I went to a new orthodontist (he seemed pretty knowledgeable about TMD and treatment) and he was trying to find out what caused my TMD problems. I told him that I've had it for like 10 years or so and he asked me if I recall anything that might've caused it, which I replied no. Then he was looking at my hands (which are kinda bony) and told me if I could bend then back. I bent them back at a 90-95 degree angle (which at the time thought it was normal :/). Then he told me to bend my thumb back towards my wrist (which i touched with no problem). He wrote down some stuff and then said that my TMD was caused by me having really really flexible and a little bit weak joints and he said to push his fingers back to prove his reasoning. I did and they bent like 30 degrees unlike my 90-95 degrees. Then he said that since your right jaw locked there might be a chance that once your TMD goes away that your left jaw might pop because of your weak and flexible joints. He also said that my TMD might not ever be fixed completely because of that but he says to remain optimistic. Is it true that my TMD possibly won't ever heal?Saturday, September 24, 2011
For Tooth975: Orthodontist Says That My Tmd Won't Ever Be Completly Fixed?
I went to a new orthodontist (he seemed pretty knowledgeable about TMD and treatment) and he was trying to find out what caused my TMD problems. I told him that I've had it for like 10 years or so and he asked me if I recall anything that might've caused it, which I replied no. Then he was looking at my hands (which are kinda bony) and told me if I could bend then back. I bent them back at a 90-95 degree angle (which at the time thought it was normal :/). Then he told me to bend my thumb back towards my wrist (which i touched with no problem). He wrote down some stuff and then said that my TMD was caused by me having really really flexible and a little bit weak joints and he said to push his fingers back to prove his reasoning. I did and they bent like 30 degrees unlike my 90-95 degrees. Then he said that since your right jaw locked there might be a chance that once your TMD goes away that your left jaw might pop because of your weak and flexible joints. He also said that my TMD might not ever be fixed completely because of that but he says to remain optimistic. Is it true that my TMD possibly won't ever heal?
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tooth975 - I can't answer that question because I have no orthodontic records on you. Hyperflexion can possibly make you able to overextend the normal range of motion of your TM joints, however, but I think your orthodontist is barking up the wrong tree. A functionally based cephalometric analysis is a must to begin with. The problem I have with your orthodontist's view is TMJ clicking is due to anterior displacement of the articular disk while hyperextension of the jaw will result in posterior displacement of the articular disk, the opposite direction. This is called a hypermobile joint. If you have clicking of the jaws when you are opening within a normal range, then your TMJ problem is due to a disk that is being forced out of place in an anterior direction and this affects normal opening and closing. Perhaps what your orthodontist is telling you is even though the articular disk has been stabilized so that it no longer gets forced out of place when closing your mouth, the disk may still pop out of place whenever you open too wide (beyond your normal range of motion). This is not really a problem because you can learn to stay within a normal range (stifling a wide yawn, for example). The important thing is not having the disk dislocate whenever your teeth are together. You can stop a disk from dislocating as a result of over opening because this can be controlled but you cannot stop a disk from dislocating whenever your teeth come together until the TMJ disorder is fixed. BTW, it is not significant if the exact reason for the cause of a TMJ disorder is not found. The important thing is to determine what is forcing the disk out of place and stopping it.
ReplyDeleteDr. G - Sorry to hear about your conditions. One thing you may want to consider is seeing a neuromuscular dentist. There are many schools of thought regarding TMD issues, such as where the joint is ideally placed skeletally, or how the teeth are positioned, but since most pain is caused by muscles, a neuromuscular dentist can relax your muscles to position your jaw in the most ideal rest position.
ReplyDeleteThis is done by using a TENS (transcutaneous electrical nerve stimulation) unit to relax your muscles, then they can actually show you the difference in your muscle activity by using an EMG (electromyography) machine.
What they normally do is make you a splint that you can wear, which you can function with, which can help keep you in that ideal rest position. If this gets rid of your symptoms, they can then talk discuss restoring your teeth so that you do not need to wear the splint.
Many dentists are not aware of the neuromuscular benefits, so just know that some dentists will try to discourage you from seeing someone. But if what your dentist is doing is not working, what do you have to lose?
The LVI link below can refer you to someone in your area who has been trained in this area of dentistry.