Hi All -
I am wondering if anyone on the boards has braces or any type of orthodontics for phase two of TMJ treatment? What has been your experience? Did you wear a splint? For how long? How long will your braces treatment be? Have you noticed a change in your pain levels since having your bite corrected? My doctor said he would not consider surgery because of my age and occupation so I am looking into fixing my bite with orthodontics. There is a lot of research out there that contradicts itself and I would really like to talk to someone who has been in a similar situation.
Thanks,
Mouse26
TMJ Treatment Question
Moderator: bbsadmin
Hello,
I'm not sure what is generally included in phase II of TMJ treatment, so I can't comment on that, but I can share a bit of my own experiences with TMJ and orthodontics.
I've had pain and problems for a few years now, and finally ended up at an orthodontist who has done extensive training in dealing with TMJ patients. I was first fitted with a bite plate that I wore 24/7 (including eating!) for about 3 month, and then was weaned off of that. The purpose of that was to relax my jaw muscles, and to let them go into their natural position to try to straighten out my jaw, which for a long time had uneven muscle pulls causing problems. With the muscles relaxed, my jaw didn't work very well, because of assymetry. My orthodontist could have lined up my teeth, but my jaws wouldn't have lined up. He could have tried to line up the teeth and pull the jaws into place, but that wouldn't have worked again, because of the assymetry.
So I had braces put on in preparation for surgery. With the assymetry correct, my muscles should be able to work properly, and my jaw should match up on all sides, thus relieving the uneven pressure and pulling that was going on in my jaw joints.
I hope that all makes sense. Basically, for me, because of assymetry, I need to have surgery to make each quadrant of my jaw the correct size. I only had my surgery last week, so I don't know yet if it will work. Time will tell... but without it, my jaw joints would have continued to have excessive wear and tear put on them, and my arthritis and degeneration would have continued, and by 50, I would probably have a completely non-functioning jaw. Right now, I am 27.
I just went back and read your post and to try to answer your specific questions: The braces were on for a year before surgery, and will be on for 6 months to a year post surgery. I already spoke about the splint therapy... I can't comment on pain levels yet. Still too soon. And I don't know if age is really a factor, if you are having a lot of problems. They wouldn't say no to replacing the hip of a 70 year old, because they are too old, so why say no to jaw surgery? (I'm not saying you are 70, but am just saying that if there is a surgery that could help you, then age shouldn't matter.) But then again, if it's not guaranteed to help 100%, then I suppose it might be worth looking at other options.
There are a couple of routes you could take from here... If you haven't asked these questions on the "Ask a Doc" page, you might want to try that, and also, I would get a second opinion, and maybe even a third before proceeding with treatment.
I also want to agree and disagree with Gene. Sometimes surgery can help. It depends on the cause of the problems. But sometimes, surgery doesn't help. The jaw joints are so small that it's hard to fix problems stemming from them. Again, you would need to discuss the options and full treatment plans with a couple of doctors.
Good luck. Sorry to have been so long winded.
take care,
peanut
I'm not sure what is generally included in phase II of TMJ treatment, so I can't comment on that, but I can share a bit of my own experiences with TMJ and orthodontics.
I've had pain and problems for a few years now, and finally ended up at an orthodontist who has done extensive training in dealing with TMJ patients. I was first fitted with a bite plate that I wore 24/7 (including eating!) for about 3 month, and then was weaned off of that. The purpose of that was to relax my jaw muscles, and to let them go into their natural position to try to straighten out my jaw, which for a long time had uneven muscle pulls causing problems. With the muscles relaxed, my jaw didn't work very well, because of assymetry. My orthodontist could have lined up my teeth, but my jaws wouldn't have lined up. He could have tried to line up the teeth and pull the jaws into place, but that wouldn't have worked again, because of the assymetry.
So I had braces put on in preparation for surgery. With the assymetry correct, my muscles should be able to work properly, and my jaw should match up on all sides, thus relieving the uneven pressure and pulling that was going on in my jaw joints.
I hope that all makes sense. Basically, for me, because of assymetry, I need to have surgery to make each quadrant of my jaw the correct size. I only had my surgery last week, so I don't know yet if it will work. Time will tell... but without it, my jaw joints would have continued to have excessive wear and tear put on them, and my arthritis and degeneration would have continued, and by 50, I would probably have a completely non-functioning jaw. Right now, I am 27.
I just went back and read your post and to try to answer your specific questions: The braces were on for a year before surgery, and will be on for 6 months to a year post surgery. I already spoke about the splint therapy... I can't comment on pain levels yet. Still too soon. And I don't know if age is really a factor, if you are having a lot of problems. They wouldn't say no to replacing the hip of a 70 year old, because they are too old, so why say no to jaw surgery? (I'm not saying you are 70, but am just saying that if there is a surgery that could help you, then age shouldn't matter.) But then again, if it's not guaranteed to help 100%, then I suppose it might be worth looking at other options.
There are a couple of routes you could take from here... If you haven't asked these questions on the "Ask a Doc" page, you might want to try that, and also, I would get a second opinion, and maybe even a third before proceeding with treatment.
I also want to agree and disagree with Gene. Sometimes surgery can help. It depends on the cause of the problems. But sometimes, surgery doesn't help. The jaw joints are so small that it's hard to fix problems stemming from them. Again, you would need to discuss the options and full treatment plans with a couple of doctors.
