TMJ

Discussion in 'Your Living Room' started by TracyInIndy, Oct 1, 2006.

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  1. TracyInIndy

    TracyInIndy Guest

    I suffer from TMJ. A forum member suggested I try to recreate some posts that were lost during the crash.

    TMJ is one of the other diseases that can mimic Meneire’s. TMJ stands for Temporomandibular Joint disorder (the jaw hinge).

    Symptoms include:
    Clicking in the jaw hinge
    Locking of the jaw hinge
    Sinus congestion
    Tinnitus
    Dizziness
    Balance problems
    Ear fullness
    Nausea
    Headaches
    Ear pain
    Pain in the face, neck, or upper back
    Jaw pain
    Numbness in the hands (a nerve bundle runs through that area).

    Causes and contributing factors include:
    Grinding your teeth (usually at night)
    Clenching your teeth
    For some reason my with TMJ had braces as a kid
    Accidents/injuries


    Treatments:
    First line treatment is a hard plastic & metal splint (similar to a retainer but it goes on the lower teeth). This splint snaps on the teeth. It’s worn 24/7 for 6-8 months. Some are allowed to eat without it some are only allowed to remove it to brush their teeth. Along with this treatment that can they suggest muscle relaxants and moist heat or ice (which ever feels better at the time).

    Second line treatment is to either cap all the teeth to change the bit (by increasing the heighth of the teeth) or braces.

    Third line treatment is surgery on the jaw joint itself. In the past this was the first line treatment, but no longer. This is now a treatment of last resort.

    More to follow, Tracy
     
  2. TracyInIndy

    TracyInIndy Guest

    How I got diagnosed:
    I’ve known I had TMJ for at least 15 years. I’ve worn a soft plastic night guard (over the top teeth) similar to what athletes wear to prevent chipped teeth for 13 of those years. About 6 or 7 years ago the clicking and pain in my jaw got bad and my dentist sent me to a TMJ specialist. He was an oral surgeon. He used a stethoscope to listen to the hinge and gave me a written test (asking questions like “Do you believe that you doctor can cure what’s wrong with you?”) His diagnosis was I need to get a life and/or see a psychologist. I gave up any hope of treatment at that point. I continued to wear the night guard, but it doesn’t treat TMJ it just hopefully helps to keep it from getting worse.

    My atypical MM symptoms started January 04. At some point between then and when I was diagnosed in June of 05 with EH (a form of atypical MM) I developed BPPV (positional vertigo). I had the EH under control, but the BPPV was happening every 6 to 8 weeks. It was so bad I spent over 16 weeks in vestibular rehab therapy learning how to reposition the balance crystals because it was happening so frequently. It would sometimes take me two weeks of repositioning to get the balance crystals back in. From September 05 on I was unable to drive a car, or work more than 3 days a week.

    In December 05 I developed almost constant nausea even when I wasn’t dizzy. I assumed it was either the EH or the BPPV. In April of 06 I developed stabbing ear pain in both ears usually when I was talking or eating. I feared I had an ear infection so called my specialist (he is easier to get into than my gp). After examining me and me telling him about the nausea, he told me there was no infection. Also he said something else had to be going on because I shouldn’t be nauseous without some sort of dizziness. As he continued the exam he placed his hands on my jaw hinges (both sides at once) and asked me to work my jaw up and down. I literally jumped 2-3 inches off the seat. It was so painful that my jaw ached for an hour afterwards and my teeth ached for 48 hours afterward. His diagnosis was TMJ.

    One of the interesting things he told me: in utero the bones of the ear and the bones of the jaw hinge start out fused together and later separate. The inner ear and the jaw hinge are very close geographically in the skull. There is only 1 pain nerve that runs to both the middle ear and the jaw hinge, the brain has no way to distinguish where the pain is coming from, it simply knows that something on that line hurts. That’s why I thought the pain was in my ears!

    I went to my dentist for a referral and I told her right off there was no way I was going back to the same doc that dismissed me last time! She said, Oh there’s a new specialist in town and we send all our patients to her! So I got on the waiting list.

    The specialist is an Oral and Maxifacial Surgeon. The exam included a full facial x-ray. Three x-rays of each jaw hinge, with my teeth together, jaw relaxed and mouth all the way open. They also measured how much I could open my mouth, and shifting the jaw all the way to the left and right. An ultrasound of the jaw hinges, and there was also all kinds of manipulation of the jaw.

