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TMJ Disorder -TemporoMandibular Joint Message Board


TMJ Disorder -TemporoMandibular Joint Board Index


Hello. I'm a 23 year old female. About a year ago, my primary care physician ordered an MRI of my TMJ due to clicking/popping noises when I opened my mouth, some discomfort, and a small lump in front of my right ear. This is what the report said:

[I]Right TMJ meniscus anterior dislocation in closed mouth position but recapture and anatomic positioning wit mouth opening. Accompanying small joint effusion. Left TMJ grossly normal. Each TMJ meniscus normal size and no abnormal degenerative attenuation. No imagining signs of arthropathy at either joint. Normal configuration mandible condyles and normal marrow intensity. Both joints have normal condyle translation in open mouth positions.[/I]

She explained to me that when my jaw is closed, it is misaligned, but when it is open, it is aligned as it should be. The first oral surgeon I saw did not specialize in treating TMJD cases such as this, but he recommended a night guard and said that if my jaw stopped shifting to find a comfortable position, the ligaments would strengthen and pull things into place as they should be. He said that that I developed this issue due to not having braces as a child. We switched insurance companies and he was no longer in network, so I went to another oral surgeon.

The second oral surgeon didn't really answer my questions. He just said my only chance to regain normal function was to do arthrocentisis in his office that day, with a local block (no anesthesia). He told me I would be fine to go to work later that day (I'm a vet tech) and restrain animals. I didn't feel comfortable having the procedure done and then going to work, so I left. I felt rushed and pressured into doing the procedure without being 100% comfortable with it, so I never returned.

I had a dental cleaning a few weeks ago and the dentist who checked my teeth afterwards said that I developed my jaw issues because I am a "thruster" and my tongue is not where it should be when I swallow. Because of this, my upper teeth are aligned poorly with my bottom teeth. She seemed to know a lot about TMJD and recommended a splint, but unfortunately, she is not a participating provider.

I have had consults with two orthodontists who said they have seen positive results by treating TMJ with braces. I'm definitely willing to do that, but they said that orthodontists usually work with another doctor who actually treats the TMJD and together they will develop a treatment plan.

Since the appointment with the 2nd oral surgeon, it's been a struggle to find an oral surgeon who treats TMJD and is in network. The closest oral surgeons who do treat TMJD are over 80 miles away, and I'm going to set up an appointment with one of them. My other option is to go to partner of the 2nd oral surgeon, who is only 10 miles away, but I just felt so uncomfortable the last time I was there, I just don't want to have the same experience. I just want to have a doctor that I can trust throughout the treatment. I feel kind of silly for seeing all these doctors and getting different opinions, but I don't want to risk making things worse. Is it necessary to have an oral surgeon, or can my dentist and orthodontist develop a treatment plan together? Does the general dentist usually develop the splint, and if symptoms improve, then the orthodontist puts braces on?

Any similar TMJD stories or advice as to where to go from here would be appreciated.





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