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    Old 12-11-2003, 05:56 PM   #1
    Arleen
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    Marlene, Crystal...some questions

    Hi Marlene & Crystal:

    Don't know if you're around these days as I'm not on the boards much myself. I also hope that you're both doing fine. Crystal, have you found someone to help you?

    I recently started seeing Dr. R. Got a good long start on history, record taking, tomograms, joint vibration analysis, impressions, etc. Gail was very nice and seemed very knowledgeable. I go next week for splint fittings. I'm particularly concerned about the upper night splint. The splint covers all my teeth and has this weird ledge type thing under the front few teeth (maybe along the lines of an NTI, except all the teeth are covered). I mentioned to the dentist that my upper front teeth are extremely sensitive and sore and was concerned that this splint puts all the pressure on those teeth. He didn't seemed too worried about this, said it's supposed you from grinding. Have either of you had a similar splint?

    He also said he can't recapture my discs. I don't know if it's both sides, as the right side condyle is far back while the left side is forward I believe. Most of my pain is on the right. Since the discs don't show on the tomos, any idea of why he'd say this? I'm particularly concerned since other people's dentists say splint therapy can help recapture discs. I called the office with my questions, but we've been playing phonetag, so don't have answers. I go back next week so will ask then, but I wondered if you've run into this.

    Guess what has got me especially concerned is Saaraah's recent comments on the board. I'm feeling very discouraged. I'd seen 13 dentists before I realized I had TMJD (as none of the dentists did). Then I saw a TMJ dentists here, who was very odd and unconcerned about my wisdom teeth erupting - opted not to see him for treatment. Then I interviewed a bunch of neuro dentists, to no good effect. Then I saw a dentist in the States. He may have been able to help had I lived closer, but I don't. The splints he made need adjustment and there's no one nearby I trust to do this, plus the splints never felt comfortable to start. So, I was really hoping I'd finally found someone who could help me, and now I'm wondering if I've selected another bad choice.

    It just seems like this "heck" is never going to end, and I'm getting more and more discouraged by the day. My symptoms are also escalating by the minute. And my bank account is in bad shape. I don't know what I'll do if my $$ runs out before I've found relief.

    Anyway, I'd welcome your take on things, since you've both been to this dentist. Also, please let me know how you're coming along. Marlene, I think you were doing very well the last time we "spoke."

    Take care,
    Arleen
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    Old 12-11-2003, 08:40 PM   #2
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    Re: Marlene, Crystal...some questions

    Hi Arleen,

    I just happened to pop in and saw this post.
    In regards to your concerns about the night splint - I also have tooth sensitivity etc. and I've had no problems with my night splint. As a matter of fact, I find it more comfortable than my day splint. I would wear it 24/7 if it wasn't for the fact that I can't eat or speak with it in.

    I'm also playing phone tag with Dr. R's office. I just received a copy of the report from my MRI, and I'm not sure whether I should be happy or sad. Apparently, my discs are NOT displaced. That would be great news except that I still have all of the symptoms. Not really sure where to go from here.

    Anyway, I wish you the best of luck with your treatment. I dealt with Gail for several months, and she seemed quite knowledgeable.

    Take care.
    Crystal

     
    Old 12-11-2003, 09:39 PM   #3
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    Re: Marlene, Crystal...some questions

    Hi Crystal:

    Thank you for responding. I wish things were going better for you. Does it sound like you have the same night splint I described. He showed me two very similar, both uppers, both with acrylic covering all the teeth. One had a level ledge under the front teeth, while the other had a sloped ledge. He said with the sloped ledge one some people experience sore bottom teeth, so he's starting me with the flat ledge.

    It's good news that your discs aren't displaced, but they why aren't your symptoms better?? Have you had recent tomos? I'm just wondering if your condyles are moving into good position, or what's happening there.

    The whole disc situation concerns me - because how can a dentist know what's happening with them if you don't have an MRI? I'm going to ask for one, and see what happens. I got back next week for splint fittings. Having now gone through this once, I'm even more worried than I was the last time. I'd so been hoping that my teeth and gum pain would stop when I had something in my mouth that was made to a proper bite (not like the nightguards I sleep with which were made according to my off bite). But once the splints were in, even after a number of adjustments, they caused enormous pressure to some of my teeth, especially on one side. That was quite a surprise. I'm worried the same thing will happen again.

