Miserable - Braces & TMJ

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#1 Post by **stace11** » Wed Jul 11, 2007 7:54 am

Hello all--

Hoping that you can provide some unbiased opinions on my current situation. I have been treated by a neuromuscular dentist for my TMJ issues for a little over 2 years. Through his treatment in creating an orthotic for me, my TMJ issues all but disappeared. I would occasionally get headaches under stressful times, but for the most part, no issues what-so-ever. As the orthotic was considered a temporary fix, the dentist gave me three options to fix the problem permanently.

1) Build up my teeth with porcelain veneers to create my perfect bite (at a cost of over $50k)

2) Create a permanent orthotic made from a stronger material that will last a lot longer than the temporary one (at a cost of just over $10k)

3) Finally, put on braces to fix my severly open bite (my back teeth do not come close to touching). Braces would cost somewhere between $6 and 8k.

So, I opted for the cheapest option and had braces put on about a month ago. I am now severly doubting my decision. Since I've had the braces on, almost all of my TMJ symptoms have come back....constant headaches, migraines 2-3x per week, neck pain, jaw pain and the clicking is starting again. Has anyone else been through this?

I'm seriously thinking about having my ortho remove the braces and go back to the orthotic since I know it works and there is no guarantee that the braces will ultimately fix the problem. It would be worth paying the extra money for the permanent orthotic just because I know it works.

Any thoughts/suggestions?? Thanks in advance.

#2 Post by **songbird0462** » Wed Jul 11, 2007 9:16 am

personally, I would talk to both the ortho and the dentist about this.
The situation could get worse or better, depending, but only the professionals would know about that.
Hope I helped!

#3 Post by **oceanblue** » Wed Jul 11, 2007 9:28 am

Hello. I have TMJ issues & braces too. I can click & pop my jaw all around and sometimes I get lucky and pop it back into a comfortable place. Scary ehhh? I was also told braces would help my TMJ issues. I've been in braces for 1 year and at first, the braces made my TMJ worse - this is what sounds like is happening to you. How long have you been in braces? Usually, the ortho doesn't address the "bite" of your teeth until the end of your treatment time. When I was given elastics to wear and my teeth stopped moving around as much my TMJ symptoms got better. It seems like once your teeth find their "final resting place" and start making firm contact with your other teeth that TMJ problems get a lot less severe. I'd encourage you to wait out your treatment until you get to the elastics stage. Maybe you could ask your ortho about getting to that stage sooner than later to help relieve your pain? Anyway - hope this helps! Hang in there.

#4 Post by **ctoler1920** » Wed Jul 11, 2007 12:31 pm

I have the same issues as you. I have a severly open bite and tmj issues. I got the braces put on in May and will have to have the surgery to correct the jaw alingment problem. I would definitely consult with your ortho to make sure that your problems that are getting worse are just the latter part before it gets better. But definitely do your own research also. It is always better to go in with more information than none.

Good luck!

#5 Post by **stace11** » Wed Jul 11, 2007 1:16 pm

Thanks for the advice all.

ocean ~ I've been in braces for about a month. Sounds like you are still having problems with your jaw and yours are due to come off soon. Did you get braces specifically to fix your TMJ problems? That's the only reason I have them on (I already had them once as a teenager, so my teeth are very straight). I really don't want to spend 15 months with these braces on and have my jaw still click & pop when I was virtually symptom and pain free while using the orthotic.

I have an appt. with my ortho tomorrow and I called my dentist today. He is going to talk with the ortho before my appt to make sure we are on the same track. I sure hope I made the right decision. Guess I will know a bit more tomorrow.

Thanks again.

#6 Post by **raysun** » Wed Jul 11, 2007 3:11 pm

Hi,

I am currently seeing a neuromuscular dentist/orthodontist as well. I've worn my orthotic for over a year and just got a palate expander put in about 2 weeks ago. I still have no symptoms but I have noticed that since my bite has shifted, just in the past week, I have been clenching more when I sleep.

Are you still wearing the orthotic? If you are, it may be that you are just very senstive and even a slight shift in your bite causes the symptoms to return. My ortho told me this was possible. But then they can readjust the orthotic to fit the new position. So, it may be that they could adjust your orthotic a bit and you'll be fine. But I think it's totally normal to have some pain in the beginning. I know that must be scary though. I'm so dependent on my orthotic. I have nightmares about losing it! My TMJ was horrific before I had it.

But I'm sure if you talk to your ortho about it, they can adjust for you and fix the problem.

Good luck!!
Rachel

#7 Post by **Jennine** » Wed Jul 11, 2007 3:28 pm

The First stage where they are shifting your teeth around is going to mess up your bite because the teeth are moving so it makes sense that symptoms would return and maybe even be worse.