    I was absolutely amazed! It was so obvious on the x-rays. First thing we noticed was that my jaw is tilted it’s about 2 cm higher on the right than the left. Also there is a dent in the jaw bone on the right side. She said that was caused by the fact that the muscles on the right side were trying to compensate for the damaged jaw hinge on the left side. Then we saw the hinge x-ray’s. The left hinge was so inflamed we couldn’t even see it on the x-ray. The right hinge was only about 40% visible.

    The doctor asked me “What was my greatest concern?” My answer “That you won’t believe me.” Even after I saw the x-rays! I was still afraid that she would blow me off. Well she didn’t! Second for me was the nausea. The relief I felt at being believed was overwhelming.

    Another thing I’ve learned through all this is that woman are much more likely to suffer from TMJ than men, and they are much more likely to be dismissed by a doctor, especially if they seek treatment early in the disease.

    Tracy
     
  3. TracyInIndy

    TracyInIndy Guest

    The Treatment:

    The impressions for the splint took about an hour. Part of it was putting me on a tense unit to relax the face muscles so they could take a proper impression of the distance between my upper and lower teeth. Two weeks later (last week of May) I had my splint. The instructions included, wear it 24/7 except to brush after eating. I’m to take smaller bites. Shoving too much food in the mouth stresses the joint. If I’m in pain I’m to try to put even amounts of food on each side and chew at the same time (try it, it’s really hard to do!) No hard, chewy, sticky or tough to chew items, no ice, hard candy, carmel, taffy, bagels, raw vegetables, nuts, popcorn or dried fruit. No singing, no shouting and I’m to place a balled fist under my chin when I yawn.

    I was given muscle relaxants and pain killers for about the first month to help me adjust. I go back once a month so they can check progress. Measurements are taken and the splint is tightened if I feel it’s loose. By the end of the month it’s loosened to the point where it feels spongy or loose when I chew. It’s not like braces where the tightening is done to further the treatment. This is tightened simply to make it more comfortable.

    They told me that whatever symptoms that were being caused by the TMJ would clear up during the first 2 months. The nausea disappeared in 1-2 weeks. My balance started to improve as well. I wasn’t walking into walls as much and could stand without feeling the need to lean against something.

    By the end of the first month (June) I began to notice dramatic improvements in my balance. Balance exercises that I couldn’t dream of doing in April were easily done! By the end of the second month (July) the nausea was gone and I was able to start driving again. Soon after I worked my first 5 day week in 11 months.

    I’ve now had the splint in 4 months. I’ve not had a BPPV episode since I got the splint. This is the longest I’ve gone without one in 2 years. My MM doc confirmed that it is possible the TMJ was causing the balance crystals to move out of place.

    I have my life back!

    Tracy
     
  4. Tai chi

    Tai chi New Member

    I had a lighter case of TMJ and the chiropractor has helped me. He helps the pain in the neck and the TMJ.

    Barbara
     
  5. Titus

    Titus New Member

    My TMJ is dislocated and doesn't recapture upon closing. It is the result of a trauma to my head and face. I've been to four specialists around the country and the general consensus is that I'll need surgery. Each specialist (they were all medical doctors who were board certified in dentistry and two were also radiologists) had a different take on splints. The first one wanted me to wear it 24/7. It made me much worse. The last one said I only needed it during the night and when I was driving or on the computer. It helped with the pain but not the dizziness.
     
  6. ToniG

    ToniG Guest

    I was dx'd with TMJ in 1998, I wear a night splint, physical therapy if I'm motivated to go..hehe. I've been offered muscle relaxers, but I'm pretty anti-meds for myself.
     
  7. Linda1002

    Linda1002 New Member

    Thank you, Tracy!
     
  8. ripper roo

    ripper roo lisa

    thanks tracy

    i am going to the dentist thursday week to ask about tmj
    as that is what my dr thinks is wrong with me

    thanks for all the info it sure helps

    lisa
     
  9. TracyInIndy

    TracyInIndy Guest

    Lisa, Linda Your welcome! and Linda thanks for the push to get this information back on the forum. I wrote it up in MS Word so if the forum crashes I won't have to try and remember all this stuff.

    Titus: An injury should be operated on. Mine was caused by: stress, clinching and braces when I was a kid.

    Barbara: glad the chiro was able to help!

    Toni: What kind of physical therapy? I know the standard soft plastic night guard is only meant to keep it from getting worse, not fix or correct anything. Is your hard? Does it fit over the uppers or lowers? Is it a partial or a full one?


    Tracy
     

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