TMJ advice please?

[dogbert]

Hi everyone, sort of new to the board and I need some advice.

Ive had TMJ issues for about 3 years now. My orthodontist has me in a splint which I wear 24/7 to help with my TMJ, and it has come to the point with the splint where it seems my symptoms are mostly stable and I experience virtually no pain or discomfort 95% of the time and I am left with only having to deal with occasional pops and clicks which are not painful. However when I remove my splint I have almost 0 contact between any of my teeth... only a small portion of my back right molar touches my upper arch molar. So in other words, my bite is really messed up.

Now I have a upper and lower jaw surgery to correct my bite scheduled in about 6 weeks. But I have read online that people with articular displacement and TMJ problems in general have experienced worsening in the problem after jaw surgery. Is this worsening only temporary or what have people on this forum experienced? I dont want to have to deal with pain and joint grinding again but I also dont want to have to wear a splint for the rest of my life with a completely messed up bite.

So im wondering if anyone here has had a similar problem or has gone through with jaw surgery after having TMJ problems, and what the results were? Im just interested to hear what you guys think about what I should do (yes jaw surgery or no jaw surgery) and why.

Thanks in advance

[spookygee]

hey man. how much does it bother you that your bite doesn't meet after using the splint? does it cause other issues? what tmd symptoms were/are you experiencing? does your current bite cause discomfort or make anything difficult? would it be difficult to live with your current situation/bite? is the splint no longer helping with tmd? do your symptoms come back after not wearing the splint? this is interesting to me, because i was in the same position as you before. i had tmj issues for a long time, pretty much throughout my life and teens and early 20s, never knew i had a bite issue because i never visited an ortho, and used a requisitioning splint made by my dentist initially which moved my lower jaw forward and helped at the time with symptoms, it opened my bite to a more open bite and i couldn't wear any splint because of the nature of my open bite so i didn't have relief anymore. i suppose it had an effect on where my joints sat where it may have found slightly better position. i had one molar on both sides touching. my dentist tried making new ones after my bite changed, one broke so i proceeded with the next phase of treatment which was braces and was recommended upper jaw surgery. i was scared during the process, and after the fact read things online about how people shouldn't expect tmd to improve with this type of surgery, however i don't know how true that is in all cases. my surgeon specialized in tmd thought the surgery 'should' help. i had skeletal asymmetry that was corrected. i think it is possible that skeletal asymmetry could cause tmd in some cases, which is what i've researched. my lower jaw wasn't operated on but was rotated forward and up and to the side because it was deviated before to the side. i have come to realize that these things may be a case-by-case basis. there are people who have tmd relief with jaw surgery, and people who have tmd symptoms after surgery who didn't before. in my case the ear pressure/tension/joint clicking/feelings of subjective hearing loss/fullness/popping/occasional locking have gotten better or went away. i think there is a better chance of not having tmd issues if you stabilize the joints with a splint prior to surgery. what are your other concerns? good luck with your journey man!

[dogbert]

hey man. how much does it bother you that your bite doesn't meet after using the splint? does it cause other issues? what tmd symptoms were/are you experiencing? does your current bite cause discomfort or make anything difficult? would it be difficult to live with your current situation/bite? is the splint no longer helping with tmd? do your symptoms come back after not wearing the splint? this is interesting to me, because i was in the same position as you before. i had tmj issues for a long time, pretty much throughout my life and teens and early 20s, never knew i had a bite issue because i never visited an ortho, and used a requisitioning splint made by my dentist initially which moved my lower jaw forward and helped at the time with symptoms, it opened my bite to a more open bite and i couldn't wear any splint because of the nature of my open bite so i didn't have relief anymore. i suppose it had an effect on where my joints sat where it may have found slightly better position. i had one molar on both sides touching. my dentist tried making new ones after my bite changed, one broke so i proceeded with the next phase of treatment which was braces and was recommended upper jaw surgery. i was scared during the process, and after the fact read things online about how people shouldn't expect tmd to improve with this type of surgery, however i don't know how true that is in all cases. my surgeon specialized in tmd thought the surgery 'should' help. i had skeletal asymmetry that was corrected. i think it is possible that skeletal asymmetry could cause tmd in some cases, which is what i've researched. my lower jaw wasn't operated on but was rotated forward and up and to the side because it was deviated before to the side. i have come to realize that these things may be a case-by-case basis. there are people who have tmd relief with jaw surgery, and people who have tmd symptoms after surgery who didn't before. in my case the ear pressure/tension/joint clicking/feelings of subjective hearing loss/fullness/popping/occasional locking have gotten better or went away. i think there is a better chance of not having tmd issues if you stabilize the joints with a splint prior to surgery. what are your other concerns? good luck with your journey man!

