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Open Bite/TMJ: Surgery vs. No surgery


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Old 08-01-2014, 01:56 PM   #1
Airy2017
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Open Bite/TMJ: Surgery vs. No surgery

I developed an open bite after seeing a jaw specialist for my TMJ. The splint caused my bite to shift so much that I am now in orthodontics and am supposed to have surgery to correct my bite. My problem is that I have SEVERE anxiety over having the surgery. I am contemplating not going through with it. My ortho has told me time and time again that it is MY decision to make but hasn't really gone over what would happen if I were to just get my braces off and get a retainer and another guard to protect my teeth from my night grinding. Can my teeth survive not having the surgery if I just wear a retainer and make sure they are protected from clenching and grinding? I really don't have the finances for this right now either. I have no insurance and paying the 7,000 for the braces was a nightmare and now I have to pay another 7 grand for surgery. It's too much...especially since I am unemployed right now. I don't know what to do. I am so conflicted. I am living in constant fear of having this surgery next month. I feel like I CAN'T do it. Has anyone NOT opted to go through with this surgery?? Please help!

 
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Old 08-02-2014, 08:44 AM   #2
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Re: Open Bite/TMJ: Surgery vs. No surgery

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Originally Posted by Airy2017 View Post
I developed an open bite after seeing a jaw specialist for my TMJ. The splint caused my bite to shift so much that I am now in orthodontics and am supposed to have surgery to correct my bite. My problem is that I have SEVERE anxiety over having the surgery. I am contemplating not going through with it. My ortho has told me time and time again that it is MY decision to make but hasn't really gone over what would happen if I were to just get my braces off and get a retainer and another guard to protect my teeth from my night grinding. Can my teeth survive not having the surgery if I just wear a retainer and make sure they are protected from clenching and grinding? I really don't have the finances for this right now either. I have no insurance and paying the 7,000 for the braces was a nightmare and now I have to pay another 7 grand for surgery. It's too much...especially since I am unemployed right now. I don't know what to do. I am so conflicted. I am living in constant fear of having this surgery next month. I feel like I CAN'T do it. Has anyone NOT opted to go through with this surgery?? Please help!
Surgery is a big decision. I think the best thing to do is get a second or even third opinion. Don't have surgery if you are not ready for it.

 
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Old 08-02-2014, 09:02 AM   #3
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Re: Open Bite/TMJ: Surgery vs. No surgery

From what I have learned on my journey, TMJD is as varied and controversial as it is expensive with no real guarantees of success.
As I see it, there seems to be two schools of thought on treatment; interventional and non interventional
The doctors who believe in non interventional treatment plans are treating patients with Flat planes splints and Physical therapy along with heat or cold packs for pain are usually tried. Maybe muscle relaxers if previous treatments have not worked. Many TMJ experts that I have seen believe that less is best.

Those doctors that believe in interventional treatment most often are treating patients who have tried all other methods but pain and disfunction have escalated. Often the disc have been damaged but this can happen and not cause any problem. These doctors may use Repositioning Splints, braces or surgery to change your bite. In my experience, this can be risky, especially for those who already have TMJ problems. Some patients have severe problems with their joints being damaged. In this case interventional treatment is of course, a patient treatment option.

You have not mentioned what kind of surgery is recommended for you or if you had an MRI to look at your discs and joints. You already have a great deal of money invested in this treatment plan and still are suffering. Are not Orthodontists by their very nature interventionalist, since what they do is change peoples bites? At least those that I met with were.

I am so sorry to hear about your struggles with this and I think it would be well worth your investment to get a second opinion. Go slow and investigate.
Good luck.

Last edited by Gretagirl; 08-02-2014 at 09:08 AM.

 
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Old 08-02-2014, 07:23 PM   #4
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Re: Open Bite/TMJ: Surgery vs. No surgery

I totally understand your anxiety with possibly having to face surgery. As they said above it is your decision and you should be comfortable with what you are having to go through with for a treatment plan. It would be good to get a second opinion to see what someone else might say for your treatment.

