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TMJ Disorder -TemporoMandibular Joint Message Board

TMJ Disorder -TemporoMandibular Joint Board Index

My Diaganosis
Jul 5, 2003
Yes, it's supposed to be "Diagnosis" :)

Hey all,

Please bear with me for the length of this post, I am curious to hear your comments & suggestions.

I had the pleasure of seeing Dr. David Rawson in London, Ontario. They have a web site under the name "Forrest City Dental". I must say, from the moment I arrived I was impressed!!!

First off, the nurse took me in to screen me with the sheets I filled out. She was impressed and actually HAPPY that I brought in a very detailed sheet of my symptoms. I had made up a list of my symptoms and brought in a chart to narrow down my area of pain and symptoms... most doctors hate that you do this.

Then, Dr. Rawson came in after about 20 mins of screening with the nurse (or Dental Assistant). I had my girlfriend with me, and from the on-set the Dr was VERY nice and VERY proffessional. He acknowledged that I wouldn't be leaving until I have all of my answers.. I was shocked. Before we even looked at my jaw, he picked up on my "stuffiness" sound and noticed a few facial features of mine that looked like I don't sleep very well. He asked me a few questions regarding the pigmintation of my gums, and asked my girlfriend some questions in regards to my sleeping patterns/habits... He then told me he suspects Sleep Apnea, and the fact that I don't breath through my nose very much, he wants to investigate that. So, I am going to a sleep clinic. For years, I have been "tired" and run down.. basically, just feeling like I fight to get through the whole day. This may be why... wow.

So, with that out of the way he took some measurements. He then had me stand up and did some tests with my hands, some neurological testing (pardon the spelling if wrong). I had my elbows on my sides, and my hands out in front of me. He pressed up against my hands to try and push them together. He told me to resist. No matter how much I resists, he pushed them together with ease. Then he grabbed some "swab sticks" (the sticks they put on your tongue when they take a peek) and broke them in a few peices and had me bite down on them. We then repeated the same test, and I was able to cause resistance and he had a harder time pushing my hands together. Excuse me as I forget the exact explanation of this, so I won't commnent and risk mis-informing you about what that means.. :)

Next we did a "TMJ Vibration test". I had what looks like "head phones" places over my TMJ area. I was then instructed to follow the screen and open and close my mouth and bang my teeth together so it'll make a louder noise, and therefore they can see on the results which are noises from my jaw and which are noises from my teeth. The results for that test, showed that they picked up on NO clicking. The clicking I hear "inside" my ears, isn't audable on the test. He explained all of that later...

Then I had Panoramic x-rays done, and some other x-rays on 3 different machines. I had to open my mouth as wide as I could for one of them, and hold it. It didn't really hurt that much during, but I felt it for the rest of the day.. that kinda hurt, but had to be done. After all of that, we waited...

Dr. Rawson then came in and we followed him to the X-RAY board. He popped on my x-rays, showing me my mouth and teeth first. My wisdom teeth are ALL impacted. The bottom right wisdom tooth is turned right against my teeth, no doubt causing pressure in that area. He suggested that ALL 4 come out. Then we looked at a root canal that I had done about 5 years ago, and he wants to see some "before & after" xrays of those before he comments, but he says that there is an area of question there, but he's waiting for the info from the doctor who did it. Now, I asked him about the wisdom teeth and addressed concern that a lot of people have "worse" problems when they have their wisodm teeth out. He agreed, however a lot of dentists take them out just because they are there or start to get a little of course. He said that if the wisdom teeth don't cause any problems, then he never takes them out. He confirmed that some people can get TMJD because of their wisdom teeth coming out, when there is no need and the body (mouth) compensates for that lost space and starts to shift things around causing the TMJ area to shift as well. Basically he said that he sees a few problems areas with me, all which could be the cause of my problems and he's going to treat them all and help me get them all treated so we can get me back on track... (I have a feeling now, that I've never really been on track!)