Its not until the end stage where they put elastics from top teeth to bottem teeth to pull the teeth into proper alignment with each other. This is the stage where your bite will be fixed

I'd say stay in braces, an aligned jaw and bite is so improtant. Think of it like chiropractics for the jaw. But still talk to your DR ofcourse

#8 Post by **HeadgearJoe** » Wed Jul 11, 2007 5:56 pm

sorry to hear your pain is back , i to am a tmj case , all my crap started in 2000, it's been a long road but the end is very near , there are going to be times that the pain will come back due to treatment changes , an in most case's it will go away , YES i would talk to my orthodontist or dentist wich ever you use , once my orthodontist/tmj doc , started cutting away at my splint an exposing set's of teeth an pulling them into place with elastics i had some tmj probs , i spoke to him an he had to slow down on my treatment , but now the molors have been pulled up enough an into place closing the bite , things are much better , as most of us know , if an i say if you have cartlage damage and torn ligaments as i do , i was told i will be beeter by about 85 to 95 % but never agian perfect , heck i'm 2 months away from the big 50 i can handle that , as the pain i was in a the meds i was on, but please talk to your doc ,

#9 Post by **oceanblue** » Wed Jul 11, 2007 7:26 pm

Hey. No I didn't get braces ONLY for TMJ problems, but maybe 60% for TMJ issues. I also had braces as a teenager (and a herbst appliance - which the doctors think caused my TMJ in the first place but that is another long story). My top teeth were straight and fine but my bottom ones had gotten crowded up again, so I went ahead with both top and bottom braces to help line up my bite in hopes it would make TMJ better. I think it has helped if that gives you any hope. However, it wasn't until my last adjustment ( a few weeks ago) that I really felt like my teeth were fitting together and my jaw felt more "correct" and lined up.
Also, speaking of a chiropractor - I see one. He helps with my jaw and pops it back into place about once every 2-4 weeks. I've told my ortho I was having a chiro do this and he seemed fine with it. None of this has made TMJ go away or 100% better, but I think it is helping and that's about all I can hope for at this point. Good luck with your consults tomorrow!

PS: Anyone reading this - just SAY NO to the herbst appliance. It's bad news and orthos shouldn't be using them anymore!

#10 Post by **stace11** » Thu Jul 12, 2007 7:09 am

raysun wrote: Are you still wearing the orthotic?

Rachel ~ Nope, no orthotic for me for this past month and it has been hell! The ortho told me to bring the orthotic with me this afternoon to my appt, so I have a feeling he will be shaving it down and putting it in. I think he wanted to try treatment without it to see how it went because he says wearing the orthotic can slow down the treatment time. Anyway, I'm like you where I was completely dependent on it. I'm hoping this fixes the pain.

He already has me wearing some elastics...only one on each side, way in the back.

Thanks to everyone else for their input. I'll give you an update after my appt today.

P.S. My TMJ issues started shortly after taking the braces off the first time around, so I was a bit hesitant about getting braces again because of it.

#11 Post by **oceanblue** » Thu Jul 12, 2007 10:10 am

Hey Meryaten - Dr. Rick on this board told me what I said about the herbst appliance. He said he doesn't use them for that exact (TMJ) reason.

Also there are long term studies done on people that had herbst appliances and all most all of them had some degree of TMJ problems anywhere from 2-10 years later. I didn't just pull that comment out of the air - I've talked to several orthos about about it and done my research. It's accurate.

#12 Post by **oceanblue** » Thu Jul 12, 2007 5:44 pm

I am sure that no one would rely solely upon my evaluation / conclusion. However, it was not MY evaluation ... it was the evaluation of several orthodontists and research. If you would like to look at the research it is quite simple to type in "TMJ + herbst appliance" into a search engine like google or go to the library yourself.

Enough said!

#13 Post by **oceanblue** » Thu Jul 12, 2007 7:24 pm

Oh good lord "Meryaten" - you need to get a life, or perhaps a new hobby other than this board. I'm pretty sure you aren't an orthodontist or god, so you might want to quit talking like you are above everyone else on here. Find something else to do ... really!

#14 Post by **jennielee81** » Fri Jul 13, 2007 5:33 pm

I feel bad for you Stacy! I've never had any TMJ issues or TMD. I can't imagine it getting worse or not going away after spending all the time and $$ on braces.

I know I'm not alone here when I say that I seriously appreciate all that Meryaten has contributed to this board. All the time she spends researching means that I don't have to or that 100 of us don't have to.

She's such an asset that I don't think that the comment above is fair.

#15 Post by **iBorg** » Fri Jul 13, 2007 5:55 pm

I agree with jennielee81. I find Meryaten a great asset to the board. She may at times be a bit edgy, but she tends to have a pretty good logic base to work from.

One thing with this list a lot of people come to it searching for absolute answers from a group of "experts." Most of us here are simply people going through or have completed treatment. Unfortunately, since we are all individuals there are no absolute answers, truths or only one way to approach a problem. For example, I'm going through a lot because thirty years ago my pre-molars were pulled. Because of that, I'm not a fan of extractions. I would not recommend extractions to anyone without seeking more than one opinion. I could advocate that extractions are wrong and should never be done and that any ortho who recommended them was incompetent. Thatâ€™s the type of absolute answer much like your statement on Herbsts. Extractions may be wrong for some, but not others.

I also agree the sample size in your referenced article was very small. We also don't know how random the sample was. Without those factors, it is little more than anecdotal.

Mike