I'm currently in the process of trying to reverse prior extraction treatment after TMJ issues began during extraction ortho treatment, worsened over the following 6 or so years, culminating in literally constant headaches, migraines, balance issues and overall poor health (sleep apnea, narrowed airway, reduced tongue space, torus on both palates developed post-debracing retainers, etc).
My original ortho was very experienced and highly regarded in a renowned capital-city university but it seems his choice of treatment for my original overjet and overbite (extraction of two upper second bicuspids, with powerchain and elastic retraction) was not necessarily the route all ortho's would have taken given my circumstances. Given that I had no crowding, only overjet and overbite, I have since discovered extraction is not necessarily the only treatment option in my case.
Since my TMJ issues became unbearable I have consulted two separate NM dentists, as well as a specialist cranio-facial chiro that my own chiro referred me to. To be honest I was not convinced their (unanimous) diagnoses could really be the answer for me; surely teeth placement that visually looked great couldn't really cause such spiralling poor health. From the minute the TMJ splint was fitted, my headaches have literally gone from unremitting to occasional faint echoes, and my spatial reasoning and balance have returned. To my (delighted) surprise, I really feel much better. The splint that seemed totally unwearable at first, is now something I couldn't close my mouth without.
So I am left with a decision to make. The TMJ splint is not a complete answer, nor is it a long-term solution to my problems. As a single mum of two small kids, I simply cannot manage going back to feeling the way I was before the splint. It is frightening to witness your health deteriorate and become unable to manage daily life, seemingly without any reason (how lucky I feel that I was able to find healthcare providers that could figure it out). Which means I have to make the right decision now to try to permanently reverse the ill-effects of my ortho treatment, where all my TMJ issues can be traced from; whether the extractions themselves have caused the problem or not, I still need to find an answer. I am hoping the answer doesn't have to be implants for the rest of my life, but if that road lies the only way to returning to functioning human status, so be it.
My current practitioner is a dentist rather than an ortho; as
braces2 mentioned, my (NM) dentist has a more holistic approach, taking into consideration how all the pieces of machinery in the human body work in relation to each other, and the effects they have on each other. My original ortho didn't seem to have any interest when I mentioned during treatment that my jaw had started 'clicking' and causing issues, grinding, etc, so I am encouraged by the dentist's approach!
So my current treatment plan involves TMJ splint therapy for 3 months (to decompress the TMJs, allow my 'slipped' discs to return to normal functioning position, give my jaw and facial muscles a chance to recover and find my comfortable bite), followed by ALF expander and braces (again) to bring my maxillary arch back to a more forward position (hopefully reversing the now narrowed airway, and give me back some space for my tongue). As I still have all 4 wisdom teeth, we are hoping to bring the upper molars forward into the extraction spaces, rather than implants if possible. I am hoping this will also help with the Sleep Apnea I've now been diagnosed with; my ultimate goal is a return to health and function of my TMJs without any appliances or sleep apnea splints at all.
I did wonder at the time when I was getting braces, and the ortho suddenly decided to extract teeth at the last minute after actually placing the brackets on them and then suddenly removing (the brackets), just how indicated it was since he'd never mentioned extractions before. But I trusted his vast experience and training. I couldn't see how removing teeth from one arch only and retracting the remaining teeth would fit functionally with a full compliment of teeth in the corresponding arch.
I have no ortho or dental training, but when I hear these discussions re extractions vs non-extractions, I can only be influenced by my own detrimental experience with extractions. I think it depends very much on the reason for your extractions. Extractions for crowding may make sense based on basic physics. Where overjet/overbite are concerned perhaps there are other options to consider. What might appear to one person to be an overjet, may actually be viewed as an underdeveloped mandibular arch (as I've since been told by 3 seperate specialists that I have), which would surely be particularly susceptible to TMJ issues if forced further back into the TMJ by extraction/retraction? In general, I wonder whether extracting a corresponding number of teeth from each arch would go further to maintain a healthy jaw-to-jaw function relationship?
My two cents worth, though it's costing me a damn sight more than 2c to have my original ortho treatment reversed