Next, the xray of my TMJ area. He found it interesting that the right side causes me more problems then my left. The root canal was on the right, the serverly impacted wisdom tooth was on the right and now the TMJ on the right side was basically pressed up tightly to my ear area. The best way I can explain it without drawing a picture is this... the joint as we all know is like a "ball and cup". The ball fits into the cup with space all around the cup to make an easy fit and a flawless system. The "space" around the ball is all nerves tied to your ear area. My right side has hardly any space between the ear and TMJ, meaning that any nerves in that area are pressed right up tight to the ear area and causing a "bulge" of sorts. This COULD be the cause of my ear symptoms, and explain the sensitivity to noise and fullness etc.. there are two muscles in that area that I don't recall the name of (I have read about them though, I belive they are called the "Typani" something.. anyways) he was impressed when I mentioned those muscles, as that's what he was going to say next. My left side isn't as bad, but is pressed up to the top area. There is still some space there, but it's still higher then it should be. After a few more questions.. we went back to the office.

This is where he showed me the "Orthotic", not splint that he wants to use for me. He NEVER suggests surgey unless there is a MAJOR problem that nothing else can fix. He's not confident that they exactly know what's going on with the surgey yet... I agreed that after reading some horror stories, that it almost sounds like surgeons go in there to "see what they can do". He explained that TMJD is under-studied, but they are seeing more and more cases. It's a cash cow for some doctors, and more and more cases are being found and people who have been in pain for 15 years with headaches, pain and the works all being told to "live with it" are getting treatment and having good quality of life again!

He showed me the orthotic, it would be worn 24/7. I would eat and sleep with it, and come in for adjustments. It will be on for 4 - 6 months, and will move the TMJ forward on the right side and down on the left side. I would be coming in regualarly to see him for check ups, and he's willing to bet that over that course of time I will slowly start to notice a big differnece. We asked a whole slew of questions about the orthotic... and were cofident that this is the right course of treatment.

I live about an hour and twenty minutes away from Dr. Rawson. He offered to get all of this work done by doctors in my area, but I told him that I wanted to go to the doctors that he uses, as I felt comfortable working with Dr. Rawson and I am hoping that his "network" of contacts will be as pleasureable an experience as this.. besides, I figured I would rather work with people who know Dr. Rawson and know what he's all about... The sleep clinic is in St. Thomas, the Wisdom teeth removal is in London (a Sept 15th consultation was booked). When my insurance information goes through, we will start right away on the orthotic, coming in to get a mold and the 2nd visit I will have it put on. It might be on before the wisdom teeth removal, which is fine... I am also going to see another ENT to look into my nasal passage to see if there is a reason I am a mouth breather.. if there is something inhibitating my abaility to breath effienctly. This will also give me another chance to ask more ear releated questions. He also suggested I see a chiroprator, he has one that is a specialist in dental chiropractics. He will do a complete body exam and xray to see what else could be playing tricks with my nerves and causing my problems. This is optional to me, but he suggests I give it a try if I am comfortable with it. I said I'd see what it was all about, and will take an appointment.

We then had a few more questions, and were on our way... My last question was "How confident are you that this is causing my ear problems?". He said that because I have seen 4 ENT's who said there is no ear problems there, and the fact that he sees a few red flags in reegards to my TMJ and other areas, he's VERY confident that I will notice big chances with all of this work done. I shook his hand, and told him that I couldn't thank him enough. I was there for like 2 1/2 hours, and he answered EVERYTHING! He was also a very nice guy, with a good sense of humour. The nurses was great when testing me, making sure I was ok..

Dr. Rawson was thrilled that I found him ONLINE! via his website (Forrest City Dental in London - do a search). I told him about Healthboards and he said that he loves the internet for medical information, it gets people talking and asking questions and people come to the office better educated and keep him on his toes.. he thanked me for coming in and I was off to sign my papers.

I ended up switching to Dr. Rawson as my dentist as well. It's WELL worth the drive to London!

I was happy with the costs.. for all of the xrays that were done, the orthotic fitting and adjustments and follow up appointments, the cost of treatment will be $1080.00 which is about 90% covered by my work. This price includes the $90 consulatation that I had with him that day...

I am not going to let myself get to excited about this, because if I go through all of this and nothing changes with my ears, I will be crushed. It was very nice to see physical PROOF that there is something PHYSICALLY wrong with my TMJ area and otger dental concerns that have ALL been linked to my symptoms.

I am looking forward to the treatment, and the sleep clinic as well. I have been dragging my butt for years, always thinking that it was "normal"... man, was I wrong!

If you finished reading this, what's your feedback?
Excuse the spelling and grammer mistakes, I typed this up as fast as I could... and I am not going to bother re-reading it (it's to long! haha)

So.. what do you all think?

[This message has been edited by Jamie (edited 07-05-2003).]

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