-2016, 08:41 PM   #4
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    Re: Has anyone gotten braces after their TMJ splint and seen improvement?

    I forgot to mention something else. My dentist promoted good nutrition to help the body heal itself.

    I told him that with the acrylic splints and teeth that didn't always touch, there was no way I could chew the spinach he promoted. He told me to drink more smoothies.
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    Old 10-17-2016, 03:55 PM   #5
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    Re: Has anyone gotten braces after their TMJ splint and seen improvement?

    Hi, I've been wearing my orthotic close to 7 months, and it has helped quite a bit with my back, shoulders and neck. My right ear is the one that has been giving me trouble for about 15 months. It started when I noticed my bite being off. I was under a lot of stress last year, and I was clenching during the day. I was clenching on pencils and wood chips. I also taught for 8 years, and I have loud voice. I had to quit my teaching job because I noticed that the excessive talking was not helping my right ear. I'll be starting another job in a couple weeks where it does not require a lot of talking. I went to an ENT last year, but to be honest I had to wait about 6 weeks to see him, and he spent less than 5 minutes with me. He checked my ears and said I did not have an ear infection. He was about to leave, when I asked him what he recommended for TMJ. I also saw a hearing doctor because my hearing is supersensitive. Now (almost a year later), I have an ENT appointment with a different doctor and an appointment with a hearing doctor.

    I feel better with my splint inside my mouth, but it's bulky and I have trouble pronouncing the 's' sound. I don't want to rush things, so I'm going to stay strong and keep wearing until I'm ready for phase II. Phase II will consist of braces and possibly jaw realignment. I have an open bite that braces may not be able to correct. I was also told that I could wear the splint for the rest of my life (with adjustments now and then), or have braces to fix my misaligned teeth and upper jaw realignment. I'm not excited about all of this, but I don't have a bite without my orthotic.

    I see my TMJ specialist and oral surgeon next month because they're telling me I'm ready for phase II. I'm using a flat plane splint with anterior guidance that fits on my upper teeth. And now my lower teeth are evenly contacting the splint when I close my jaw. My TMJ specialist said that my TMJs have stable hinge axis movements. And if it weren't for my right ear, I would be ready for phase II.

    I ordered the book that you recommended, and I started reading it(: It's a good book. I agree that nutrition plays an important role in the recovery of this disorder. Thanks for replying, and have a blessed evening(:

    P.S. I'll keep you guys posted on what my doctors say(:

     
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    Old 10-17-2016, 04:03 PM   #6
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    Re: Has anyone gotten braces after their TMJ splint and seen improvement?

    For some reason, I have this picture in my head that my muscles are tight or in spasms and are squeezing my eustachian tubes): Hopefully, the new ENT that I'm seeing on November 8th will be able to help with this. I've been doing a lot of walking in the evening to clear my head and destress. I'm so ready to get my ears back. Thanks for reading and listening. God Bless!

     
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    Old 10-17-2016, 08:56 PM   #7
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    Re: Has anyone gotten braces after their TMJ splint and seen improvement?

    It took me a long time to figure out the ear/TMJ connection. I have an incredible ENT who I had been with for years who I went to twice and he couldn't find anything wrong with my ears. He offered tubes to try to help with the stuffiness after so many months, but we both decided that wasn't the right way to go. When I saw my Audiologist, she couldn't find anything physically wrong. I've gone to the Audiologist regularly since I was in Kindergarten and found out I had severe hearing loss in my right ear. I've always been very protective of my good ear. When I went in this time, I had developed a borderline moderate hearing loss in the good ear. Not what I was expecting. The pain/stuffiness was horrible in the right ear, not the left 'good' ear. I was so disheartened. (Ironically, my pain was in the right ear and I eventually found out I had much more degeneration in my left TMJ than the right.)

    When I came across a reference to TMJD and hearing pain on one of my internet searches, something clicked. I typed in those words together and just knew that was my problem. I went back to my ENT and asked and he referred me for TMJD assessment. He also helped me out with occasional muscle relaxers to help with the ear pain since I'd finally figured it out. It took me several tries to find my final TMJD specialist.

    Would you believe I got hearing aids and braces both one month before my 40th birthday? Happy Birthday to me....

    Being intentional about the relaxation is very good as part of your TMJD treatment toolbox. I've learned with other chronic health issues about the 10% theory. If I get 10% relief from the splints, 10% from the therapy, 10% from trigger point work, 10% from muscle relaxers, that is 40% relief from the pain that day. It isn't exact, but because there is no easy 'fix' for TMJD, I had to be grateful for every bit of relief I had on any given day. Over time, I found that I had days I didn't need all the tools in my box, just some to help me through the day/night.

