Bridging the Gap - Treating TMD...(Finally an update! p.5)

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#1 Post by **Meloho** » Wed May 30, 2007 11:00 am

I'm not the greatest blogger, I feel like my entries about my experience with braces will hardly do my snazzy title justice. Regardless, I'm here to tell my story about living with TMD and how its final phase of treatment will mean my entering the elite "metal-mouth/Ugly Betty" club. I only wish I'd have documented the last few years of TMD drama to a small extent anyway, as I don't remember much of it really...I mean c'mon, there are more important things to think about, right? So I'll try, summing up the first phase of treatment as best I can.

I believe my jaw joint troubles began around age 18-19. I had the standard clicking when I'd eat, although my bite was never bad (not like father's and HE doesn't have pain like I did...oh well), so I'm not sure why my TMJ decided to act up...oh well, who can explain these things? I went a good year or two with the clicking in my jaw before mentioning it to my dentist (who just happens to be educated in TMJ disorders, as well as being an orthodontist AND oral surgeon...talk about your 3-for-1 deal). He did the routine Xrays and discussed treatment, but for financial reasons, we didn't proceed right away. But, another year or two later, I couldn't take the pain anymore, so we started, knowing full well the entire process would take about 5 years.

Phase I entaled widening my upper arch with an adjustable splint I wore 24/7 religiously, turning its screw once a week. The next splint did the same, but for my front teeth, pushing them outward. The final stage of Phase I included the most massive splint which I wore on top and its bite plate wrapped down the sides of my bottom teeth, forcing my jaw forward. I got that one two years ago, and it was the most uncomfortable, painful, and awkward one I've had. I cried on the way home because my jaw felt strange jutting forward, I felt ugly, and I wanted it out. But soon enough, I became dependent on that splint as it stablized my jaw the best of all.

Phase II started about a year or so ago, which includes the top and bottom splints you see in my photos below. The goal was to narrow the gap between my molars caused by bringing my jaw forward. It has proven extremely effective, since the gap was a good half inch more than it is right now in the pictures (taken yesterday). So now I sit at the age of 25, waiting for my braces to be installed on Tuesday, June 5th. I've educated myself browsing threads and articles on this site and I feel prepared. With my braces, the ortho will cement in a Rick-a-nator, which will further stabalize my jaw joint. But I'm so used to removing appliances to clean them, I'm worried about what'll get stuck under that thing...eewww! Oh well, it won't be forever.

So that's it for now (I guess I was more thorough that I thought I'd be). I'll post again around Wednesday with my braces experience and maybe some more photos. Speaking of which, pardon the blurriness of my shots; I have a lousy CyberPix camera that is clearly (or blurrily) only worth the $100 we paid for it. Ok then, talk to you all later.

#2 Post by **Meloho** » Fri Jun 01, 2007 8:20 am

I forgot to mention that my teeth were professionally cleaned before the spacers were put in. I'm sooo glad, and didn't learn till recently that it's a necessary step before braces are put on. I've been almost obsessive keeping them clean until Tuesday; flossing twice a day and brusing 3-4 times a day...Wanna keep that smooth, slick feeling.

Eep, only 4 more days...

#3 Post by **mjbusch** » Sat Jun 02, 2007 8:39 am

Meloho,

I am so happy that you posted. I have been having tmd problems for the last 4 years. I haven't been so lucky getting treated correctly the first time. Right now I am being treated with a gelb splint; which functions like yours but mine only fits on the lower jaw. When I got the splint a few months ago it felt like i had an underbite when it was in place.

Anyway, I would like to know more about your treatment. It appears that you have been wearing a twin block appliance for your tmd. How long did you have to wear it before your symptoms had went away? Did you have to eat with the splint in place?

My joint problems started around the same time as yours. But I thought it was a ear problem for the longest time. I am also 25 and still having some pain on my left side.

#4 Post by **Meloho** » Tue Jun 05, 2007 7:14 am

Meloho,

I am so happy that you posted. I have been having tmd problems for the last 4 years. I haven't been so lucky getting treated correctly the first time. Right now I am being treated with a gelb splint; which functions like yours but mine only fits on the lower jaw. When I got the splint a few months ago it felt like i had an underbite when it was in place.

