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  • What is Mild-Moderate-Severe TMD?

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    Old 07-08-2004, 08:42 PM   #1
    Anthem
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    What is Mild-Moderate-Severe TMD?

    This is my first post, so please be kind. I am sitting here with humming in my left ear so nerve wracking I feel as if someone installed a tiny air conditioning unit next to the ear drum. I also have a swollen sensation in the ear. I went to a ear specialist and he confirmed the ear is just dandy but it is probably referred "pain" from TMD. I went to a pain mgmt TMD specialist in Phoenix and he agreed, took excessive measurements, had me wear a day time splint for a month (not to change the bite but to supposedly take pressure off the left joint to promote healing). Instead, it caused symptoms to worsen, e.g., terrible mini cramps in BOTH joints and neck pain. His reaction? "Just stop wearing it then..." So I paid this guy $1500 so far to be back at square 1. Also, he wants me to keep coming back each month to tell HIM how it feels at $150 a shot (no recommended treatment so far other than the splint - he takes notes then sends me home again - feel like I am going to a Freudian psycho-analyst!).

    I now wear a different hard mouth splint every night to hopefully stop the motivating factor (doesnt allow me to really grind/clench), but the symptoms continue from damage already done, or so it seems...

    Anyway, now that I have whined, I would like your help in putting TMD into some sort of context and ask, has anyone here read any success stories? Does it ever just go away on its own? I get the gist that is my doctor's hope, even though he has no problem billing me for his little 10 minute review sessions.

    My symptoms have included popping in the left joint (now gone) and locked jaw (now gone). I now have predominantly a puffy feeling in the muscles of the left jaw but no real pain. I have ear puffiness and a humminmg but no real pain. I have sore left jaw upper teeth with a little pain when brushing them and sensitivity to cold drinks.

    However, I suspect that my TMD is probably considered quite mild? If so, I have tremendous love for anyone who suffers MORE than this, since it is really affecting my quality of life.

    1. Is my case in your opinion "mild"?
    2. Does such a case ever resolve itself? (I ask this if some of you are old timers and have seen people come/go).
    3. I apply heat each night, ice at other times, eat gentle foods (no peanut brittle or baggles) and treat the jaw with respect. Nonetheless, this has gone on now for about 6 months and so far I don't see any improvement since the popping, locking and initial pain went away. I seem to be on a plateau where I can "live" indefinitely if necessary but it is far from what the average person would find "healthy". I can't go for more than a short time without my mind thinking about it unless I distract myself with gardening or some labor intensive task.

    Note: The doctor says my case probably was due to teeth grinding and clenching. I had the boss from hell last year who drove me to quiting my job, left California for a new state, lost both parents, then watched my dog get run over by a car that didn't even stop. The NEXT DAY the TMD began where I could not eat or open more than 1 finger width. I know in retrospect that I was causing this damage for a long time via clenching/grinding. My teeth have tiny cracks and 1 front tooth has a tiny piece missing (just fell out) but not noticable to the general public. I now wear a plastic mouth splint every night to hopefully stop the motivating factor, but the symptoms continue.

    This entire thing takes me to even metaphysical areas, e.g., is there a God that allows such things to happen to people? Sure, I sound naive about reality. I saw a car bumpersticker the other day that fits "REALITY is when it happens to YOU!" How true.

    Last edited by Anthem; 07-08-2004 at 08:53 PM.

     
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    Old 07-09-2004, 02:50 AM   #2
    Condyle
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    Re: What is Mild-Moderate-Severe TMD?

    You seem to have improved some since the locking and limited opening. I started with only ear issues, and ended up with messed up TM joints because of a PHX TMJ dentist. His attitude, response, and prices seem similar to what you described!

     
    Old 07-09-2004, 08:07 AM   #3
    delilah1963
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    Re: What is Mild-Moderate-Severe TMD?

    I feel for you. My TMJD has not gotten better on its own, one failed splint therapy and many other non-irreversible treatments later. Over two years now. So do I wait another 5 (I had read somewhere 7 years average). If I do that, am I only causing more damage to my joints? How long is long enough? I am consulting another specialist, referred by one of the best in the world, and hopefully it will help me decide what to do. My pain is not severe, as I can still work, but during the week that's about all I can do. My neck and jaw wreak havoc everyday.

    I am a clencher too. I feel for you. I catch myself all the time, even when wearing my splint (like Heidi, sometimes I feel like it gives me something to bite down on). Sometimes my teeth aren't touching but I grimace and cause muscle tension that way. How to reprogram yourself?? It's hard.

    If you can function, albiet uncomfortably, I would sense your case it mild, like mine. Some people are in such pain they cannot work, or do most things except to try to control the pain.

    Anthem, the best thing you can do is cough up the bucks to get the proper diagnostic testing (tomograms or MRI) and see if there is joint damage, if not, it may be primarily muscular and you can determine what your options are then. I find chiro/massage/acupuncture helps to cope, but it is a large commitment in time, energy, money. I want my life back too, and I think the natural tendency as a person is to strive to get better. Not manage the TMJD, but really get better. And many people do. I've met them and they rarely have headaches, jaw pain, etc. So far, I just haven't been one of them.

    Not much help, I know, but there's just no silver bullet or guarantees.

