I'm new to the forum but not new to the problem.
I'm working on my 3rd round of TMJ in the last 15 years. I had my diagnosis consult today with my ortho.
I have cross bite pretty bad. I have a small open bite and a very small overbite.
He recommends the SARPE and then braces with the whole thing taking ~2years start to finish. (not counting retainers) My worry with the SARPE is he thinks I need 6mm of expansion. That doesn't seem very large, so how necessary is it really?
The braces will be about $5300.
During our discussion he talked about recovery time for the SARPE. He thinks I will handle it fine since I've had 2 c-sections, an appendectomy and my gallbladder removed. Because I teach and talk a lot i'm worried about how many days it will be uncomfortable to talk and work. I'm at a new school with 12 days of sick leave (I have 2 children). I am hoping I can pull off the SARPE around Thanksgiving so that i have at least 4 days off without using sick leave.
SO any information about recovery time would be good. I had my wisdom teeth out with NO trouble or pain so that is not a good analogy.
The other thing he mentioned is that if we expand the jaw it may change the relationship of my top and bottom jaw in the joint creating a larger overbite. I'm curious if anyone has heard of this and how big this chance may be.
I'd appreciate any comments you can give me.
what the ortho said...
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science teacher
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SARPE, etc.
Welcome, science teacher.
I had the SARPE, and just finished my expansion--only 6 mm exactly. Believe me, in the scale of your mouth, it does make a difference. If the skeletal structure does not match, they cannot really arrive at a good result. I didn't want to go through with it, but I'm glad that I did.
I had my SARPE surgery (outpatient) on a Thursday, and was feeling completely normal by the following Monday. Well, COMPLETELY might be an overstatement, but I was well enough to be back working, etc. There are other issues to deal with, such as eating and talking, but that's part of the game.
I am a teacher as well, and worried about my speech. Today is my first day of teaching for the school year (about one month post surgery), and I have to say that I can speak pretty well with the expander, although it does take practice and motivation to learn how to adapt. I still cannot make a satisfactory "S" sound, or "EE" sound without stopping and thinking about it, but I come pretty close.
I wish you the best of luck!
I had the SARPE, and just finished my expansion--only 6 mm exactly. Believe me, in the scale of your mouth, it does make a difference. If the skeletal structure does not match, they cannot really arrive at a good result. I didn't want to go through with it, but I'm glad that I did.
I had my SARPE surgery (outpatient) on a Thursday, and was feeling completely normal by the following Monday. Well, COMPLETELY might be an overstatement, but I was well enough to be back working, etc. There are other issues to deal with, such as eating and talking, but that's part of the game.
I am a teacher as well, and worried about my speech. Today is my first day of teaching for the school year (about one month post surgery), and I have to say that I can speak pretty well with the expander, although it does take practice and motivation to learn how to adapt. I still cannot make a satisfactory "S" sound, or "EE" sound without stopping and thinking about it, but I come pretty close.
I wish you the best of luck!
If you are having trouble with TMJ you might want to get another opinion on the SARPE. I also have a crossbite and TMJ and was recommended SARPE. Being the obsesive person that I am, I got several different opinions. It seems there are two schools of thought on this: the 'Baylor' guys focus more on the teeth than the jaw (Baylor guys like SARPE), the other guys (Roark?) focus more on the jaw health. I have been told that for jaw health it is better to go with a LeFort expansion (mulitsegmented Lefort). With the LeForte they can line everything up exactly where it needs to be. With the SARPE there can be asymetrical expansion. It will open the pallate, but at the expense of the jaw.
There is a Dr. Arnett in Santa Barbara who is supposed to be really great (an OS) As I have only recently changed all of my plans (from SARPE to this) I still haven't had a lot of time to surf the web and find out more information.
In my case I will be starting splint thearpy, then braces and the expansion. I will hopefully have a bit of a timeline after I see my ortho on Monday.
There is a Dr. Arnett in Santa Barbara who is supposed to be really great (an OS) As I have only recently changed all of my plans (from SARPE to this) I still haven't had a lot of time to surf the web and find out more information.
In my case I will be starting splint thearpy, then braces and the expansion. I will hopefully have a bit of a timeline after I see my ortho on Monday.
SARPE
I would like to respond to Delag's comments.
I do not have severe TMJ symptoms, just occasional soreness and clicking. My expansion with SARPE WAS asymmetrical, which will later be corrected with a LeFort I Osteotomy. I'm not sure why my OD chooses this route of treatment, but he must feel that it produces a better result than a segmental Lefort.
Additional opinions never hurt, so that certainly can't be bad advice!
I do not have severe TMJ symptoms, just occasional soreness and clicking. My expansion with SARPE WAS asymmetrical, which will later be corrected with a LeFort I Osteotomy. I'm not sure why my OD chooses this route of treatment, but he must feel that it produces a better result than a segmental Lefort.
Additional opinions never hurt, so that certainly can't be bad advice!
Hey Phil! I think there must be as many different opinions as there are doctors out there:lol: . I never ment to imply that one way was better than another, and I am glad that it wasn't taken that way. When I saw my first two orthos and OS they never mentioned anything other than SARPE as an option. As a matter of fact, I did not choose them because they completly dismissed my TMJ problems.
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science teacher
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- Joined: Wed Aug 30, 2006 7:31 pm
- Location: kansas
Thank you for the responses.
My student's think I talk funny now because I say things like ya'll and many made up sounds and words. I guess not being about to say an s properly won't be unusual.
