Stablization Splint Pre surgery. HELP

[dogbert]

Hi all, im gonna vent a little but also ask some questions:

So im 21 and ive been in braces for 2 years now and im supposed to have a lefort 1 and a BSSO done, and let me point out I dont recall having any TMJ issues before getting braces although my bite was really messed up. My ortho has given me a stabilization splint which covers all my upper teeth which he says is supposed to relax the jaw muscles and let my jaw stabilize so that the surgeon can more accurately know where to put my jaw during surgery. Now im supposed to wear it 24/7 and I have been for 4 months now. However 1 months ago I started getting a clicking and popping sound from inside my mouth when I talk, or finish a sentence. Saying sounds like 's' k' 't' or burping/yawning all make a clicking/grating sound that is quite annoying, but im not sure if its coming from my TMJ or from my soft pallette or else where. And just this week I got my splint readjusted and have been getting some pretty serious headaches from the facial tension from my jaw muscles in the past 2 days, ive also been experiencing alot of ear fullness (sometimes the ears crackle or pop ever so slightly, which just adds to the noise im already hearing from talking) and it feels like there is something in them. My ortho told me that muscle tension and other symptoms can be expected but should get better with time because the splint is trying to reprogram the muscles to how they're supposed to be. And I have had facial tension before but not like these headaches ive been getting, and it sort of freaking me out.

So my questions are:
1)How exactly do stabilization splints work and why do I need to go in to get it adjusted every 4 or so weeks?
2)Are these normal TMD symptoms?
3)And does anyone else have my talking/clicking problem? Simply chewing or opening my mouth doesn't cause this clicking, its pretty much only when im talking/burping/yawning.

Help is very much appreciated!!!

[dogbert]

Seriously? No one has any input?

[sirwired]

These are serious questions best for your ortho and/or oral surgeon. I will mention that the whole "decompensating" part of pre-surgical ortho treatment is unpleasant to say the least. If I were in your place, however, I'd gently suggest to your ortho that he might have done all he can, it might be time to back off a little, and any more jaw adjusting is going to have to take place after the surgery when you have a proper bite. I can't imagine coming into surgery with an annoyed TMJ is going to help your recovery.

[dogbert]

By 'decompensating' are you referring to what the splint is doing?

[sirwired]

"Decompensating" is what an ortho does prior to surgery. Your jaw muscles and teeth adjust your bite as you grow up so that you can chew, even with a misshapen jaw; this process is called "compensation." It forms an "integrated" bite; your teeth (primarily your molars) do what they have to so they mesh as much as they can.

If you went right into surgery before ortho, the surgeon would just have to "freehand" your jaw into the new position because your teeth would not yet have been adjusted. What happens instead is that the ortho "decompensates" your teeth into the position they should be in if you had a proper jaw; that way all the surgeon has to do is cut your jaw loose, and the teeth will "naturally" go to their correct positions, guided by your new bite and your surgery splint.

It sounds like your ortho is also decompensating your jaw muscles with a pre-surgical splint. If he didn't do it now, you'd end up going through the same muscle changes after surgery instead; perhaps he's trying to speed that up, as it's the most painful part of surgical recovery. (You'd think it was the bone drill, chisel, and mallet that hurt, but the surgery severs the sensory nerves, and things heal before the nerves grow back.)