Metal Mouth Message Board

**I posted this at the 'naked tooth' before seeing the ask the doc board.

HI!

Please try and stay with me, sorry for the long post, but I want to give you guys as much information about my problem as possible in hope that you can help me.

In April 2004 I went to see an ortho about braces to correct my exact bite and was told I had to recieve ortho surgery with the braces for best and desired result. The following summer I had to have all 4 wisdom teeth extracted so I could put my braces on. My braces where put on late September of '04 and the first 3 months of having them where fine. I always had one of those 'cracking jaws' and tended to jilt my jaw foward because I was self conscience about my chin/jaw area and doing this made it appear larger and more defined. I continued to do this throughout my ortho treatment. December 2004 came around and I was told to wear the elastics and the did the whole power chain thing and for three weeks I started to notice that my jaw felt quite uncomfortable (jilting it out didn't help matters) and that following January the uncomfortable feeling turned into pain. My jaw still cracked all the time, but I caused that many times as well. From January until August 05 the pain was horrible (i became reliant on pain meds at just eightteen). My jaw would lock, contract, move suddenly, go out of position, etc. It was so horrible I couldn't explain and the pain from the braces made things reach a maximum of pain! Finally, in September I recieved upper jaw advancment (so my upper jaw came over my lower teeth) and a genioplasty. Recovery was fine and there where no problems whatsoever. The cracking had stopped, the movement of my jaw when I talked was smooth comfortable and chewing was a ease! I was so happy that the pain was gone and that I could finally live my life again! In the middle of January I had my braces removed and was given an upper retainer that I was told to wear at nights as well as a perm lower retainer that isn't removable like the upper one. For the first 2 weeks things where fine. I wore the retainer as instructed but then my jaw started to become rather stiff (feb 05) and I went to see the ortho to speak to him about this (it's only still during the night 6pm and on and not so much during the day) and the ortho said it was grinding at night that was causing it (but if that was the case, wouldn't it be more painful when i woke up rather than the evening and before bed?)so he made me a night guard to wear during the night when I sleep and it gave me relief right away the first night I wore it and then the stiffness returned a couple days after use, he also said that I didn't need to wear the retainer anymore because the night guard would act as a retainer, as well. The gaurd works well when I wear it but it's these two hunks of plastic in my mouth and it isn't ideal to wear during the day when i go out, school or anything because i can't talk when I wear it. To explain the areas that it's bothersome is hard but I'll try- My two upper back teeth and the area that surrounds them is REALLY stiff and somehwat painful as well as the upper jaw to some extent. Granted, it's nowhere near as painful as it was prior to surgery it still hurts when I talk or apply any movement to my jaw. I don't jilt my jaw foward at all since my surgery and my jaw hasn't cracked or anything post op. I've done everything they've asked but it doesn't seem to get any better. It's starting to make me depressed because I feel like I'm running out of options here. I don't know what is causing me this pain and I've done just about all I can do to stop it. Please, if you having any suggestions or have had a similar expierence i ask you to share them with me. I'm really upset about this and really don't want a repeat of last year. I need to be able to talk and socialize with people but doing so just aggravates it. I don't go out anymore because of the of the stiffness and I just wish there was something that could help me ( I excersize alot and that doesn't help, either) . I'm sort of at the end of my rope here. The results from the new bite and teeth after braces are optimal but NOT worth the pain that I have to go through and sometimes I wish I never went through this whole braces/ortho surgery, at all! If you can offer me any suggestions, insight or piece of mind i would really be greatful.

Thanks for sticking through the long winded post.

It sounds like you have been through a horrible ordeal! I'll share with you my thoughts, though I'm not a dentist or anything like that.

First, have you had an evaluation for TMJ problems, specifically an MRI of the TMJ joints. I was having jaw/bite problems and the MRI indicated that the anatomical structures of the TMJ were so out of place that I was literally experiencing bone scraping against bone. If you are having mobility problems, I would certainly recommend getting the TMJ and related areas xrayed or MRI-ed.