    I hope if Dr. R. can't help you, you find someone soon who can. Please keep in touch. Maybe the new year will bring better things for both of us.

    Hugs,
    Arleen
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    Old 12-12-2003, 06:13 PM   #4
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    Re: Marlene, Crystal...some questions

    Hi Arleen,

    Come to think of it, my night guard may be different than the ones you describe. When I first started seeing Dr. R. I had just gotten a new night guard from my regular dentist. Janie took that night guard and added a "gob" of acrylic to the front of it then had me bite into it to make an impression. So originally my bottom front teeth fit into the impression when I wore the night guard. I found that my bottom teeth got really sore at night, so Janie modified it to more of a ramp that prevents my jaw from falling back while I'm asleep. It's hard to explain.

    When I went to see Dr. Rawson recently, he took tomos and also did a joint vibration analysis. He said my condyles are in a perfect position within the joint, and there is no clicking in the joint. There is definitely some deterioration to my condyles, but basically the splint has done its job. When I started seeing Dr. R. my right condyle was posteriorly displaced, so my problem must be purely muscular now.

    Good luck in asking for an MRI. Dr. R. didn't order my MRI. His reasoning at the time was that the waiting list is so long that you could be through splint therapy in the time it takes to get in. I had to convince my family doctor to order it. My pregnancy posed some complications, but even after I had the baby they were going to make me wait for four months. I ended up calling the MRI centre myself and convinced them to move up my appointment. I was lucky enough to deal with a really nice person. Now that I've had the MRI, I realize how unimportant it really is. The treatment of TMJD is not an exact science, and most dentists treat it based on symptoms, not so much on clinical findings.

    I hope your splint fitting goes well. Keep us posted.

    Crystal

     
    Old 12-14-2003, 04:42 PM   #5
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    Re: Marlene, Crystal...some questions

    Arleen:

    I've been seeing Dr. Rondeau since late September. I got my splint around a month and a half ago. It is a 'pivotal splint', where only the back teeth touch. Before I got my splint, my opening was 32mm, now it is 45. The day I got my splint, there was some specialist there from the States, and he injected me with something and wiggled my jaw around -- increased my opening by 7mm in a matter of seconds!

    Honestly, I have no idea whether the splint is working or not. I have been experiencing slight aching recently, but nothing too dramatic. I still haven't experienced any great pain (knock on wood). Now that I can open my mouth wider, I can hear clicking when I open my mouth wide, so that may be a good sign. Dr. Rondeau seems confident that the disks will recapture, and I'm getting positive vibes from the office. Also, my disks were not visible on the tomogram either, but they suspended any judgment on the matter because of my 'lock' or limited opening. As for you, perhaps the reason they think your disks won't recapture is because they are both in different positions. Good luck with treatment, though.

    Take care,
    Sheldon

    Last edited by SRH_NF_isback; 12-14-2003 at 04:43 PM.

     
    Old 12-15-2003, 12:51 PM   #6
    Arleen
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    Re: Marlene, Crystal...some questions

    Hi Crystal & Sheldon:

    I was at Dr. R's today for my second appt and still feel like my head is whirling.
    Crystal, I think I know what you mean about the ramp for the nightguard. Dr. R. had showed me two types, one with a flat ledge and one that was a little hill - maybe that's what you've got?? He mentioned that some people's bottom teeth get sore with the little hill one. I asked Gail today if they were like NTIs and did I need to worry about openbite. She said sort of like NTIs although those are designed not to wear for very long. She also said I wouldn't get an open bite because all your teeth are enclosed. I was under the impression I'd have two splints, both ready today, but they've started me with the day splint to be worn 24/7. Then if it turns out my jaw drops back while I sleep or whatever, and I need a night one, they'll take impressions for that and make. I kind of wonder about the night one as I believe it's flat plane. I asked Gail how you can be healing the jaw joint if it's flat plane and you can move your mouth all around. She said something about the night one giving your muscles a break. I don't know.


    Sheldon, I'm glad you're not experiencing much pain. Great too that your opening has increased. I hope it's doing wonders for your condyles and fossa.
    I asked about booking an MRI and was told Dr. R. can't book them - that they have to be booked by an MD. I'm going to see if I can get someone to book one. I know it may take a while, but after dealing with all this for 2 years and 13+ dentists, I'D like to have some idea of where my discs are. I asked Gail about Dr. R. saying he couldn't recapture them, and how does he know where they even are since they don't show on tomos. She said he's given me the worst case scenario but that he can't tell where they are.