The LeFort hasn't come up with my ortho. I'm scheduled to see an OS on 9/27. It may come up then. I think the Lefort has much more of a recovery time and it would have to wait until summer.
Thanks
My student's think I talk funny now because I say things like ya'll and many made up sounds and words. I guess not being about to say an s properly won't be unusual.
The LeFort hasn't come up with my ortho. I'm scheduled to see an OS on 9/27. It may come up then. I think the Lefort has much more of a recovery time and it would have to wait until summer.
Thanks
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science teacher
- Posts: 428
- Joined: Wed Aug 30, 2006 7:31 pm
- Location: kansas
About the TMJ. The SARPE and braces are the way the ortho thinks we can fix it. My joint literally pops out of place every time I open my mouth wide. I haven't been able to eat many foods since April because of it.
This is the same proposed treatment as the first time i had a TMJ episode. I was 20 and in college and said no way.
This is the same proposed treatment as the first time i had a TMJ episode. I was 20 and in college and said no way.
Hi Everyone,
I'd be interested to hear any other opinions from people who are seeking treatment not only because of wonky teeth, but also for TMJ issues.
I've had headaches since I was 17 (25 now) and am about to start braces followed by a lower advancement (which I can definitely see is needed - facial profilewise).
The first OS I saw recommended Sarpe, followed by upper and lower advancement. However the second one only recommended the lower advancement.
He said that although my palette was fairly narrow, it was still a good size relative to my lower jaw, so expanding the upper would make it too large compared to the lower.
Has anyone here with TMJ/headaches actually had much relief by having braces/surgery?
It seems that some OS's agree that fixing the bite has a reasonable chance of reducing my head/muscle ache, whereas others seem to say that as its the muscles that are causing the problem, then fixing my teeth won't help.
I'm definately going ahead with the braces/lower surgery, but just wanted to see if anyone else has been in a similar situation?
I'll be posting my first blog once my wisdoms have been removed (in a week) and I have my upper linguals places (4weeks after that)
Cheers everyone!!
Dave
I'd be interested to hear any other opinions from people who are seeking treatment not only because of wonky teeth, but also for TMJ issues.
I've had headaches since I was 17 (25 now) and am about to start braces followed by a lower advancement (which I can definitely see is needed - facial profilewise).
The first OS I saw recommended Sarpe, followed by upper and lower advancement. However the second one only recommended the lower advancement.
He said that although my palette was fairly narrow, it was still a good size relative to my lower jaw, so expanding the upper would make it too large compared to the lower.
Has anyone here with TMJ/headaches actually had much relief by having braces/surgery?
It seems that some OS's agree that fixing the bite has a reasonable chance of reducing my head/muscle ache, whereas others seem to say that as its the muscles that are causing the problem, then fixing my teeth won't help.
I'm definately going ahead with the braces/lower surgery, but just wanted to see if anyone else has been in a similar situation?
I'll be posting my first blog once my wisdoms have been removed (in a week) and I have my upper linguals places (4weeks after that)
Cheers everyone!!
Dave
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science teacher
- Posts: 428
- Joined: Wed Aug 30, 2006 7:31 pm
- Location: kansas
Thanks Meryaten,
I agree with pretty much what you've said. Although i've found lots of evidence that TMJ is caused by many factors (grinding teeth, stress, pushing my jaw forward, muscle spasm) I also haven't found any evidence that sorting out my bite will actually make it worse.
I've spoken with my OS regarding this, and he says that some OS's believe that sorting out your bite with/without surgery will help, and others
dont believe that the 2 are connected.
Its a big risk for me to do this, and I certainly don't want things to get worse! Its not unbearable pain or anything like that, just light headaches most days, and ringing in my ears, and sometimes jaw muscle pain.
The way I see it is......... do I really want to feel like this forever? THe answer of course is no! So i'm going for it!! My wisdoms come out next week, and then braces start 4 weeks after that.
A quick question Meryaten..... you mentioned in a post somewhere that you've had lower advancement, but are now in elastics as your muscles are fighting the move.... can you tell me a bit more about what you mean?? I was told that I wont need elastics as i'm having the surgery, which is espeically good as elastics are difficult to use with upper lingual/lower ceramic combo that i'm going for.
Cheers for all of your input on this site.. It doesn't go unnoticed!!!
I agree with pretty much what you've said. Although i've found lots of evidence that TMJ is caused by many factors (grinding teeth, stress, pushing my jaw forward, muscle spasm) I also haven't found any evidence that sorting out my bite will actually make it worse.
I've spoken with my OS regarding this, and he says that some OS's believe that sorting out your bite with/without surgery will help, and others
dont believe that the 2 are connected.
Its a big risk for me to do this, and I certainly don't want things to get worse! Its not unbearable pain or anything like that, just light headaches most days, and ringing in my ears, and sometimes jaw muscle pain.
The way I see it is......... do I really want to feel like this forever? THe answer of course is no! So i'm going for it!! My wisdoms come out next week, and then braces start 4 weeks after that.
A quick question Meryaten..... you mentioned in a post somewhere that you've had lower advancement, but are now in elastics as your muscles are fighting the move.... can you tell me a bit more about what you mean?? I was told that I wont need elastics as i'm having the surgery, which is espeically good as elastics are difficult to use with upper lingual/lower ceramic combo that i'm going for.
Cheers for all of your input on this site.. It doesn't go unnoticed!!!