Second, I agree with you that often times the pain of mouth surgery and treatment is not worth it. Lousy conclusion, but it is true. Remember the orthos and oral surgeons recommending all these procedures do not have to go through them, pay for them, or experience the pain associated with them. While the orthos et al have good intentions, they generally "shoot for the stars" in terms of suggesting any and every procedure that might be successful, in hopes that one or two are. However, they forget what it is like to go through all that they suggest. If there has been at least some improvement, I hope you can take some solace in that.

Third, I got a little lost in the post in trying to figure out if you were trying to figure out whether to have another procedure, figuring out what to do next, or just frustrated. If you are thinking of having another procedure, please post what it is so we can give some feedback. If you're just frustrated, that's understandable, too.

My frustration now is getting different opinions from different orthos - I'm not sure who to believe anymore.

Anything positive come from this whole experience?

It sounds like you have been through a horrible ordeal! I'll share with you my thoughts, though I'm not a dentist or anything like that.

First, have you had an evaluation for TMJ problems, specifically an MRI of the TMJ joints. I was having jaw/bite problems and the MRI indicated that the anatomical structures of the TMJ were so out of place that I was literally experiencing bone scraping against bone. If you are having mobility problems, I would certainly recommend getting the TMJ and related areas xrayed or MRI-ed.

Second, I agree with you that often times the pain of mouth surgery and treatment is not worth it. Lousy conclusion, but it is true. Remember the orthos and oral surgeons recommending all these procedures do not have to go through them, pay for them, or experience the pain associated with them. While the orthos et al have good intentions, they generally "shoot for the stars" in terms of suggesting any and every procedure that might be successful, in hopes that one or two are. However, they forget what it is like to go through all that they suggest. If there has been at least some improvement, I hope you can take some solace in that.

Third, I got a little lost in the post in trying to figure out if you were trying to figure out whether to have another procedure, figuring out what to do next, or just frustrated. If you are thinking of having another procedure, please post what it is so we can give some feedback. If you're just frustrated, that's understandable, too.

My frustration now is getting different opinions from different orthos - I'm not sure who to believe anymore.

Anything positive come from this whole experience?

Perhaps you can try a different type of nightguard. I've heard that the NTI nightguard that just attaches in the front works better at controlling muscle tension. Do some research on the internet on it. Type in NTI nightguard, then ask your dentist.

Wish you the best. I know TMJ pain. It can be depressing. My pain is not excruciating but comes and goes.

Thanks for the feedback!!

I pretty much posted that for ideas of treatment for what I can do. I feel so hopless right now and just can't see myself living with such pain. What is even worse is that I have big dreams, big ambitions and am so focused but this pain holds me back so much (sometimes I can't even talk it's that bad) and I'm sort of at the end of my rope here. I've asked these orthos over and over again for help and it seems that things where fine 4 or so months post op and then I was given that retainer and things just screwed right up! I can't say I trust my ortho (seeing as how hes the one who gave me the retainer and caused the pain through braces), my family doctors solution is pain killers (which i dont want to take for obvious reasons) and lack of money (poor student) don't give me many options. I'm in Canada so maybe a MRI is free here? covered under the OHIP plan?

Let me try and explain my pain better for you guys

The upper roof of my mouth at the very back (the 4 back teeth molars) are extremely stiff and the surrounding areas get more and more stiff as the day goes on, until I'm here (11:40pm) and it affects my speech (spasms) giving me mercy to this massive chunk of plastic they call a night guard! it's the only thing that provides me relief.

I saw the dentist a week ago and he wont do anything without the orthos approval and the ortho seems to think that the night guard is a cure all but it's been 2 weeks since ive had this and although relief is provided while I'm wearing it, if i'm not wearing it it's back to pain...the night guard isnt ideal during the day because i can't talk when i wear it, etc. I just want my mouth to be how it was before i jumped into braces because although i didnt have the best teeth, i was pain free!!! i'd take that over better looking teeth anyday!

is there any kind of surgeries that can correct this? cortisone shots? anything! i'm so hopeless, i'll do just about anything for this pain to go away. I don't mind getting my jaw broken again, whatever, the long recovery would so be worth not having this pain.