    They couldn't do the EMG and jaw tracking today because the equipment got wet and now needs a new computer card - so they'll do at my next appt. I was surprised that splint fitting took about 15 minutes - very different than the neuromuscular approach which is much more time consuming. I just hope I can wear it as I feel a lot of pressure on one side, in the same way I did with the neuro splint. I don't know why that is, plus my teeth and gums are so tender and sensitive at this point.

    Crystal - so, what are you doing for treatment now. Since Dr. Rawson said everything looks okay (which is great news), can he do something for the muscular end of things? Or, how about a home TENS unit? Would that help? or physio? I wanted to pop in to meet Dr. Rawson, as he was so kind to me on the phone, and who knows, if this doesn't work, he could be next. I'd have gone with him this time, but figured Dr. R. had more experience dealing with TMJ and I need all the experience I can get.

    Guess Marlene isn't on the board these days?? Hi Marlene, if you're out there. I hope you're doing well.

    Take care,
    Arleen
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    Old 12-16-2003, 07:06 AM   #7
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    Re: Marlene, Crystal...some questions

    arleen - hope you dont mind me jumping in here. :)

    do you have your splint right now? you know how you said that you feel pressure on one side -- well, i had the same problem when i first got my splint. it's taken a couple of adjustments, but it feels better now. my teeth were hitting too hard on one side. the splint takes some tweaking and then it feels fine. as well, since you have problems with your gums, you can move the little metal prongs yourself by using needlenose pliers.

    anyway, i wish you well with your treatment. i hope that it works for both of us. :)

    - saaraah.

     
    Old 12-16-2003, 10:43 AM   #8
    Arleen
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    Re: Marlene, Crystal...some questions

    Hi Saaraah:

    Jump in any time. They explained about moving the metal prongs. They also gave me some clear, gooey stuff to use on the splint if there's an uncomfortable spot - I think to even it out. Did you get some of this? They gave me two small containers - one green and one red - guess they're in festive Christmas mode, and I think worried that if I run into problems over the holidays they'll be closed for a couple of weeks.

    I didn't wear my splint during the day yesterday as I worry more about my teeth all hitting and grinding at night. I'd been sleeping before with a really badly done rubbery nightguard. So, I slept with the splint last night and it was okay. I can't say for sure if my teeth stayed where they should, be nothing was killing me this morning. I have one or two teeth lower right that feel sore. I don't know if it's because it's too high there or if it's the wires so I'll adjust the wires tonight. If my teeth feel okay tomorrow, I'll start slowly wearing it during the day. My teeth and gums don't seem able to withstand much pressure. I think wearing it at night, while lying down, puts less pressure on everything which is maybe why it didn't hurt as much as it did in the office yesterday.

    I really wasn't pleased with yesterday's appt at all. I was passed from one person to the next, no one seemed to want to answer my questions - except Gail, who I had to nab with questions as she was passing by. Marilyn looked in my mouth and did some record keeping. When I asked what she was doing, she said she's looking at my teeth. No kidding! Maybe they're not used to patients asking questions, but she was just plain miserable, which is why I asked Gail what Marilyn had been doing. I didn't find Jainie much nicer, but then she'd been nice to me on the phone once BEFORE she found out I'd had to cancel my appt twice. When she found that out her whole manner and attitude changed towards me. The receptionist wasn't any better. Can't comment on Dr. R. as I only saw him for 5 minutes when he did an adjustment on my splint.

    I was feeling very down yesterday thinking I should never have gone to that office. Apart from Gail who has been very nice, it's just left me with a bad feeling, and they seem very assembly line, like the patient doesn't really matter. You'll excuse me today, I'm just all round p.o.'d. I'm sick of dentists.

    I hope you're doing okay. I'll let you know how things go with the splint.

    Take care,
    Arleen
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    Last edited by Arleen; 12-16-2003 at 01:24 PM.

     
    Old 12-16-2003, 12:55 PM   #9
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    Re: Marlene, Crystal...some questions

    Quote:
    Originally Posted by Arleen
    Hi Saaraah:

    Jump in any time. They explained about moving the metal prongs. They also gave me some clear, gooey stuff to use on the splint if there's an uncomfortable spot - I think to even it out. Did you get some of this? They gave me two small containers - one green and one red - guess they're in festive Christmas mode, and I think worried that if I run into problems over the holidays they'll be closed for a couple of weeks.

