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Tmjd or something else?

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Old 09-05-2012, 02:07 PM   #1
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Tmjd or something else?

After going to a recommended TMJ specialist, I feel pretty confused. I have a possibly misaligned bite and my chiropractor thought it could be causing some of my symptoms. Thing is, I also had poor sleep position and posture habits. One day I woke up with sudden skull pressure and neck/shoulder pain. It causes headaches and back pains, as well as feeling disoriented. My jaw has started bothering me more recently but it isn't severe and bothers me much less than my other symptoms. I have nonstop tinnitus but I think I've been this way my whole life. I used to clench my teeth but trained myself to keep my teeth parted over time.

I felt like the TMJ specialist was going to recommend invisalign for my bite matter what, like they were trying to make a sale to me. The tests they ran were bogus... An EMG where half the sensors werent reading, yet they still relied on the results. I didn't get any good answer on why they believed my bite to be the underlying problem and not a neck issue. Yes I know my bite isn't perfect, but I want to spend my money wisely on what will help me, not just on a guess. I know there will always be some guesswork involved, but I'm leaning much more towards a cervical spine issue.

Is this normal or should there be a better test and confirmation? I also feel much better when I'm not sitting often... Would this be true for a bite issue? I would think it wouldnt matter if it were my bite causing it.

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Old 09-05-2012, 08:41 PM   #2
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Re: Tmjd or something else?

It took me a couple tries to find an orthodontist who specialized in TMJ disorders, did a thorough exam and actually had a treatment plan that made sense to me.

It has been a couple years so I may not remember everything, but some of the tests that I had that gave me a more thorough understanding of my tmj issues were:

A thorough health history questionnaire
Muscle palpatation
3D cone beam tomography
Joint Vibration Analysis
Computerized Jaw tracking
Occlusal bite analysis
Adrenal assessment
Nasal airflow measurements (I don't remember the name of this test)
Recommendation for overnight sleep testing and oxymetry (I'd already been scheduled for this prior to my visit so that worked well.)

My testing visit was about 3 1/2 hours plus an additional visit to a specfic MRI center that did good TMJ scans. I had my records visit about a week later. At that visit, he discussed my issues and the range of treatment options available.

I chose to go with a lower mandibular repositioning splint and nighttime custom tmj/sleep splint for Phase I and self-ligating braces for Phase II. From what I understand about invisalign it moves the teeth, but doesn't substantially change a bite. With my discs slipped forward, my lower jaw was pushed back mm's towards my ear and I needed to get it permenantly positioned into proper forward location away from my ears.

I was also recommended to a great PT who worked on my alignment, jaw muscles, neck muscles and shoulder muscles. I had already seen her before I started TMJD treatment. When your TMJ is out of alignment, it can trigger alignment issues all the way down to your feet. Your sitting issues can certainly be related.

I will say that I've made tremendous progress with my ear issues and nighttime bruxism throughout my treatment for TMJD.

If you've read any of my other posts you may have seen that I found a book that gave great TMJD information and advice. I came out after I'd spent way too much money looking for answers, many of which are addressed in the book. Topics such as posture and sleeping posture are discussed. It is called The TMJ Healing Plan by Cynthia Peterson, PT. You might find it helpful in addressing some of your day-to-day habits.
Asthma, Allergies, Dry Eye, severe LPR/GERD, TMJD, Hearing Loss, Ulnar Impaction Syndrome, Shoulder Impingement, Ankle ligament repair, arthritis, Joint Hypermobility Spectrum Disorder

Last edited by MountainReader; 09-05-2012 at 08:47 PM.

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tUrRrRa (09-07-2012)
Old 09-07-2012, 02:11 PM   #3
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Re: Tmjd or something else?

Thank you very much for your reply! The TMJ specialist I saw was actually per a recommendation given to me, but I think it would be best for me to get a second (or more) opinion. Maybe they are just really bad at communicating, but I didn't have a great feeling there. I felt like they were jumping to conclusions.

I just received a 3-page report in the mail with all of my findings and recommendations, as well as the EMG readings. Before I would get ANY kind of treatment, I would absolutely want to have more testing done to make sure TMJ disorder is an issue for me. I did very well on some of the other simpler tests they did, like measuring how I could move my jaw.

After reading their recommendations, it goes into MUCH more detail than they told me in person. I was sitting there for 2 full hours but the TMJ specialist only talked to me for maybe 5 minutes. I sat by myself waiting hooked up to the EMG most of the time and spent the remainder with an assistant. Definitely not 2 hours of testing, which would have been much more helpful. The recommendation in person was pretty much invisalign, and they did believe that I only need my bite adjusted by a very small amount, which is maybe why it was recommended. They did say that for most, a splint would come first, but mine was pretty minor. The report mentioned invisalign AND a splint and talked about the phase 1 and 2 treatment, all of which wasn't discussed with me in person.

After looking at everything, I just can't possibly get all of that done right now. One, my dental plan does not cover ANY of it and I wouldn't be able to afford likely over $10,000 of treatment in a shorter period of time. I already have the top dental plan offered by my employer but it doesn't cover TMJ issues or orthodontic care for adults. I may potentially have a better option with my spouse's new employer, but I won't be able to make the change just yet. I suppose I can start doing my research though. I also have quite a number of appointments right now and struggle getting them done and making up the work time, so I really don't want to add more stress by increasing this.

I will definitely look into the book. Thank you for sharing! That also sounds great about the adjustments. I may look into all of this for ways I can at least treat the symptoms and feel my best. I really need to continue with my neck treatment to see what the underlying cause really is, since it's possibly not even my bite doing this. I've caused some neck trauma over the years that could very well be bothering my jaw too (and my jaw hardly bothers me compared to everything else). Hard to tell when it's all connected. I just want to make sure I am following the right treating before investing all of the time and money.

Thank you so much again! I appreciate your thorough reply and sharing your own experience.

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