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TMJ Disorder -TemporoMandibular Joint board


First here's a summary of TMJ history and therapy:

I am 22 and suffered two blows to my jaw (blows to the bottom of my chin thrusting upwards) a year apart from each other, the first being in October of 1998. I didn't realize the importance of seeing someone about the jaw clicking/popping that followed until a year later however one doctor said nothing can be done, and another tried some major repositioning therapy with 2 splints (one daytime, one nighttime)that moved my jaw forward in order to potentially correct the slipped articular disc that is present on both sides of my jaw. I have several clicks that happen on various levels of opening my mouth, when my mouth is all the way open - after all the popping takes place, the cartilage discs on both sides are back in place, but upon closing they go right out of place again.
This somewhat extreme physical work on my jaw with the repositioning splints did not work for me however, because it impaired my speech and he gave me a somewhat hopeless prognosis of "poor" for my chances of success for repairing the damage by my injuries.
This doctor (Cliff McNaughton of Sioux Falls, SD) did have several x-rays done so I am aware of most of the extent of damage to my jaw.
The heads of the condyle bones (right near the TMJ area) on either side have already experienced some wear and deterioration due to bone on bone rubbing because the articular disc is out of place or is being worn on 95% of the day.
His therapy included personal jaw exercises and massage, but also weekly electroyde (??) patches on the jaw area that supposedly stimulated and relaxed the muscles. Nevertheless, the expense of his proposed therapy, poor prognosis, and the ultimate distraction of the 2 splints led me to find a different specialist.

Current Treatment (from Oct. 02 till present):
My current doctor is Dr. James Fricton, a professor at the University of Minnesota School of Dentistry who sees patients like me at the TMJ/Craniofacial Pain Clinic near Minneapolis. He is seeking a different therapy rather than repositioning treatment. It is a behavioral approach that includes personal exercises again, a flat-plane splint that goes on my bottom teeth worn at night (because I grind my teeth pretty bad), and enforcement of behavioral habits such as eating soft foods, RELAXING my muscles and being aware of the tension of my muscles.. etc. Also, mild muscle relaxers like flexeril are in use.
He's told me that my TMJ can not be repaired, but it can be made manageable with a prognosis of "very good".
I've been seeing him since October once a month - a total of 3 times though because travel to MN is difficult amidst college classes.

Treatment success??:
The splint worn at night has helped prevent wear on my teeth, but the grinding continues. I wake up in the morning with my facial muscles EXHAUSTED like I've been eating steaks all night long.
The exercises and stretches have NOT helped to decrease tension, however the clicking and popping has been reduced.

CURRENT PROBLEMS:
- I have tried clonapin, flexeril, skelaxin, and lorazepam, none relieve any tension in my face and jaw.
- Throughout the years while I've had the injury I've been fortunate to NOT experience actual pain in my jaw even when it clicks, but since december the muscle tension has increased 200%, and has moved from my jaw area to the middle of my forehead, around both my eyebrow areas, and sides of my head towards the top.
Nothing relieves this tension I experience, it's inescapable - in somewhat bright light (or outside), and most of the day is when it's the worst.

Current Medications and other diagnosis':
I have ADD and have experienced depression - while other meds have failed before my diagnosis of ADD, the meds I'm on now work great for the "mental" issues I experience.
I take 10mg of Adderoll in the morning along with 10 mg. of lexapro - it works great.

QUESTIONS:
I greatly desire to escape the facial muscle tension I experience as the muscle relaxers I've tried seem so mild that they do not help. I understand that Adderoll, being a stimulant, does not help muscle tension. Does anyone else take stimulants while dealing with TMJ?
What other kinds of muscle relaxers (to take at night) would work better. I just need to experience even a couple hours of relief at night from this muscle tension.
I am a nighttime teeth grinder, how have others dealt with reducing the grinding and muscle work that takes place at night, since my current splint does not keep my jaw in a locked position at night but simply protects my teeth from wear? Would a splint that does keep your jaw in a specific position at night help or do nothing to decrease the automatic "biting down hard" that a grinder experiences?
I'd like to hear any responses or reflections, personal experiences or questions ANY person may have, and thank you for taking the time to read through this.
Dana Wigg - Sioux Falls, SD.