Metal Mouth Message Board

Hi -

For those of you who have TMJ, and if you grind and or clench at night - - has it stopped once you got your braces on? I am wondering how much I will aggrivate already sore teeth if I am grinding at night - or whether my mouth will stop itself if it causes pain. Either that or the pain will wake me up!

This is very much an individual thing. My TMJ is much better than before. I still grind and I think I may clench more (with the biteplate I can at least see the damage). I have had periods where the TMJ has flared and periods where it seems cured. What is interesting to me is it used to be centered in one spot. Now it seems to move about. It was all on my left side, now it is sometimes on my right. My cheeks right now feel it. I've not experienced that before.

The positive is I used to take a bunch of meds for the pain. Now a heating pad for twenty minutes provides tremendous relief.

Mike

I did fine with my TMJ during my braces journey UNTIL the ELASTIC phase and that did me in and I had to quit as it was making it worse. Now that I've been out of the braces for over a year I still have days of TMJ pain (I wear a nightguard). Like the previous poster said, everyone is different, but I have found that most people's symptoms just come and go. I suppose it depends on how well they sleep at night or whether it was a grind and clench night.

Hi and thanks for the response! Glad you are feeling better and no longer need pain meds. I suffered with a lot of pain for close to 2 years. But most if not all went away back in October and I have been good ever since - knock on wood. I would be okay with return of some pain, I think that is to be expected but I feel pretty confident that it won't be as bad as what I went through.

I figure grinding with aggrivate already sore teeth so hopefully I won't do a lot of it in my sleep.

Take care -

Chris wrote:I did fine with my TMJ during my braces journey UNTIL the ELASTIC phase and that did me in and I had to quit as it was making it worse. Now that I've been out of the braces for over a year I still have days of TMJ pain (I wear a nightguard). Like the previous poster said, everyone is different, but I have found that most people's symptoms just come and go. I suppose it depends on how well they sleep at night or whether it was a grind and clench night.

Hi Chris -

Were you totally pain free before your braces went on? Makes sense that if the elastics were used to shift your bite that it caused pain. I will have to grin and bare that part even if it does cause me a lot of pain - because the elastics are the most important part of my treatment. I need the elastics to close my bite which is why I am getting braces to begin with. I definitely agree each person is different, and each caues of TMJD is different. I don't have any disc damage - mine is entire muscular due to a bad bite. So his plan is to move some of my teeth into proper alignment first, and then close my bite. He seems very confident in the whole treatment plan - so hopefully it will work for me.

Take care.

I had TMJ issues prior to getting braces. It was mild to moderate and pain came and went uneventually. My ortho was confident that treatment would take away my TMJ but it didn't. I saw an xray of my jaw joints years ago and there was already joint deterioration. I suppose what I have is an unstable joint, but thats my personal opinion. My bite always seems to change.

I'm the exact opposite of Chris. Elastics have actually helped my TMJ problems.

Mike

The first couple of months were brutal with my tmj issues, the clenching was certainly a pain. After about the 1 1/2 year mark everything started to dramatically improve. After about 4-5 months, there was no clenching or clicking and besides being a little stiff....everything is great now!

Hope the best for you!

After the first 1 1/2 year mark? Wow - how long were you in braces?

I figure worst case scenario if I end up in THAT much ongoing pain - then we take them off. I only pay up to how far along I am in treatment.

I have been treated for TMJ with repositioning splints (among other non-invasive methods) for about 5 years. On March 11, I started orthodontics as Phase II TMJ treatment because, like you, my teeth no longer met.

My treatment plan is to consist of first just the top brackets to expand the upper teeth as much as possible. I talked to a couple of orthos that had different approaches for this...one w/a pallatal expander and another w/brackets that used the archwire to expand the teeth. As an adult, the pallete is fused so even w/an expander the pallete itself is not expanded (this is the way it was explained to me). Rather the teeth are pushed outward to the outer limit of the bone that holds them (I forget the name of it) and are slightly flanged to create an "expanded" upper. I for a few reasons went w/the ortho that chose to use brackets and archwire to widen the upper.

At this time I still wear my lower repositioning TMJ appliance. W/in a few months I am to receive brackets on the bottom as well, (after the upper teeth are moved outward) and will have a new TMJ splint made for the UPPER, so I'll have ceramic brackets on upper, metal brackets on lower, and an upper TMJ appliance. After the bottom teeth are corrected and in proper position, elastics will be used to close the bite. My bite is currently open in the back a couple of mm's I would say. I am not looking forward to the elastics part...I believe it will hurt, but we will see.

So far just having the (ceramic) brackets on the top w/the archwire applying light tension outward has been no problem at all. Nothing compared to TMJ, neck, shoulder, etc. In fact, for whatever reason the tension almost seems to help...though I cannot explain why.

FYI -- my ortho is working in concert w/my TMJ dentist. She will do the braces, he will do the TMJ appliances. Also, my ortho used a process called indirect bonding by which the brackets are applied all at once in a tray based on an impression taken a short time prior. It was a snap. I don't understand the entire process but honestly I was finished in 30 minutes, maybe 45 w/instructions, etc. Also I don't have ligatures but something called self-ligating brackets, so the archwire snaps in and does not need to tied to the bracket in anyway.

I will keep you posted as I can.