    I didn't wear my splint during the day yesterday as I worry more about my teeth all hitting and grinding at night. I'd been sleeping before with a really badly done rubbery nightguard. So, I slept with the splint last night and it was okay. I can't say for sure if my teeth stayed where they should, be nothing was killing me this morning. I have one or two teeth lower right that feel sore. I don't know if it's because it's too high there or if it's the wires so I'll adjust the wires tonight. If my teeth feel okay tomorrow, I'll start slowly wearing it during the day. My teeth and gums don't seem able to withstand much pressure. I think wearing it at night, while lying down, puts less pressure on everything which is maybe why it didn't hurt as much as it did in the office yesterday.

    I really wasn't pleased with yesterday's appt at all. I was passed from one person to the next, no one seemed to want to answer my questions - except Gail, who I had to nab with questions as she was passing by. Marilyn looked in my mouth and did some record keeping. When I asked what she was doing, she said she's looking at my teeth. No kidding! Maybe they're not used to patients asking questions, but she was just plain miserable, which is why I asked Gail what Marilyn had been doing. I didn't find Jainie much nicer, but then she'd been nice to me on the phone once BEFORE she found out I'd had to cancel my appt twice. When she found that out her whole manner and attitude changed towards me. The receptionist wasn't any better. Can't comment on Dr. R. as I only saw him for 5 minutes when he did an adjustment on my splint.

    I was feeling very down yesterday thinking I should never have gone to that office. Apart from Gail who has been very nice, it's just left me with a bad feeling, and they seem very assembly line, like the patient doesn't really matter. I had taken in xrays from the neuro dentist I saw, for their information. They asked if they could copy them, so I left them there after my last visit. I explained yesterday that I'd need all my xrays to show my insurance company, so I was given them when I left. Only thing, they didn't give me my originals back - they gave me the copies, which isn't the same quality at all. I don't know if it was intentional or not, but it seems sleazy. So, now I'll have to wait to my next appt or drive 2 hours to make the switch. They also didn't give me all the ones Dr. R's office had taken. You'll excuse me today, I'm just all round p.o.'d. I'm sick of dentists.

    I hope you're doing okay. I'll let you know how things go with the splint.

    Take care,
    Arleen
    Hi Arleen,

    I posted to you on another thread....but, I did not know that you were not pleased with your treatment during your appointment. I am so sorry that you were treated poorly. I think it is soooo important that the people in a tmj treatment office be upbeat, kind, and understanding. Patients are in pain and it's hard enough driving to the appointment sometimes, without people making you feel bad.

    ((((Hugs Arleen))))
    Navy1990

     
    Old 12-16-2003, 06:35 PM   #10
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    Re: Marlene, Crystal...some questions

    Hi Arleen,

    Dr. Rondeau has been dealing with TMJD for much longer than Dr. Rawson and they both have a very similar method of treating TMJD. So when Dr. Rawson learned that I had already dealt with Dr. Rondeau he told me that he didn't think he could help me. I totally respect him for that honesty.

    I have done the whole physio, chiropractor, massage, cranio-sacral route to no avail. I have made arrangements to see one more dentist in January. He's from the U.S., but will be in Canada for a seminar and has agreed to meet with me. If he's unable to help me than I'll likely give up trying.

    I hope you can hang in there with your new splint. I honestly think that Dr. Rondeau's office is one of the best in treating TMJD, regardless of any personality conflicts you may have.

    Take care.

    Crystal

     
    Old 12-17-2003, 07:57 PM   #11
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    Exclamation Re: Marlene, Crystal...some questions

    I agree with Crystal. I never had any problems with anyone in Dr. Rondeau's office - and I was "affectionately" known as their "P.I.T.A" Patient! At the risk of starting a "discussion", I think that like any other business/office/profession, they're allowed to have "off/bad" days too. The way I look at it (and looked at it when I was undergoing treatment myself), the dental profession is not there for me to love - as long as a treatment makes sense and works, "chairside manner" isn't the most important thing to me.