I can tell you though what my oral surgeon has told me. There is a slight chance I may also have to have bite surgery due to an open bite. I have just went through athroplasty to my joints and we need to let that heal before looking into correcting the other problem. The surgeon said that if your teeth/jaw is not properly distributed for weight it can only cause problems for the joints. The uneven pressure usually affects the joints and can cause more pressure on one side than the other. I can tell you that I may have the same thought process as you. I am hoping my orthodontists can fix the open bite so no surgery is needed. But if they say surgery is the only option I will have to look at all my options.

Megan

 
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Old 08-02-2014, 10:52 PM   #5
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Unhappy Re: Open Bite/TMJ: Surgery vs. No surgery

Yes, I am actually scheduled to have orthognathic surgery of the lower jaw. I am terrified and literally having anxiety attacks every night about this. I feel like my body/mind is not handling the idea/concept of going through with this surgery very well. I am just scared beyond belief. I haven't had a second opinion. Just the opinions of my dentist, ortho and the oral surgeon. The dentist seems to think it's up to me and hasn't been either pro or anti-surgery. He just stays pretty neutral about it and seems fine with everything. My orthodontist is pushing the surgery as well as the surgeon (Of course) and I don't think there is anything that could be done to change the position of my bite without surgical intervention. My bottom jaw has receded and my bite has only a few back teeth hitting. I can chew food OK but I do have problems. I can't bite into a sandwich like a normal person but I have managed for 8 years like this fine. I know my back teeth are getting a LOT of wear on them and I have actually broken 2 crowns from my night-grinding. I know that the surgery is the BEST option to choose but I feel financially stressed as well as not mentally prepared for this. It has been 2 years of having these braces on and I feel like it has all been a waste of time since I just want them off and I want my life back. I just worry about the consequences of removing them and just fixing the broken crowns and getting a retainer and a night guard to protect my teeth as they are. I feel like I could live with the bite being off but I don't want to lose teeth over it. I am just incredibly confused and overwhelmed. I feel very alone right now.

 
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Old 08-04-2014, 12:45 AM   #6
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Re: Open Bite/TMJ: Surgery vs. No surgery

Quote:
Originally Posted by Gretagirl View Post
From what I have learned on my journey, TMJD is as varied and controversial as it is expensive with no real guarantees of success.
As I see it, there seems to be two schools of thought on treatment; interventional and non interventional
The doctors who believe in non interventional treatment plans are treating patients with Flat planes splints and Physical therapy along with heat or cold packs for pain are usually tried. Maybe muscle relaxers if previous treatments have not worked. Many TMJ experts that I have seen believe that less is best.

Those doctors that believe in interventional treatment most often are treating patients who have tried all other methods but pain and disfunction have escalated. Often the disc have been damaged but this can happen and not cause any problem. These doctors may use Repositioning Splints, braces or surgery to change your bite. In my experience, this can be risky, especially for those who already have TMJ problems. Some patients have severe problems with their joints being damaged. In this case interventional treatment is of course, a patient treatment option.

You have not mentioned what kind of surgery is recommended for you or if you had an MRI to look at your discs and joints. You already have a great deal of money invested in this treatment plan and still are suffering. Are not Orthodontists by their very nature interventionalist, since what they do is change peoples bites? At least those that I met with were.

I am so sorry to hear about your struggles with this and I think it would be well worth your investment to get a second opinion. Go slow and investigate.
Good luck.
Thank you for your help. I am supposed to have my lower jaw moved forward. It's not a double jaw surgery. I did have a full head scan done and the surgeon said I had some slight deterioration in the jaw bone from arthritis. I am not sure what exactly that means though. I am still so conflicted over what I need to do. I know the surgery is booked but I am on the fence. I am actually beyond stressed about not having any kind of protective bite guard for weeks after the surgery. I grind SO bad that I am almost positive I will crack/break teeth after the surgery without any protection for my teeth.

 
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Old 08-04-2014, 07:34 AM   #7
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Re: Open Bite/TMJ: Surgery vs. No surgery

Airy

I am sorry that you are feeling alone with this. Please know that we are all here and you can vent and discuss anything that you need to. I can tell you that has helped me so much while I was going through my rough patch.