When do you get your braces on? What is your proposed treatment?
Best,
Del

P.S. Editing to include the fact that for about 5 days the inside of my mouth was sore from the brackets, but wax and eating kiwi helped that. Also my treatment is to last 16-22 months...I'm just saying 2 years so I am not disappointed. Del

I noticed that I started clenching more when I got my braces on, although I've been a clencher for the last 10 years or so. However, around the time I got my braces on, my OS put me on amitriptyline, a very small dose (10 mg), which has really reduced my clenching! I have been off of it for a week right now do to some issues I had with another medication, and I can really tell that I am not taking it because my jaw is sore again.

Amitriptyline in higher doses is used to treat many things such as depression and headaches. It is a muscle relaxer, but in small doses has a secondary effect of reducing clenching at night.

If you find you are clenching a lot and having a lot of resulting pain in your teeth and/or joints, you may want to consider asking your doctor about this medication, I have certainly noticed a difference since taking it.

I have braces for my TMJ and my braces have drastically improved my symptoms. I do not wear an additional night guard, but I do grind and clench a lot. I also wear elastics full-time because I have a cross bite.

The braces have been a miracle for me, as I was in a split that I wore all day long (could not keep it in at night... kept on spitting it out) and it was custom made by my dentist. My migraine headaches have gone down by 75%, as I was having one almost everyday, and my migraines were so severe I was getting dibilating double vision. Since a few weeks after getting braces, my double vision and migraines have reduced signficantly. I still have both, but I can at least tolerate them... instead of having to wear an eye patch and being sick everyday.

I also had severe neck pain, popping/ clicking, locking, pain, swelling, heaches, eye pain, ringing/ stuffy ears, and the list goes on. My TMJ/ TMD was due in part because of a poor bite. I did not get my braces for any cosmetic reason whatsoever.

The braces have drastically helped, however I will probably be splinted or have more TMJ work done AFTER braces to make sure things continue to improve.

[quote="delilah"]>I have been treated for TMJ with repositioning splints (among other non-invasive methods) for about 5 years. On March 11, I started orthodontics as Phase II TMJ treatment because, like you, my teeth no longer me

Wow me too - tho not for 5 years, I gave up after 18 months. I had repositioning splints and tried a few different doctors but things just didn't work out for me and I spent so much money on all that, but live and learn. I stopped the one splint last Summer and come the fall I was pain free. My bite is obviously totally out of wack - see my pics - and that was all a result of the TMJ or the TMJ was a result of the bad bite that got worse, but I'm now at the point where it is time to correct my bite once and for all. I had some docs say I needed to wear a splint for atleast a year to rest the joints and reduce inflammation. I had some docs say I had a severe case of TMJD with joint displacement, and others say I didn't have it at all! But many many people have joint displacement with no pain. My issue was that my TMJ was compounded by a horrendous bite - a lot of people have TMJ with perfectly healthy bites. But the latest opinion for me is that mine is muscular - and my muscles are messed up because my bite is so bad - how it got that way, we don't know. So this is my next logical step to correcting things.

>Nothing compared to TMJ, neck, shoulder, etc. In fact, for whatever reason the tension almost seems to help...though I cannot explain why.

Yeah I hear you on that. I know that I have a pretty high pain threshold and have gone through various procedures with not a lot of issues but the TMJ pain I went through for months on end was by far the worst. I'm just grateful I am pain free for now.

I had a TMJ dentist - but when I took the appliance he made me - first an upper and then a lower to other dentists they could not believe what he was using. There are a lot of dentists out there with a lot of different treatment methods. Unfortunately there is no right approach it seems, so we have to be careful about who we see - good that you found someone who you trust and who is helping me. I finally ventured into NYC and saw a Park Avenue TMJD specialist - who is world reknowned in TMJ. He told me to have this one tooth removed and see an orthodontist asap. He told me my MRI's looked very good - meanwhile the TMJ dentist who had been treating me basically told me they were endstage TMJ and VERY bad. Unbelievable!

I am having my one fractured molar removed next week. 3 weeks later I go in for my separators and one week after that I get full braces - top and bottom. Not sure what you mean by proposed treatment plan - he will straighten out my teeth and close my bite. I didn't ask for much detail other than that.

Take care - stay in touch and good luck!

[quote="Steph-in-WI"]Amitriptyline in higher doses is used to treat many things such as depression and headaches. It is a muscle relaxer, but in small doses has a secondary effect of reducing clenching at night.

I was taking Clonoazapine for a long time - just one half at night. Same thing - muscle relaxer. Might have to go back to that, I take it from time to time as well.

Thanks!

[quote="purpleteeth"]The braces have been a miracle for me, as I was in a split that I wore all day long (could not keep it in at night... kept on spitting it out) and it was custom made by my dentist. My migraine headaches have gone down by 75%, as I was having one almost everyday, and my migraines were so severe I was getting dibilating double vision. Since a few weeks after getting braces, my double vision and migraines have reduced signficantly. I still have both, but I can at least tolerate them... instead of having to wear an eye patch and being sick everyday.


I'm curious - why do you think this is? Is it because your bite was moved THAT quickly after treatment began? I have had all the same symptoms you have had in the past - but most docs I consulted with said I needed to be pain free before orthodontia - which I am and have been for 6 months.

I don't plan to return to any of the TMJ docs I saw prior - as none of them helped me anyway. I will continue to be see by my ortho to watch my bite after treatment is complete, which makes sense to me.

THks for response.