What have your down moments been and why? (caution: rant)

[TMJJill]

How do you find out you have TMJ ? I am currently experiencing a lot of facial pain and massive headaches that are so bad that I can not sleep hence my post on here . I am with a neurologist at the moment and they have not mentioned anything about this, they are putting everything down to muscular tension. Anyway I had a 6 month brace fitted and am about two months in but the pain has increased ten fold, does anybody have any idea why this might be ? I really am at the end of my tether, any input would be appreciated.

There really is no easy answer to your short question. As far as I know there are no actual medical or dental specialities for TMJ treatment. Any dentist can say they treat TMJ even with just a few hours of training. Ultimately what worked for me was searching out a dentist who was trained in functional orthodontics (treatment of the bite as it relates to the teeth and the rest of the body). He also has additional training in orofacial pain, sleep dentistry and tmj treatment.

The easiest "test" for TMJD and the one many docs and dentists use is to put your fingers in your ears or right in front of them and open and close your mouth. If you feel "popping" you may have tmjd issues. THe popping feeling is your disc slipping in and out of place. This is far from definative though. Many docs and dentists take various approaches to diagnosis. It took me several tries. To get my final confirmation, I had an MRI, a 3-D CT scan, jaw vibration analysis, x-rays, jaw movement analysis, occlusal equilibrium assessment, bite measurements, posture analysis, physical neuromuscular assessments, etc. My first assessment appointment with this particular dentist took about 3 hours for completion. At my records appointment, he went in depth about the results from all of the assessments, what he saw my issues as and what my options for treatment were. He was much more comprehensive and could explain things to me much better than the other dentists I saw. It was difficult to find him though.

If you are interested in seeking out a local dentist trained in treating TMJD, I recommend searching functional orthodontist or neuromuscular dentists first. Look for additional training in TMJ treatment, orofacial pain treatment, and what percentage of their practice treats tmj. It is very important to find a dentist who understands how the function of the jaw relates to the health of your body. If your headaches and facial pain come from tmj issues, they need to understand that connection.

Sorry this is long, I had some negative experiences and met multiple docs who didn't have any idea about the tmj connection to my pain as I searched for my answers to my symptoms.

If you are interested in further strategies for addressing the muscle spasms/pain related to TMJ maybe we can start a new thread. It typically takes a multi-prong approach with various strategies.

If you are wanting some quick thorough information on TMJD issues and how they relate to facial, head and neck pain, there is an incredibly good book called The TMJ Healing Plan: Ten Steps to relieving headaches, neck pain and jaw disorders by Cynthia Peterson. It is fairly inexpensive, explains the tmj/body connections well and provides many suggestions for things you can do on your own as well as helping you understand what you should be asking your doctors/dentists about in advocating for your own health.

[pellepee]

@Beaniebean: aside from what TMJJill has already covered, just get as many opinions as you can until you find someone you are comfortable with. If I had gone with my first ortho, I'd be in braces already and would be in for a horrible, painful ride and I'd have never known why. She was only concerned about straightening teeth... not restoring function. I was lucky, my second opinion was with a neuromuscular dentist a block away from my office who had a hygienist in his office who was almost out of braces for the exact same jaw issues! I got her ortho's number, made an appointment with him and ended up with my prosthodontist. I trusted these people, and the four of them (including the hygienist) have my jaw health as their top priority.

There are people out there who you can seek help from, you just have to find them. Where do live? Maybe by chance you live near someone else on the boards who might have a good reference?

TMJD pain as I understand is different for everyone. Mine in particular goes from my right jaw joint, up into my eye and right temple and then down into my neck, then the crease of my neck/shoulder all the way down to under my shoulder blade. I mistook it for bad posture at the computer desk as I'd been using computers since a child and I'm right-handed. I wouldn't say its a burning pain... like a mix of heat and tension and it pulses subtly.

@Klobird: A forsus? That sounds like a medieval torture device to stop peasants stealing gold! My gosh, it probably feels like one for you at the moment yeah? I really do hope it is worth it in the end, to stay out of the elastics and get things moving. Are you able to ... this will be easier said than done... but put something over the spring where it catches? Cling wrap? Aluminium foil? You wouldn't be able to chew with speed but at least you'd have relieve I guess. I don't know what they look like, so I don't know if it would be an option. Best of luck! Th forum will help you get through it.

@TMJJill: I asked my doctor at my adjustment today how I would transition into braces and he said there wouldn't be anything in my mouth. He said I'd probably have a 6 month period without any appliance before my jaw would move back itself so the aim is to have a 'naked jaw' and get my back teeth moved with braces (and things) as fast as possible. Then, if there are issues I'd get a bit of resin on the back teeth to remind me where I am supposed to bite until everything else is sorted. I may need a night-time splint (from what I gathered would be forever I guess), just to stop my jaw sneaking back over to the left at night. He had a look at my bite today, and my ideal jaw position means only the first molars on the right touch... barely... so now I understand how I got into this predicament to begin with.