I know you have been going through the braces for a couple of years now and it has taken a tole on your mindset. You honestly may want to look at postponing the surgery. I know with surgery in the future it can cause people to have a different mindset and worry more. This is one topic that people have a right to get stressed about. Doctors never fully understand what we as patients go through until they honestly have to go through it themselves. If you are this stressed on a daily basis and at night it can hurt your recovery from surgery. You want your best possible option to recover fully at 100%.

You may want to ask your oral surgeon how can they prevent you from grinding your teeth at night after the surgery takes place. I am not sure when your next appointment is with the doctor but you may want to write down a list of questions to be able to ask them. If they truly care about your case and your thoughts they should be able to answer them for you. Yes all most doctors are concerned about getting the money for treatment. However, you do hope that some have the heart and actually care about their patients feelings with their treatment plan.

The grinding is one concern for me because my surgeon believes that may have been the start of my trouble while I was in school. I feel I may have to wear either a splint or night guard for the rest of my life to hopefully protect my joints. I can tell you my dad went through the surgery and they had to reposition both his upper and lower jaw. Mainly because 3% of his teeth where meeting. I think that he was possibly in his 30's and he is now in his 70's.

Megan

 
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Old 08-04-2014, 05:05 PM   #8
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Re: Open Bite/TMJ: Surgery vs. No surgery

Quote:
Originally Posted by Airy2017 View Post
Thank you for your help. I am supposed to have my lower jaw moved forward. It's not a double jaw surgery. I did have a full head scan done and the surgeon said I had some slight deterioration in the jaw bone from arthritis. I am not sure what exactly that means though. I am still so conflicted over what I need to do. I know the surgery is booked but I am on the fence. I am actually beyond stressed about not having any kind of protective bite guard for weeks after the surgery. I grind SO bad that I am almost positive I will crack/break teeth after the surgery without any protection for my teeth.
If you are this stressed out about surgery - don't do it. Postpone it and talk to your surgeon and orthodentist again about the expected outcomes and risks; talk to them about your concern about getting a protective night gaurd as well. And in the meantime, get a second opinion from another oral surgeon.

You have to be mentally prepared for this type of surgery. The worse decision you can make is to go through with it and be this anxious and not being mentally prepared because your emotional state of mind can have a profound impact on your recovery.

Talk to your ortho and oral surgeon says about postponing surgery for a couple of months and during that time get a second opinion.

A good surgeon should respect your feelings.

Take care and let us know how it goes.

 
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Old 08-12-2014, 01:18 AM   #9
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Re: Open Bite/TMJ: Surgery vs. No surgery

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Originally Posted by Canuck65 View Post
If you are this stressed out about surgery - don't do it. Postpone it and talk to your surgeon and orthodentist again about the expected outcomes and risks; talk to them about your concern about getting a protective night gaurd as well. And in the meantime, get a second opinion from another oral surgeon.

You have to be mentally prepared for this type of surgery. The worse decision you can make is to go through with it and be this anxious and not being mentally prepared because your emotional state of mind can have a profound impact on your recovery.

Talk to your ortho and oral surgeon says about postponing surgery for a couple of months and during that time get a second opinion.

A good surgeon should respect your feelings.

Take care and let us know how it goes.
Thank you again for your help and the advice. I called my ortho's office and they told me they could no longer postpone and that the surgery either needs to take place next month (beginning of september) or the braces need to come off because they have been on too long (I didn't realize 2 years was too long?). I think they are sick of me and my anxieties. Maybe it's just because I am paid off and they just don't want to serve me since I take up time and money when I come in now? I don't know. Either way, I told the ortho I would call him back within 2 weeks to schedule the braces getting taken off. If I gather some bravery together I will continue through with the surgery but I am not counting on it. I have never felt this guilty/depressed/anxious in my entire life about something. My family is making me feel like an idiot for having spent so much money on the braces and not following through with surgery to correct the bite. I am feeling like I could survive without having it but that my life could improve with an adjusted bite. I don't remember what it's like to be able to bite into a sandwich or even bite my nails. But, my nerves are just overruling every aspect of this.