Thanks for the reply man. My current bite doesnt cause problems because I always keep my splint in so I have a better biting surface then I would without it, I can eat talk no problem. I never take out my splint so im not sure if my symptoms come back without it, but I would guess that they would considering how I have absolutely no bite surface without my splint. When my TMJ starts acting up and I experience symptoms its usually a lot of sounds (clicking, popping) along with a lot of muscle tension along my jaw line which pulls my jaw in one direction or the other (sometimes to the right sometimes to the left), tension in the neck and skull area which can cause migraines, ear fullness, and lastly sometimes a burning kind of sensation in the jaw joint/ear area. However these symptoms for the last while come and go on occasion (maybe once every 2 or 3 weeks), I call them "Bad Days". So in other words the splint has made things alot better for me, because these symptoms used to be on a daily basis almost 24/7, and now i only have to deal with them every few weeks it seems like.

So it sounds like you were pretty happy you did the surgery even tho you were pretty scared going in?

[spookygee]

No problem dude. I think that's a fair assessment to imply your symptoms may come back if you stopped using the splint, however it's good that you have relief when you wear it. What type of bite do you have now? Are you being treated with braces before surgery? It sounds like it bothers you that you have to wear the splint 24/7 to maintain relief, is it that you don't want to have to wear a splint all the time throughout life that is one of your concerns? I could only have relief with my splint initially for a few months before my bite got worse and couldn't use a splint which sucked. Yeah man, I experienced pretty much the same symptoms as you which was 24/7 at the time. Very bothersome. Surgery for me was overall a success, I've been told that I hit the 'jaw surgery lottery' in that my bite is still the same as it was after braces were removed and it helped my TMJ as opposed to it worsening/not helping. Though my life has been pretty traumatic in general especially the past few years I am prone to anxiety and depression and sometimes dwell on the surgery most likely because of other things in life though things turned out well. I think I had asymmetry in my lower jaw which I never knew was there before which may have been a factor in the TMJ, here is a photo to describe what i'm talking about https://imgur.com/a/OIJDb Is your surgeon aware of your tmj issues and did they say that the surgery should help?

[dogbert]

No problem dude. I think that's a fair assessment to imply your symptoms may come back if you stopped using the splint, however it's good that you have relief when you wear it. What type of bite do you have now? Are you being treated with braces before surgery? It sounds like it bothers you that you have to wear the splint 24/7 to maintain relief, is it that you don't want to have to wear a splint all the time throughout life that is one of your concerns? I could only have relief with my splint initially for a few months before my bite got worse and couldn't use a splint which sucked. Yeah man, I experienced pretty much the same symptoms as you which was 24/7 at the time. Very bothersome. Surgery for me was overall a success, I've been told that I hit the 'jaw surgery lottery' in that my bite is still the same as it was after braces were removed and it helped my TMJ as opposed to it worsening/not helping. Though my life has been pretty traumatic in general especially the past few years I am prone to anxiety and depression and sometimes dwell on the surgery most likely because of other things in life though things turned out well. I think I had asymmetry in my lower jaw which I never knew was there before which may have been a factor in the TMJ, here is a photo to describe what i'm talking about https://imgur.com/a/OIJDb Is your surgeon aware of your tmj issues and did they say that the surgery should help?

Yes I have braces right now. Ive had them almost as long as ive had the splint, I wore the splint for like 3-4 months before braces were put on. I dont hate my splint, its been a life saver, I just would like to be able to eat with my teeth like a normal person instead of with the splint in my mouth. I dont know how to describe my current bite, because I barely have any contact what so ever (only my back molar makes contact with my upper arch). I guess it sort of an open bite with over jet, and I my lower jaw needs to be rotated to the right (so its kind of criss crossed with my upper arch). I think this is called cross bite? My surgeon is aware of my tmj issues, and all hes really mentioned is that the jaw surgery wouldn't improve the popping and clicking I hear from my jaw, but he never really said it wouldnt help me overall. However I read things from people who did have clicking/popping improve after surgery, so I think my surgeon is mostly just implying that there is no guarantee that it will do anything to help the popping and clicking. My main concern is I just dont want surgery to worsen my symptoms, because i am a lot better now then I was several years ago, and im content with how my jaw symptoms have improved. I would honestly be happy if the surgery didnt do anything to my symptoms and just left them the way they are now, because its not so bad anymore except for on occasion.