You have your arm in a cast too? Poor thing! I hope it is mending quickly. I am getting dual health problems sorted too; I have been having stomach issues which have progressed to seeing a gastroenterologist so I feel like I'm falling apart all over the place. Yet, my gym membership remains unused... and I wonder why I am withering away haha! This started before the splint, so it isn't the appliance which I've read it can be... shame!

You sound like a strong person having gone through what you have; I hope you get to the end soon and can jump up and down and know that this was all worth it; show off your smile and enjoy life pain-free.

[smartygirl]

oh ugh, down moments indeed...

1. last spring when i realised that my teeth were moving in the wrong direction. instead of one tooth being intruded, the whole row were being extruded. my jaw was sore and i remember catching a glimpse in a mirror and my whole face looked crooked. ugh.

2. minor: i went in for my impressions 1 week prior to debanding, and my ortho instead said "hm, maybe just one more month, with elastics..."

3. last night when i went to put my elastics on after dinner & brushing, i noticed that an upper incisor - a tooth that was never bracketed, never a problem - is now sticking out a bit. i wonder if the elastics, instead of pulling out the tooth that was lingual on the bottom, pulled on the upper it was hooked to and that's what made my incisor stick out? does that make any sense? i really need to call my ortho this morning but i just don't want to. i'm supposed to be in a tv shoot with my son on monday, and i don't want any extra metal in my mouth!!

funny it seems like a lot of troubles with elastics lately... or maybe i'm just noticing it more now that i'm experiencing that misery too!

[Beaniebean]

TMJJill thanks for your input it was really informative and I'm glad I just read your reply now as I am off back to my neuro tomorrow and you have certainly given me some food for thought. In all honesty I never even thought my headaches and facial pain where down to my jaw until I got the braces fitted, so maybe they ae a blessing in disguise in that I might be getting to the root of my problem. I did that short test that you mentioned and my jaw certainly pops when I close my mouth, the strange thing is that it pops on the right side really loud yet my pain is mainly left sided. The problem I guess I have is that in the UK I have to go through the NHS system which means a long drawn out process, If I could afford to go private I would but this is not an option. Anyway thanks for posting back to me, it sounds like you have had one of a painful journey and I am pleased that you seem to finding a solution to your problems.

Pellepee, I am also greatful for your post back, it certainly helps my fragile state of mind when I know other people are overcoming similar problems. I too believed that all my problems where caused due to postural problems as I work at a computer, strange that nobody else in my office suffers to the same extent. I am religious in doing stretches etc but have never had relief and I am now becoming convinced that my jaw has a lot to answer for. My ortho at the moment is only interested in aesthetic look of my teeth, hence the 6 month fast track route. Whenever I try to discuss bite problems she just tells me that she can sort this at the end although I'm not sure how. Anyway hopefully now I have some insight I can maybe get the ball rolling. Thanks again and I hope your brace journey ends well .

[TMJJill]

Beaniebean,
TMJD is a pretty crazy thing. So many different symptoms and manifestations.

I can relate. When I had my 3D CT scan and MRI's of my jaw, it showed my discs had slipped forward, but my left condyle was much worse than the right. All of my pain and ear stuffiness was on my right side. Go figure.

I saw a neurologist several months after I began splint therapy (ended up I had viral meningitis) and had him evaluate me further because my ears had gone numb (that novacaine like feeling) and the ENT, PCP and Audiologist couldn't find anything wrong. He did several MRI's of my brain and neck and didn't find much. He attributed my issues to the TMJD as well.

My treatment is a bit opposite of yours. The braces are to fix my bite. Ironically, while I had a few gaps, my teeth were pretty straight before the braceds went on. Makes me wonder how different they will actually look after all this $ and time for treatment.

Other TMJD patients I've chatted with on other boards are actually dealing with TMJD as a result of orthodontics. That is why I now recommend people to see functional orthodontists.

Good luck at your appointment.

[tarabears]

My down moments -

1.) This entire time my Orthodontist has been attempting to move my canines back to close my extraction gaps. My side profile looks god-awful horrible and it has been such a slow process. I've had two gaps on either side of my canines for over 7 months now. Hopefully with my next appointment I'll get the powerchains on to move my front teeth back finally.

2.) I do a lot of public speaking, and for some reason ever since I got braces my mouth gets dry very quickly if I'm speaking for too long. One particularly embarrassing yet equally humorous occasion regarding this happened when I forgot to bring water up with me to the podium. My mouth got so dry that my upper lip kept snagging on to my upper brackets every time my I talked and it probably looked like I was snarling at the audience LOL.