Anyway, I would like to know more about your treatment. It appears that you have been wearing a twin block appliance for your tmd. How long did you have to wear it before your symptoms had went away? Did you have to eat with the splint in place?

Thanks for telling me what type of splint I have...that's one thing the ortho never told me...lol! The first spint I wore keep my bite farther apart, easing my jaw right off and reducing the clicking when I'd chew within the first few days - it was very quick. However, although the clicking stopped, I've had consistent jaw pain since. Greatly diminished, I must say, but it still hasn't healed competely. And I wore/wear all my appliances 24/7, even when eating (had to, that was the crucial time to wear them). I just remove them for cleaning.

My joint problems started around the same time as yours. But I thought it was a ear problem for the longest time. I am also 25 and still having some pain on my left side.

My right side has always been worse and still pops occaisionally, but it's not related to chewing. And yeah, it bugs my hears too, my neck, and my shoulders.

Do you have a thread of your own? I'd like to read about your treatment...

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#5 Post by **Meloho** » Tue Jun 05, 2007 7:20 am

Meloho I'm sure if your ortho considered your teeth needed a clean, he'd have told you.

Yeah, I suppose so. I guess it's to each their own - I've read people saying that cleaning before bracing was required, and now you, KK, and Meryaten say it's not...lol! Just shows how all patients are different and all orthos/dentists are even more different.

#6 Post by **Meloho** » Tue Jun 05, 2007 6:00 pm

So brace day came and went and here's how it went down:

I was fine until an hour before the appointment, then I was nervous and antsy for another hour into the appointment. I followed advice on here, coating on the lip balm and running to the loo before getting in the chair, but both were futile (the balm got rubbed off within the first 5 mins and 5 brackets in, I ran to the loo again, with lip stretchers still in place...)

The first thing was etching the teeth and gluing on the brackets, as usual. I have triangular brackets cuz my ortho said they'd work faster. They cost him an additional $150, but in the end if it saves him a year's worth of vists from me which he can replace with other paying customers (since all my visits have been payed for for ages). So it's more profitable for him, faster for me...win-win! Brackets were placed on all my top teeth (except for the last two on either side) and the four bottom teeth on either side...brackets will be placed on the remaining teeth for straightening later when the molars are together and the rick-a-nator is out.

Next, the rick-a-nator was cemented onto the second-to-last molars and the archwire was put in (I got gold ligs...they're pretty). The bottom brackets aren't wired yet, just held onto the top with elastics. DAMN (I had to be somewhat profane here...) those elastics are a pain! I can hardly open my mouth or talk - they're hooking up my four upper and lower molars on either side to bring them all together - but it is rather uncomfortable. Also, the rick-a-nator is another thing for my tongue to get used to, so right now, I sound like Shelly (Eric's sister) on South Park. I hope the elastics don't bother my TMJ...I'm a tad worried. I was told that if they hurt too much, I can just wear them to sleep, but the more I wear them, the faster the teeth will close the gap, so I'll suffer for the hope of having them out sooner.

I go back in two weeks, just for an evaluation, and my first adjustment will likely be in a month, as per usual.

Eating wasn't too bad - I had soup and a few curly fries (softened with saliva...lol!) The ortho even said I'd need to be careful what I ate because of my molars not meeting. Then, I tried flossing and couldn't do them all cuz of the rick-a-nator cemented in the way. I tried a proxy brush (recommended by the ortho) to clean around the brackets some and tried to wedge into other places...but the best was brushing w/ my same old toothbrush. It's not so bad and it'll all just keep getting better.

So that's it for now - I'll take pictures tomorrow and post them ASAP. Cya later!

***Edit*** I just found out my brackets are Delta Force Stainless Steel. (woulda preferred ceramic, but what can you do? Lol!)

#7 Post by **Meloho** » Tue Jun 05, 2007 7:17 pm

It's only been about 4 hours of wearing these elastics hooking my upper and lower molars and I feel like my whole jaw is gonna fall off...Please tell me it's gonna get better from here...