    Marlene

     
    Old 12-18-2003, 01:47 PM   #12
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    Re: Marlene, Crystal...some questions

    Hi Crystal and Marlene:

    I agree "chairside manner" isn't important as long as treatment works. But I think people should answer questions and not be snarky about it, after all I'm the one paying for the treatment, I want to know what's wrong and to understand what they're doing or looking at in my mouth.

    I seem to have one really bad pressure spot on my gums and teeth, and one lesser, both on either side of my front teeth. With the splint in, one of them started bothering me. I asked the doctor about this and he said it may be referred pain. That doesn't make sense, as the spot is red and sore, and in both spots the papilla have been receding when they've had pressure. Maybe next time he'll had time to give it more consideration but it looks like I'll only be wearing my splint nights until next month because of it. Let's hope these spots don't get worse, or I'm back to my old lousy nightguard. It just feels like that's another month of my life gone.

    Sorry to be so crabby on the boards lately. I'm just at the end of my rope, and my patience these days in non-existent. I've had enough of runarounds, outright lies, and mistreatment from dental and medical professions. And I expect my questions to be answered in a professional manner. Maybe they were having an off day. Well every day for me for the last two years has been an off day, and at this point I don't feel like I've got any hope for the future. I will continue treatment. The office staff do seem like they know what they're doing and appear very thorough. I hope so, because I can't bear the thought of having to go through all this again with yet another dentist. So, excuse me, I'm very much a grinch these days..

    What does P.I.T.A. mean?

    Arleen
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    Last edited by Arleen; 12-18-2003 at 01:47 PM.

     
    Old 12-18-2003, 03:27 PM   #13
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    Re: Marlene, Crystal...some questions

    tee hee Arleen ...If I were to guess, I would think P.I.T.A stood for Pain in the you know what patient. So, Arleen, apparently you're not the only one that gets grumpy with the tmj mess.

    I sure hope this works out for you.

    Navy1990

     
    Old 12-18-2003, 03:42 PM   #14
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    Re: Marlene, Crystal...some questions

    arleen - no, i wasnt given any gooey stuff.

    im sorry that you had a bad visit, and felt like you werent treated well. i've been treated well there, so i cant relate. i find jainie to be very informative and helpful. i have found it strange, tho, that dr. r isnt involved in my treatment at all. he has only done 1/2 of one adjustment [out of 3] with jainie and dr. matton doing the others. i dont mind, tho, because jainie is great.

    i know what you mean about asking questions, tho. i like to have *real* answers - not the pared down 'patient' answers. it seems that you really have to probe to get the info you want. i wouldnt take that personally, since it seems like most patients dont ask informed questions.. you know what i mean? we seem to be a rare breed of patients who want the straight info. :)

    it must've been a bad day for them, which isnt an excuse for not treating you professionally, but it's something to consider -- try not to take it personally.. im sure that they dont have it in for you.

    i really hope that your treatment goes well, arleen. im rooting for you. :)

    have a great day.

    - saaraah.

     
    Old 12-19-2003, 08:22 PM   #15
    Arleen
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    Re: Marlene, Crystal...some questions

    Hi Saaraah:

    Thanks for your kindness - it really helps when I'm feeling miserable.

    I find it strange too that I hardly see Dr. Rondeau. I saw him at my first appt for about 15 minutes. He quickly reviewed some of the xrays and helped in doing the impressions as it was tricky because I've got all my wisdom teeth and can only open my mouth so wide. I saw him for less than 5 minutes last time. I was taken to Jainie who I was told would do splint adjustments - but she didn't - Dr. Madden did initially then he left. It still felt odd, so then Dr. Rondeau did some adjustment. I believe time's been set aside at my next appt for him to go over my situation in more depth. So, although I was taken in to see Jainie, she hasn't really done anything. What kinds of things did she do for you?

    I'm finding that to get answers, I have to become very persistent. So, this definitely won't make me a favourite there. I can tell when they answer my questions, they're wanting to rush off to do whatever else it is they need to do next. I can understand how busy that office must be, but I've taken 2 hours to drive there, and so far have also spent money on a hotel because my appts were first thing in the morning and I worried about not making it in time, or getting stuck in snowstorm.

    I hope it was just a case of a bad day - it was Monday - this probably isn't the best day to have an appt anywhere. I think my next one's on Monday too

    I hope things go well for you too. Keep in touch.

    Take care,
    Arleen
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