 
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Old 08-12-2014, 01:53 PM   #10
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Re: Open Bite/TMJ: Surgery vs. No surgery

Quote:
Originally Posted by Airy2017 View Post
Thank you again for your help and the advice. I called my ortho's office and they told me they could no longer postpone and that the surgery either needs to take place next month (beginning of september) or the braces need to come off because they have been on too long (I didn't realize 2 years was too long?). I think they are sick of me and my anxieties. Maybe it's just because I am paid off and they just don't want to serve me since I take up time and money when I come in now? I don't know. Either way, I told the ortho I would call him back within 2 weeks to schedule the braces getting taken off. If I gather some bravery together I will continue through with the surgery but I am not counting on it. I have never felt this guilty/depressed/anxious in my entire life about something. My family is making me feel like an idiot for having spent so much money on the braces and not following through with surgery to correct the bite. I am feeling like I could survive without having it but that my life could improve with an adjusted bite. I don't remember what it's like to be able to bite into a sandwich or even bite my nails. But, my nerves are just overruling every aspect of this.
I know this must be very frustrating, But if I were you: I would want to know why do the braces have to come off now? What's the after care plan (I've been advised that I need braces to correct my bite before having total joint replacement surgery - the braces would come off immediately after surgery but I would be wearing a retainer of some sort for probably 1 to 2 years post surgery to make sure my bite is maintained. I know your surgery is different but I would want to understand how do they intend to maintain your bite - can this be done with retainers? I know your surgery is different from mine -are they wiring your jaw shut?

Secondly, is it clear in your mind what orthognathic surgery is intended to accomplish? And has the oral surgeon clearly explained the risks and benefits? How will surgery help you chew better? Will it reduce pain?

Third - if you are a grinder - you should be wearing a custom night gaurd at night to reduce the impact of grinding - grinding is extremely damaging to your teeth and very hard on your TMJ joint. I know you can't wear one with braces - but once the braces come off they should make one for you.

Fourth, have they explained the risks and consequences to you of not going through surgery and simply wearing a retainer and night gaurd?

I know this must be an extremely stressful decision. You're are not an idiot for having fears and concerns over surgery. And you shouldn't feel bullied into it. Its your body - you have the right to make an informed decision. If you can, I would still get a second opinion on the surgery.

Take care

Marsha

 
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Old 02-19-2016, 09:16 PM   #11
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Re: Open Bite/TMJ: Surgery vs. No surgery

Quote:
Originally Posted by Airy2017 View Post
I developed an open bite after seeing a jaw specialist for my TMJ. The splint caused my bite to shift so much that I am now in orthodontics and am supposed to have surgery to correct my bite. My problem is that I have SEVERE anxiety over having the surgery. I am contemplating not going through with it. My ortho has told me time and time again that it is MY decision to make but hasn't really gone over what would happen if I were to just get my braces off and get a retainer and another guard to protect my teeth from my night grinding. Can my teeth survive not having the surgery if I just wear a retainer and make sure they are protected from clenching and grinding? I really don't have the finances for this right now either. I have no insurance and paying the 7,000 for the braces was a nightmare and now I have to pay another 7 grand for surgery. It's too much...especially since I am unemployed right now. I don't know what to do. I am so conflicted. I am living in constant fear of having this surgery next month. I feel like I CAN'T do it. Has anyone NOT opted to go through with this surgery?? Please help!
Hi Airy,

I've read through old posts and wondered how you are doing? Did you have the surgery to correct the open bite? How are your results? I too have an open bite caused by a TMJ splint. I only touch on my back left molar. I have worse TMJ pain now. I am now trying to figure out what to do. I'm encountering that an open bite caused by splints is much more common than I thought. Were you warned that could happen or to watch for one to develop? I never was. My splint was a bottom one which is apparently not designed for long term use as it had a built up ramp on the anterior part.
Anyway, I wonder if anyone has had successful litigation in these cases?
I truly hope you are well and that if you had the surgery it was not nearly as bad as you feared it was gonna be

 
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Old 02-19-2016, 09:46 PM   #12
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Re: Open Bite/TMJ: Surgery vs. No surgery

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Originally Posted by Pugsnotdrugs View Post
Hi Airy,

I've read through old posts and wondered how you are doing? Did you have the surgery to correct the open bite? How are your results? I too have an open bite caused by a TMJ splint. I only touch on my back left molar. I have worse TMJ pain now. I am now trying to figure out what to do. I'm encountering that an open bite caused by splints is much more common than I thought. Were you warned that could happen or to watch for one to develop? I never was. My splint was a bottom one which is apparently not designed for long term use as it had a built up ramp on the anterior part.
Anyway, I wonder if anyone has had successful litigation in these cases?
I truly hope you are well and that if you had the surgery it was not nearly as bad as you feared it was gonna be

Hello!