    Other tools that may be useful for your TMJD toolbox... a CD by Denise Lynch that does guided relaxation for the TMJ called Freedom from TMJ. It is a little older, but helped me with my intentional muscle relaxation. Heat or a cold pack depending on the day. Heat to help relax the muscles, but cold just felt better at times. Shoulder PT. Calcium, Magnesium, B12 and Vitamin D were recommended by 2 of the TMJ specialists I saw. Essential oils for relaxation. I found Deep Blue by doTerra to really help as I massaged it in. Making a point to avoid foods that are hard on the jaw to chew. Things like solid meats, hard candy, gum, lettuce, and foods with skins like pickles and peppers were on my avoid list. I also became conscious of my sleeping positions. Sleeping was difficult for me because I had other health issues too.

    Have you been assessed for sleeping disorders. A huge number of people with TMJD have sleeping problems they aren't even aware of. I had 2 sleep studies done. One right after I started wearing my nighttime splint and another when I got my braces off to see if I needed additional support. I had asthma and life-threatening acid reflux issues I needed to address at the same times.

    As for my ear pain and hearing issues, my jaw is now 3mm forward of where it was when I started treatment. When I feel problems starting back with the muscles, I go back for some 'touch up' PT. While I can't get my hearing back, I haven't had any more loss since completing treatment. Honestly, I've had a review of my health history since then and wonder if it actually was the TMJD that contributed to my hearing loss. It was that I had such serious ear issues when the hearing loss set in. I also realize I had viral menengitis around the same time the ear problems set in. That could have been a coincidence in timing.

    For the muscle spasms, to this day, I find my neck extremely tight. It is very tough to find a solution for. I always tend to get a headache in the back of my head in the neck area when my TMJ area muscles are beginning to spasm. I had absolutely no idea it wasn't normal for muscles to be like that. I could totally see the eustacian tube 'squeezing' feel. There is such a minute distance from the jaw to the ear. The were muscles squeezing and holding my jaw into my ear...who knew?

    One thing I learned as I was nearing the end of Phase I with my splints is that most dentists consider a 30% improvement in TMJD pain to be a success. I view mine as 90-100% better. The 90% is for when I have those days I need to work my muscles loose some . Other days, I feel 100% better. I really hope both of you find the success I did. It is tough to hear, but it took me 3-4 years to get to that point. The first year, my ears improved greatly. The other time was helping re-establish my bite.
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    Old 10-19-2016, 07:36 AM   #8
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    Re: Has anyone gotten braces after their TMJ splint and seen improvement?

    Thank you so much for the detailed information. I got the book that you recommended, and I'm currently doing the 'Lopsided Blowfish' exercise on page 148(: I did physical therapy last year, and it helped. My PT did dry needling and focused on helping me find my trigger points. I start my new job on Nov. 1st and I'll have insurance and money to got back and see a PT. My new job won't require me to talk too much, and I'll be working for the State. I'm praying is not a stressful job since I'm still healing. I've had a lot of improvement with the orthotic, but still dealing with my ears. My earaches have diminished, and when I do get an earache, a 200 ibuprofen will help my ear. The weird thing is that sometimes I get an earache in my right ear -- most of the time it's in my right ear. But occasionally, I'll get an earache on my left side. And then there is the crackling in my ears when I breath out and air comes out of my ears.

    My TMJ specialist thinks its my euchastian tubes and told me to go see an ENT and a hearing doctor. My oral surgeon wants to help me stabilize my bite, but he said he may not be able to help with my ear. They are glad I've improved, but I still have TMJ):

    I went to the hearing doctor yesterday (same doctor) I saw last year, and my hearing is fine. She compared the results from last year to this year, and my ears are the same. She asked about my TMJ, and I told her all of my other symptoms were gone, but that I was still dealing with my ears. And I told her that my ears were getting better because in January and February (before I had my orthotic) I would hear a loud swooshing sound in my ears, and it was really bad when I laid down to go to bed. The swooshing sound is now gone. It went away after two weeks of splint therapy. Back then, I thought my ears were going to be the first to heal. She said that the ENT would be the doctor to shed some light on what is going on with my ears. I looked up the doctor, and he's fresh out of medical school. I told my husband, and he said 'That's great! He'll have lots of new ideas and will be up-to-date with the latest treatments'. I pray the new ENT will be able to help me. I'll let you know what he says.

    Have a great day and God Bless(:

    Last edited by austinbobcat; 10-19-2016 at 07:45 AM.

     
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