Braces for TMJ, just got orthotic

[Megsi99]

Hi all! So I’m not in braces yet, but after six months of this orthotic I’ve had for three weeks, that’s the most likely outcome.

I’d love to hear from anyone else who’s been down this path because of TMJ. How long did it take for the orthotic to help. I have nasty headaches and neck pain I’m hoping it will help. Thanks in advance!!

[Prometheus]

Hi Megsi99, I had severe TMJD, I crushed out the disk in my left tmj and had degeneration of the joint, bone rubbing against bone, clearly seen in the x-rays. I got an orthotic in Dec 2014, lower braces in March 2015 and upper braces in July 2015. Unfortunately the orthotic didn’t help very much, the pain was a bit less, but still pretty bad. When I got the lower braces put on the Doc added bite turbos behind my upper incisors so none of my back teeth could touch. That made all the difference. Without the ability of my molars to mesh, the strain on my joints from my posterior crossbite went away. By September 2015 I was feeling much better. Today, three years later I’m completely pain free, the cross bite is gone, but still have a full set of braces. Not sure when I’ll be done, hopefully sometime in 2018. Hang in there it will get better, but it is a slow process. Good luck to you! -P

[Megsi99]

That’s awesome news, I’m glad you’re feeling so much better! What were your TMJD symptoms?

[Prometheus]

Unrelenting pain in the joint when I chewed or talked. Then ringing in my ears (tinnitus) that would not go away. It was so bad I could not sleep. The ringing has diminished, but is still there, albeit at a much lower level. The strange thing is I knew I had a bad crossbite but was told I didn’t need to get it fixed unless it bothered me. It didn’t, until it did, just as I turned 58 years old. Had I known what I was in for I would have fixed my bite 30 years ago.

[tmjd]

Hi Meg.

I am in the same side. Braces on for 3 months, and it's incredible the amount of progress. I have Insignia customized braces because of the level of detail that my bite needed in order to work. I used the orthotic for about a year, it's a palliative, but not a solution, so i took the plunge and went for it. So far so good. Not a single migrane in those 3 months (mainly because molar build-ups impede my bite to close to the painful position in my case).

[Megsi99]

I’m glad you’re having such great results! Did the orthotic eventually help with migraines before you transitioned to braces? I had my first adjustment yesterday, he said he doesn’t tell people to expect improvements until he makes the first changes so I’m crossing my fingers and hoping for the best. This neck pain is BRUTAL.

Did you do anything else when you had the orthotic? Physical therapy, chiropractor, etc?

[tmjd]

Yeap, the orthotic helped as long as I wore it, it was very tall and didn't allow me to close completely my mouth, allowing my joint to rest in a comfortable position. However, if I removed the orthotic for as little as 20 minutes, migraine stepped in almost immediately, and the only way to kill it was to take Ibuprofen or Excedrin Migrane, or have the orthotic back in the mouth and wait for 40 minutes to an hour. I ended using the orthotic almost 24/7 for about 6 months.

Let me say that it was not the first orthotic I wore, at first with my initial orthodontist, I had a orthotic that was very thin, no difference at all. He told me to have patience, but when I went for a second opinion with a very carefully chosen orthodontist specialized in joint issues, he had me took a tomography with different mouth openings to ensure the height of the orthotic was enough to let the joint rest in a neutral or comfortable position. This step was necessary to develop a plan and have the custom made braces and archwires move my bite to that optimal position.

I've had "migranes" back from when I was 15 years old, and suffered from labyrinthintitis (sever vertigo) 3 times. I did serveral neuro consults but nothing helped, until one doctor saw in an MRI that the problem was one of the joints pressuring the ear nerve a little bit, so it's not really migrane but TMJ inflicted pain. If I knew this 15/20 years ago, I would fixed it ASAP (my teeth are very well alligned, my parents taught I would not need even an orthodontist consultation).

My guess is that neck/back pain is indication of a worse TMJ condition. I wish you a lot of luck, and always try to get a second opinion if your pain does not diminish.

[Megsi99]

That’s super helpful, thank you.

The person I’m seeing is a neuromuscular dentist and it sounds like he did similar testing with sensors to measure my muscle tension. My neck and temples (headaches are in right temple) were sky high when I bit down. That was validating to see. Once he found the spot where everything matched the tension when my mouth was open(minimal), he took the impression for the orthotic.

Last question, I promise! How long until your headaches went away? I just had my first adjustment yesterday and he said he tells people to not expect improvements until then. Here’s to hoping.

[tmjd]

All the questions you need, no worries. That's why this forum is for.

My orthotic was fixed (only the first adjustment to provide the exact height and optimum occlusal function of my bite). It was initially intended for night wear only (to prevent unconscious over stressing the joint and the ear nerve while sleeping). I noticed improvements from the very first night, as I used to wake up with pain and sore face almost every day. Over the day, I tried consciously not to bit too hard on that side to prevent the trigger, but stress always triggered the pain, so when I talked to the orthodontist about it, he suggested to use it 24/7 to see if that helps, and from there design the real orthodontic work. It worked like a charm and spend full 6 months of 24/7 orthotic wear.

My suggestion is to use the orthotic as directed, but experiment once or twice in your first week to have it all day (first week of 24/7 wear is hard, not only for the position of the mouth, speaking correctly is almost impossible, and you can only drink water). I think the approach your ortho is doing is to first let your get used to the feeling or thr orthotic in your mouth and then adjust it. The first time in the "optimal" position feels very very strange for the first few days (specially on 24/7 wear).

[Prometheus]

It’s very interesting that tmjd points out in comment #5 that the molar buildups made a big difference in pain relief, similar to my experience with the bite turbos. My experience with the orthotic wasn’t great, I was miserable, it was so big I really couldn’t talk properly and it didn’t do much for the pain. Also, today after several years of braces my bite has been so re-engineered it is almost as if I have a completely different mouth. It is surprising how much more comforable my resting bite is, this journey has been worth the effort.

[iceman]

[quote=Megsi99 post_id=499569 time=1515034264 user_id=31178]
Hi all! So I’m not in braces yet, but after six months of this orthotic I’ve had for three weeks, that’s the most likely outcome.

I’d love to hear from anyone else who’s been down this path because of TMJ. How long did it take for the orthotic to help. I have nasty headaches and neck pain I’m hoping it will help. Thanks in advance!!
[/quote]


There's an interesting blog about TMJ causes and possible solutions here: https://treningogrehab.no/true-cause-so ... ction-tmd/

Essentially, the author says the cause of TMJ is an under-developed maxilla which causes a recessed (too far back) lower jaw which then puts too much force on the TMJ causing it problems.

The author recommends consciously bringing your lower jaw forward to "unjam the TMJ."

I wonder though, could an alternate solution be to bring the maxilla up and forwards (using natural methods, not surgery) ? This will then causes the lower jaw to be brought forward, which then puts less force on the joint, and thus could resolve the problem as well.

We're only talking millimeters here, but it could take a few months, and a reasonable amount of dedication, to see results.