Good luck. Sorry to have been so long winded.
take care,
peanut
Braced: September 23, 2004
Surgery: September 13, 2005
Surgery: September 13, 2005
Hi Peanut,
Thanks for your detailed response. I am not sure why my dr was so strongly against surgery except that I stay home to care for my daughter. I am just a tad older than you...maybe there was more to it...like he didn't feel like the odds were very good for fixing my problem with surgery combined with age and the fact that I stay at home.
Your situation sounds very similar to the course of treatment my dentist is recommending - an anterior repositioning splint and then ortho to line up my bite so it supports the new jaw position. Did you find it difficult to deal with the splint? Did you stop using the splint (biteplate) and then go on to ortho or was there a time when you combined both? I still have a lot of questions for my doctor.
Best of luck to you,
Mouse26
Thanks for your detailed response. I am not sure why my dr was so strongly against surgery except that I stay home to care for my daughter. I am just a tad older than you...maybe there was more to it...like he didn't feel like the odds were very good for fixing my problem with surgery combined with age and the fact that I stay at home.
Your situation sounds very similar to the course of treatment my dentist is recommending - an anterior repositioning splint and then ortho to line up my bite so it supports the new jaw position. Did you find it difficult to deal with the splint? Did you stop using the splint (biteplate) and then go on to ortho or was there a time when you combined both? I still have a lot of questions for my doctor.
Best of luck to you,
Mouse26
Hello,
The splint that I had to wear made talking really hard at first, and made eating really hard, because I had to eat with it in. I just ate a lot of really soft foods, and lost a bunch of weight. The weight loss wasn't a bad thing then, but I didn't gain most of it back, so before my jaw surgery, I had to make sure to gain a few pounds, so I have weight to lose this time around, and still stay healthy.
I remember taking Advil frequently while using the splint. Because it dealt a lot with the muscles in my jaw, there was some discomfort, but nothing horrible. Once my ortho felt he had gone as far as he could with the splint therapy, he did a full evaluation of my mouth, and gave me a treatment which included surgery. He said he could just do braces, and my teeth look nice, but it wouldn't do anything to help the other problems. Because I was having headaches and other problems, I decided to go ahead with the surgery option. Given my problems, and his explanation, it made sense to me, so I didn't bother getting a second opinion. Also, I know other people that used him as an orthodontist, and that used the surgeon he sent me to, and they were all happy with his work.
I don't think the fact that you stay home to take care of your daughter is a big deal, as far as surgery is concerned. It would probably be easier for you to arrange alternate childcare for a couple of weeks, than it would be to get time off work. If you had to have surgery, you would probably want her in full time care for the first two weeks, and then maybe part time for about 2 weeks after that. For the first week, you would have some time in the hospital, so you would probably want her out of the house, so that you can rest properly once you are home from the hospital. For that second week, you might even be able to have somebody come in and just help out a bit. That is how I see it, if I had to take care of a child post-surgery. I have baby-sat full time, so I know what child-care entails, and it's not entirely possible after the surgery, as long as you have lots of help. This is just a what-if scenario. Perhaps, as your ortho stated, your situation won't require any surgery at all.
I'm not sure why your surgeon told you that you are too old. Hmm... I really think you should get a second opinion, given that you don't seem to have much confidence with this first doctor. Also, for more information, Yahoo has a great orthognathic surgery support group that has a lot of activity. You might want to post this same question there. Lots of people your age, and even older have had surgery to treat their problems. They may also have some words of advice to you. This group can be found at here if you are interested in checking it out.
Good luck as you continue on within.
peanut
The splint that I had to wear made talking really hard at first, and made eating really hard, because I had to eat with it in. I just ate a lot of really soft foods, and lost a bunch of weight. The weight loss wasn't a bad thing then, but I didn't gain most of it back, so before my jaw surgery, I had to make sure to gain a few pounds, so I have weight to lose this time around, and still stay healthy.
I remember taking Advil frequently while using the splint. Because it dealt a lot with the muscles in my jaw, there was some discomfort, but nothing horrible. Once my ortho felt he had gone as far as he could with the splint therapy, he did a full evaluation of my mouth, and gave me a treatment which included surgery. He said he could just do braces, and my teeth look nice, but it wouldn't do anything to help the other problems. Because I was having headaches and other problems, I decided to go ahead with the surgery option. Given my problems, and his explanation, it made sense to me, so I didn't bother getting a second opinion. Also, I know other people that used him as an orthodontist, and that used the surgeon he sent me to, and they were all happy with his work.
I don't think the fact that you stay home to take care of your daughter is a big deal, as far as surgery is concerned. It would probably be easier for you to arrange alternate childcare for a couple of weeks, than it would be to get time off work. If you had to have surgery, you would probably want her in full time care for the first two weeks, and then maybe part time for about 2 weeks after that. For the first week, you would have some time in the hospital, so you would probably want her out of the house, so that you can rest properly once you are home from the hospital. For that second week, you might even be able to have somebody come in and just help out a bit. That is how I see it, if I had to take care of a child post-surgery. I have baby-sat full time, so I know what child-care entails, and it's not entirely possible after the surgery, as long as you have lots of help. This is just a what-if scenario. Perhaps, as your ortho stated, your situation won't require any surgery at all.
I'm not sure why your surgeon told you that you are too old. Hmm... I really think you should get a second opinion, given that you don't seem to have much confidence with this first doctor. Also, for more information, Yahoo has a great orthognathic surgery support group that has a lot of activity. You might want to post this same question there. Lots of people your age, and even older have had surgery to treat their problems. They may also have some words of advice to you. This group can be found at here if you are interested in checking it out.
Good luck as you continue on within.
peanut
Braced: September 23, 2004
Surgery: September 13, 2005
Surgery: September 13, 2005