The worst of all this is that i'm an model/actor and i can't even talk because of this pain so the prospect of work seems more out of reach and i stopped going on auditions now. School is fine because its during the day and although the stiffness is there, it's not so bad during the day. I'm just 19 and i already feel like life is over with this pain!

It's so depressing and i feel so hopeless

KevinFrank86 wrote:
The upper roof of my mouth at the very back (the 4 back teeth molars) are extremely stiff and the surrounding areas get more and more stiff as the day goes on, until I'm here (11:40pm) and it affects my speech (spasms) giving me mercy to this massive chunk of plastic they call a night guard! it's the only thing that provides me relief.

...it's been 2 weeks since ive had this and although relief is provided while I'm wearing it, if i'm not wearing it it's back to pain

School is fine because its during the day and although the stiffness is there, it's not so bad during the day. I'm just 19 and i already feel like life is over with this pain!

Perhaps you can look into a pain management center, acupuncture, massage therapy, biofeedback, etc. As hard as it might sound, Try not to focus on the pain, that usually just makes it worse. I'm a believer in redirecting my thoughts to something else when I am in pain. For me it helps. I don't give in with negative thoughts like this will go on forever.

Since you've only had the nightguard for 2 weeks, I would say give it more time.

Perhaps you can try a different type of nightguard. I've heard that the NTI nightguard that just attaches in the front works better at controlling muscle tension. Do some research on the internet on it. Type in NTI nightguard, then ask your dentist.

I agree with this. I have first hand experience with these devices and they truly relax the jaw.

Another thing you can try is chiropractic and/or accupuncture, if you have consulted with doctors and they are not giving you results. The thing with pain is that doctors don't know where it is coming from. Sometimes they will do an MRI and see nothing. This happened to me with my back. No one knew where the pain was coming from. When someone figures out how to pinpoint the source of pain they will be the richest person on earth!

Anyway, I got better on my own after years of chiropractic, x-rays, MRI, Physical therapy, an expensive "air" bed and many $$$. They way I finally got over my pain was through pilates which stretches and strengthens the back. This is something the doctors just couldn't fix. And I think I spent maybe $15.00 on the pilates CD! Who knew?

All I can say is don't give up, don't lose hope, there is a solution out there, you just have to find it. The more anxious you get about this pain the more your jaw will go into spasm. You don't want that. Stay calm, breath, relax and consider what options you have.

It is wierd but when I first went into have my teeth looked at by the ortho and the dentist - they would tell me to clench down so they could see where my bite was. When I did that they would literally wrestle with my jaw to get it to where they thought it was supposed to be! Where they were putting my jaw did not feel natural to me at all. I was like "what the heck?" It sounds like you may be doing that too - putting your jaw in an unnatural position - (although it feels natural to you)

Much luck to you. I sincerely hope you feel better.

This is what came to mind after reading your ordeal.

Leave the ortho, now. Leave the dentist, too. As I said, this is my opinion, but as I read I kept wondering "what good are these people doing this poor guy." Seek another opinion, or two. So often we are conditioned to think that we have to stay with one practitioner, like we'll hurt their feelings if we leave. Guess what? They hurt you! Please, get another opinion because it doesn't sound like things will get better as they are.
BTW, have you gone to an oral surgeon? They might be able to give you a better take on things.

I had another thought. You commented that the pain diminished when you wear the night guard, but clearly that is only a solution for nighttime. Those "invislign" braces are kind of like night guards, I think. Don't they slip over your teeth after being molded to the shape of your jaw? Do you think it would be possible to look into getting just an upper invisilgn, not for the purpose of moving teeth but for the purpose of serving as a 24-hour night guard.? Just an idea.

Good luck and keep us posted.

Wow! Thanks so much for your feedback everyone!

It's like you guys care about giving me good advice more than the guy I'm paying to correct all this!