I actually had the braces removed. It was a long procedure to get them removed. They had to then get me in rubber bands to shift my teeth to a better spot for life WITHOUT surgery. It was annoying and time consuming. The rubber bands were rough for me. I hated them.

I truly wish I had gone through with the surgery though. I will not lie about that. If you can get the courage to go through with it...DO IT. My bite has been maintained where I am now hitting a good amount of teeth which is nice BUT the pain is still there and I am always grinding at night. I wear my retainers religiously but they do not cushion against intense grinders like me so I have to put a sports-guard (kind of like what football players or hockey players wear) that I cut down to size between my teeth at night to stop from bashing my teeth too hard. My mouth never feels right though. It just feels...off. I truly regret my decision and wish I had gotten more courage to follow through. It was an immense waste of money on my part and an even bigger waste of time and stress. I paid 7 grand out of pocket for nothing. That's what happened. It's sad that I couldn't muster the mental fortitude to do the surgery. I implore you to go through with it because I know it would be better then living in constant pain.

Good luck and stay strong!!

 
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Old 02-20-2016, 09:21 AM   #13
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Re: Open Bite/TMJ: Surgery vs. No surgery

Thank you so much for taking the time to reply. I am sorry that you now regret your decision not to do it. I wonder had there been someone like you telling you so strongly to do it if that would have helped you to stay the course to surgery? You now are helping me and can help others with your story. So, just know your pain and suffering is not in vain! I know surgery is not for everyone and it is an individual decsion but I will remember you and your strong recommendation to do it. Was the surgery they were gonna do called a La Fort procedure? I'm pretty sure that is what they would do on me.
Hang in there and gentle hugs

 
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Old 02-20-2016, 01:25 PM   #14
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Re: Open Bite/TMJ: Surgery vs. No surgery

Also, I am curious about a few things if you don't mind answering back. Did your splint Dr that gave the splint that created the open bite ever tell you that 1) It was extremely important to have frequent regular follow ups to adjust and monitor the splint, 2) were you warned that an open bite could happen? 3) How was your bite before splinting? Mine was edge to edge and maybe slightly open to begin with 4) were you told what kind of splint you were getting and the purpose of it?
I was not told anything really. I showed him my old night guard that was pretty worn and was a top fitting one. He said "I'll make you a new one" , so I thought I was just getting a new "night guard". When I got it I didn't even see the Dr, just his assistant that told me it would take time getting used to and how to take care of it. It was a bottom fitting one and it felt really different. I went back maybe 2 more times but he never really looked at it. I trusted him as he was the "TMJ expert" in the area. Now upon my increased TMJ pain and open bite and taking a closer look at it, it looks like maybe a Tanner splint? It has a slope or ramp on the front part of it. Anyway, my notes don't say anything about the need for frequent adjustments/monitoring and they don't even state the style or name of the splint, it's just referred to as a TMJ splint. So, needless to say I am not happy. I'm just wondering if others are not told much about them either?
Thank you!

 
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Old 02-20-2016, 01:30 PM   #15
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Re: Open Bite/TMJ: Surgery vs. No surgery

Hi again!

No problem! I'm glad to express my feelings about it. I know this situation is different for everyone but I do wish I had pulled myself together and just gone through with the surgery. I think my pain might have been gone and my profile would be fixed as well which would give me some self esteem back.

Yes, the procedure was a la forte but there might have been a class to it. I can't remember if it was a class 2 or 3 la forte. I definitely remember that being the procedure type though.

I should also mention that although I couldn't get myself to do it and I DO regret it...it's not the end of the world. I'm ok. I'm not dying. I'm not in agony. I am living my life. The jaw pain is manageable with Advil for me and sometimes it's not there. It's just that things feel "off" and that my jaw is always tender that bother me the most.

Do it if you can but don't go nuts if you feel that you can't.

Good luck and thanks for the response!

 
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