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TMJ Disorder -TemporoMandibular Joint Message Board

TMJ Disorder -TemporoMandibular Joint Board Index

What type of splint is it?
Or is it an orthotic?
They are very different things.
If you were given a flat plane splint for example, those are not often successful because they are not a custom mouth piece that has been made with your specific TMD needs in mind.
What kind of doctor are you seeing? It might benefit you to research dentists that are specifically focused on TMD and who are actively continuing their education and research into the field. Not all dentists/orthodontists/oral surgeons go out of their way to study or treat TMD.
I agree with the above comment RESEARCH RESEARCH RESEARCH
Knowledge is power in all cases of TMD. You need to know what your specific diagnosis is. Is your TMD promarliy muscular based? Is there trauma/damage to your jaw/condyles/discs? Are the discs displaced?
You need to find someone who will do a very thorough physical and technological examination of you and your signs/symptoms.
These are very important things in an examination:
Physical: mouth/teeth/tongue/facial muscles/joints(muscle palpating test)/neck/shoulders/c-spine/posture/head
Tech/scans that help diagnose:
CT or iCAT scans to check on the bone/joint status
Tmj MRI to check on surrounding muscles/tissues
Tomography X-ray
TENS unit (relaxation of facial/jaw muscles through electric pulse stimulation)
JVA (joint vibration analysis)

The last 5 are typically used in Neuromusclar Dentistry TMD treatments. You should look into this as one option that may benefit you. Most dentists who go out of their way after dental school to learn about and treat TMJ use a neuromuscular approach or a combination of methods related to this.

If you do start meeting with TMJ specialists or anyone who will be treating you, here's a list of things I put together to keep in mind when I interview them. And yes I do mean interview. You are responsible for your health and you are in control of what happens to your body. Be prepared, do your research, and make your treatment your priority.

I put this in another post but it's worth repeating. This is all based on my own research. You should always do your own research and pick the path that makes the most sense to you:

Anyone can call themselves a "TMJ specialist" because it's not an officially recognized dental or medical title, so you will have to really hunt for the people that have gone out of their way to truly help people with TMD. "Cosmetic dentistry" and "smile dentist" are also not medically recognized titles. To become a good "cosmetic dentist", someone who focuses primarily on teeth whitening/veneers/implants/etc., would have had to go out of their way after dental school to continue their education in the field. This is the same case with "TMD/TMJ specialists/dentists." You need to make sure that they have been studying TMD for many years and that they are currently making an effort to study the latest tech/treatment methods for tmd cases. Do thorough research on any professional you plan to see. Is there license current? Does there website focus mainly on TMD or is it a combination of cosmetic and TMD? What does it say their treatment method is? Read any and all reviews on them and their practice. Contact past patients of theirs through Yelp if possible and ask if they would still recommend this dentist and why.
If you decided to start meeting with people for consultations, always get multiple opinions and never jump into treatment immediately. Take the time to compare doctors so you find the one you think will have your best interests at heart.
Bring a list of questions with you and ASK ASK ASK. If they get uncomfortable with your questions or get defensive or won't answer them to your satisfaction, take that into account, it is very telling.
Some good questions to start with:
How long have you be studying TMD?
What % of your practice is TMD related? (If the number is small, ask why. Treating TMD takes more time than typical dental patients, so it may be because they just can't handle too many at a time, but you won't know unless you ask.)
What is your TMD treatment success rate?
What do you consider a successful treatment?
Please explain your diagnosis and treatment process. (No matter what, the diagnosis & treatment should be done on an individual basis. What works for one TMD case may not work for another. Diagnosis of your specific TMD problems and causes is crucial and requires a very thorough physical exam of the mouth/teeth/joints/facial muscles/neck/shoulders/c-spine/posture/head, along with many technological tests and scans/x-rays to confirm the status of your jaw bone, condyles, discs, muscles.)
If the dentist is neuromuscularly trained, ask him or her about phase 1 and phase 2, what they include/entail, for how long, and how much the cost will be.
Are you passionate about TMD?
Do you have any experience with Functional Jaw Orthopedics/Orthodontics? (Phase 2 typically includes braces as an option to permanently correct your "bite" after phase 1 treatment is successful. FYI, braces should never be the first step. Finding your jaw's ideal resting place is the first priority to ensure that your symptoms are gone for at least 6 months or more before moving forward with a permanent solution. A regular orthodontist could do more damage. Functional jaw ortho takes into consideration the entire jaw structure when doing braces.)
Do you charge a fee for copies of any of the scans or tests taken during the consultation? (I would personally beware of anyone who wants to charge you a ridiculous amount for scan copies, particularly because they usually charge you a consultation fee. If in the consultation they do scans, you have a right to copies. One guy wanted to charge me $250 for a copy of 1 scan.)
Do you send out the iCAT scan to be read by a radiologist? (A dentist will not always know how to read a CT or iCAT scan, it is safer to have it looked at by a radiologist so that you can rule out anything being wrong with your joints/etc)
Do you use MRI scans in your diagnosis?
What insurances do you accept?
How often will check-ins/orthotic adjustments be scheduled to accommodate my changing bite?
At each adjustment/follow-up appointment do you do further scans to make sure I'm making good, healthy progress?
How long do I spend in the phase 1 orthotic before you begin stage 2? (It will be different for every person. You should be pain/symptom free for at least 6 months before beginning phase 2. If they give you a rigid cut-off date, this is fishy because for every case it will take a different amount of time to achieve the optimum results. For some people it can take up to a year to reach 95% pain/symptom free status.)
Will the orthotic change my bite? (The answer should be no. The first phase is meant to be reversible, and only serves to find the optimum position for your jaw and muscles to relieve your symptoms.)
If at any point the treatment fails or makes me worse, do you offer any kind of full or partial refund? (Many places do not do this, which I find infuriating.)
Do you have any financing options such as CareCredit?
Will you be referring me to other specialists (chiropractor/physical therapist/etc...) to help my progress?

REQUEST these things from the doctor:
1. Contact info for a few successful patients (3-5) currently in phase 1 and a few in phase 2, a few who are at least 3-5 years post treatment, with the patients' permission. (Talking to their patients can be extremely helpful and reveal a lot about a doctor and his practice. If they are reluctant to do this or say no, this can be telling as well. If they have many success stories and have obtained the patients' permission, why wouldn't they be eager to share their success stories with you?)
2. Cost analysis/cost of entire treatment. (This is for your records and also for insurance purposes. Insurance companies want to see everything itemized and listed, not a single lump sum for treatment.)
3. Financing options in detail (interest rate, time to pay it back, etc...)
4. Copies of all tests/scans for your records.

Take notes at each meeting and write down how you felt about the doctor and the practice right after meeting with them. You should feel comfortable trusting your TMD to the one you choose because they take the time to answer your questions and to diagnose your specific issues before suggesting a treatment plan.

I hope this helps!!
I've found that the key to not sinking into your anxiety/TMD depression is to continually be searching for solutions. Be an active participant in your health. I have found TMD success stories and each one gives me hope. There are a few that I've found in these boards as a matter of fact. These boards are about 90% darkness and confusion and worry, but occasionally the people who have found success do come back to offer advice or describe their experiences.

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