After reading your feekbacks I'm feeling a little bit better just to know that there a ton of other options out there for me. I was doing Physical therapy and that would help for like 2 hours afterwards but the pain would soon return and this was during the peek of the pain with the jaw (may 2005-July 2005) pre op. I'm not sure what kind of nightguard it is I have now, I know theres like a retainer type thing inside of it and it's two clear hunks of plastic. I've thought about chiroprators but I always thought you needed to be referred for that kind of thing? I wouldn't mind trying it once to see but i'm sort of iffy because of the whole Physical therapy thing not working out in the long run. I'm at my end, though, so I will try just about anything and one session wouldn't be too pricey....$60.00 maybe? am I right? I've never seen one before. I just find it so hard to stay calm when it gets stiff and gives spasms because it reminds me of last summer and that awful pain I had and how I had to get the jaw surgery for it and then what makes me even more depressed is that the jaw surgery worked only to have the pain back (My worst nightmare!) 4 months later.

The oral surgeon I think did the best job he could and he got rid of the pain, it was the ortho who did the whole retainer thing and screwed everything back up. I trust the oral surgeon 100% the ortho...uhh...not so much so. The only problem is my parents paid for all this so it's more or less up to them. I've made them aware of my situation and my dad seems pretty good on getting another opinion but we'll see. One thing is for sure, I don't trust them. I'm depressed about this. I can't let it go on. so I'm thinking this might be a good track for me-

a second opinion
chiropractor

I read one of those information things they have at the ortho's about the invislign and I thought about that as well. You know, I don't think it wouldnt hurt for me to bring that up in my next visit. I'm booking something ASAP with him to tell him I'm really upset. the mouth guard isn't ideal. something needs to be done! if he gives me the same story or throws out anyth excuse than i'll be going to get a second opinion, but i'm going to bring up the invislign for sure, because i think youre on to something with that.

I feel a bit better after talking about this with you guys, atleast it gives me some stuff to talk about and more options of treatment because theres no way i can go on depressed and in pain like this. there just isn't! not after 2 years of braces and major jaw surgery!

Thanks, again

paw655 wrote:This is what came to mind after reading your ordeal.

Leave the ortho, now. Leave the dentist, too. As I said, this is my opinion, but as I read I kept wondering "what good are these people doing this poor guy." Seek another opinion, or two. So often we are conditioned to think that we have to stay with one practitioner, like we'll hurt their feelings if we leave. Guess what? They hurt you! Please, get another opinion because it doesn't sound like things will get better as they are.
BTW, have you gone to an oral surgeon? They might be able to give you a better take on things.

I had another thought. You commented that the pain diminished when you wear the night guard, but clearly that is only a solution for nighttime. Those "invislign" braces are kind of like night guards, I think. Don't they slip over your teeth after being molded to the shape of your jaw? Do you think it would be possible to look into getting just an upper invisilgn, not for the purpose of moving teeth but for the purpose of serving as a 24-hour night guard.? Just an idea.

Good luck and keep us posted.

I completely agree with Paw655. If I were you, I would seek help from another dentist and ortho.

Your ortho and dentist are suppose to believe you when you say you're in pain and they are suppose to help you and do anything they can to minimize that pain. Giving you a mouthguard and telling you that this will help when it clearly doesn't (only when you are wearing it), they are suppose to find a new solution. And if they don't know what to do, they should refer you to someone who could help. So please go and seek help from someone who will do something when you say your in pain. Good luck and I really hope something is done real soon!

You need a referral to a specialist in my opinion. Definitely you need a second opinion.

It may be that you have some very rare issue which is why your regular practioners haven't identified it.

But while trying acupuncture and whatever for pain relief is a great idea, the underlying issues causing the pain must be dealt with.

check out www.clenchingsyndrome.com/ I think you can email them to find a dentist who understands how to equilabrate teeth after ortho treatment or get you a balance bite splint. What i did was get some ink paper and bit down on it so i could see where all my teeth were hitting and which ones were hitting to hard. check out this site and i hope it helps.

Another thing you can do is file a complaint with the ortho dental association in your state. They will start an investigation and a panel of orthodontics will review your case and look at your teeth. I would ask your ortho for your before and after pictures and x-rays to see if the teeth were put in the correct position before braces were taken off and if the roots of the teeth were parallel with the crowns. possibly the teeth may have moved and are hitting wrong in the back.