I can hardly open my mouth, could barely fit in an advil and a tylenol (ortho said to combine them...dunno why). Oh please tell me it'll get better. I'm worried about my jaw joints...like they'll fuse up on me or something. I know they won't, but it feels like they will. *sniff*

#8 Post by **Meloho** » Wed Jun 06, 2007 8:26 am

Thanks for the kind words Meryaten and KK. It doesn't seem like that much to get used to given the large bite block I had; this seems very much the same. However, the block didn't give me this much pain though; I bet I'll be on Advil all day, every day, for the rest of the week. But this is not news to others with braces...you've all been there.

For the elastics, my ortho said I'd need to take them out to eat, so that's good. He even said that I could just wear them to sleep if they hurt me too much, but it would speed it up to wear them as much as possible, as you said Mery. So I will wear them as much as possible, but days I have plans (which aren't too many, so it's not bad) I likely will leave them out, especially if I have to eat in public. Not wearing them for a few hours a couple days a month shouldn't affect anything.

I also had a hard time sleeping last night, probably cuz I was afraid of popping an elastic or doing something odd in my sleep. But I did eventually fall asleep and when I woke up, I felt fine - tonight will hopefully be better.

Thanks again, guys - it's very helpful to hear from people who've been there.

#9 Post by **Laurie** » Wed Jun 06, 2007 8:32 am

That seems like an awful lot to cope with all at once! Hopefully before too long it will become much more liveable with it all in your mouth.

#10 Post by **Meloho** » Wed Jun 06, 2007 6:40 pm

Thanks KK for the link to Jaws' story...her brackets are just like mine! Her pictures are clearer too, so if anyone wants a better look at the brackets, check out Jaw's story in the link above.

So here they are, my crappy week 1 pics. It'd be great if I could use a better digital camera for later pics...lol!

There's not much new to report at the moment. My cleaning routine is similar to before braces...before, it took me 15 minutes, now it's about the same, but with a couple different steps. Because of the rick-a-nator cemented at the roof of my mouth, I can't floss between all my teeth and I'm not sure how to clean around the molar bands and the acrylic surrounding the very back uppers. So I try to clean w/ the proxy brush and toothpaste w/ normal brush. Hopefully those teeth won't rot away...lol!

#11 Post by **Meloho** » Wed Jun 06, 2007 6:54 pm

Thank you Mery - I always liked my teeth and if it weren't for my TMD-causing bite, I'd have never really needed braces. Save for a side tooth on the bottom being twisted a bit, they were pretty straight all along.

#12 Post by **platinum** » Thu Jun 07, 2007 6:18 pm

Your mouth is full of stuff!!!!
How can you eat or speak?

You have very nice teeth!

#13 Post by **Meloho** » Fri Jun 08, 2007 8:17 pm

Your mouth is full of stuff!!!!
How can you eat or speak?

I know, eh? It's nuts, although if I said that IRL, it'd have come out as, "it'sth nutsth." I have a terrible lisp due to the rick-a-nator and excess spit. I also couldn't open my mouth too much w/ the elastics so I mumbled quite a bit. That's improved somewhat already, but there's a way to go yet. Thank goodness I can take the elastics out to eat, otherwise it'd be impossible. I'm still eating soft foods for now, but I can feel my molars shifting so chewing's already getting a bit easier.

You have very nice teeth!

Thank you! That's so sweet of you guys to say...

I'll be glad to be able to whiten them after the braces come off. I've been wanting to do that for years, but decided to wait till after my treatment.

I'm stunned to report that after only three days, my molars have erupted quite a bit. I'll give it till Tuesday, which'll make it a week, and take a comparison picture. I hope it's not just me, but I swear I see the gap narrowing. It'd be great if I could amaze my ortho and be rid of these elastics sooner...lol!

#14 Post by **Meloho** » Sun Jun 10, 2007 1:01 pm

Ugh, there's a stupid sharp spot on my left molar bracket (at the join to my rickanator) and my tongue keeps going to it...so annoying. Guess I'll have to go in a week early to get it shaved down. I'd have liked to try to get it smoothed out myself with a nail file or something, but I don't think I should risk it...lol! I tired putting wax on it, but it kinda makes me want to gag when it's there.

#15 Post by **minlou01** » Sun Jun 10, 2007 1:55 pm

Ouch Meloho...that doesn't sound very comfy! I hope you are able to get in and get it smoothed out tomorrow. Good Luck!