    Take care,
    Del

     
    Old 07-09-2004, 12:56 PM   #4
    Anthem
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    Re: What is Mild-Moderate-Severe TMD?

    Thank you both!

    Interestingly, my ortho. seems more optimistic than I am. I said during the last visit "Is this like a bad back that will always bother me with symptoms?"

    He responded "It would be like a very mild bad back where the symptoms will go away, and you can live a normal life, but need to just be aware of the weak point in your body and not damage it again".

    Then he sent me home without any recommended treatment, implying that time would heal all wounds. It hasn't so far. I think it would work better if he'd just put on a fancy witchdoctor headdress, said some magic words, threw some pixie dust on me and proclaimed me cured. Then maybe my mind would buy into the idea that progress is being made and I am healing.

    He said my muscles are very tense, and implied that it is a muscle problem, not a disk displacement (since that supposedly causes a great deal of pain). But he only took an x-ray and now I am not sure why, since he admitted it does not tell if you have a disk displacement. Hmmm....maybe they do all these tests and take all these extensive notes (the questionnaire I filled out for the first appointment was 20 pages long....) as part of that witchdoctor scenario, e.g., if they know everything, then somehow that means they are making progress. But sometimes I think they are taking all these notes just to keep busy and show some sort of activity for my money. And the last time I was there I was able to hear the doctor with someone next door. I felt such sadness for that patient, since they were in excruciating pain, but he gave them a cortisone (?) shot and it did not help, so he felt the problem was not the joint, and had to send them elsewhere. But he boasted that if the problem is joint related and there is great pain, he can find the perfect drug to alleviate it. Hmmm....that is sure great to know, but I want a SOLUTION, not to become a junkie! Of course, TV is now constantly telling us to run after our doctor asking if we can take more pills. Don't you love the commercials that do not even tell you what the pill does, but just urges you to contact your doctor? I find it all very unwise.

     
    Old 07-14-2004, 12:45 AM   #5
    Isobelj
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    Re: What is Mild-Moderate-Severe TMD?

    I used to think mild tmjd is tmjd which is 'only' muscular, no joint movement or disc displacement. However I've realized that many can function well and without pain even if they have displaced discs and a certain amount of locking due to this (locking can happen due to technical stuff to do with the position of the displaced disc, or just because of muscle spasms being so tight they don't allow full opening - the latter is a bit like limping, similar to when the spasms around a sprained ankle or whatever won't let you move it normally -). I have a friend with tmjd due connected to her wisdom teeth, she locks, but has no pain really. My latest dentist is similar, both discs displaced since braces about ten years ago he said, but he is pain free and ear problem free, so leaves things as they are. Disc displacement and even locking due to it doesn't seemingly then need to cause pain, the body can adapt.

    I on the other hand started off with the muscular problems and now have one slightly displaced disc, but full opening. However I do have pain and did from the beginning when I 'only' had muscular probs. Yet my tmjd is supposedly categorizable as 'mild'.

    I could feel it when my disc displaced late last year, my joint feels different when I touch it and if I touch it lightly when opening the disc on that side (right) moves down and out, is no longer in sync with the normal left side. Also, there is a slight click on the right when I get to about a thumb's width, apparantly because it occurs pretty soon and not when my mouth is more widely open it means the disc is only a little displaced (a click doesn't necessarily mean you have a displaced disc however). The first maxillo facial surgeon I saw told me my disc is not displaced but I didn't believe him because of what I could feel (later tomogram readings and a new and much better dr confirmed my own sensations of what was going on), so actually someone telling you you are ok will not necessarily make you so!

    Anyway, I hope this could help you a little with self diagnosis. Tomograms (relatively inexpensive) will not show the actual disc but will show space between condoyle and skull, if it is normal the disc has room to be in place so this at least would be a good thing for you to know.

    Isobel

    ps. Anthem, I like what your dr said to you about the back, where you need to be aware of the weak point but it can go away...

    Last edited by Isobelj; 07-14-2004 at 12:49 AM.

     
    Old 07-14-2004, 09:53 PM   #6
    BLACKdragon78
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    Smile Re: What is Mild-Moderate-Severe TMD?

    Anthem,
    I know how you feel. My specialist charges the exact same amount for my appliance and additional appointments. i feel I don't get enough treatment for the amount I pay, I mean ten minutes for an office visit??? i don't even get a chance to finish explaining to him all of my symptoms, etc., for me that is the biggest obstacle. One time I had an appointment at the end of the day and my specialist talked to me for twenty minutes because he had no other patients, I know he wants more time to see his patients. Anyhow I haven't had much luck with any tmd treatment but I do believe my symptoms are directly related to my stress. I grind at night but during the day I tense my neck muscles without even knowing it. Now I have two splints but it doesn't prevent me from clenching at night, it just keeps my teeth apart. My pain got so bad I couldn't work for a long while and at one point was bedridden for nearly two weeks, couldn't move, couldn't even lay still. Plenty of rest, ice packs, and neurontin eventually eased some of my pain. My specialist knew i had severe tmd before he even took x-rays. I've had it for so long sometimes I forget I'm even in pain, if this is the case for you yours is likely to be severe or close to it. I would seek treatment right away especially if the pain is occuring in your back or arm muscles.

     
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