I am a 22 y/o female with a TMJ problem.
One day when I was about 11 years old, I
suddenly became aware of strange sensation
in my jaw. I could not open it fully, and
when I tried it made a clicking, or
popping sound. I had no pain but I was
terrified of this sensation, and thus
began a myriad of trips to general
practitioners and dentists. I was told it
was probably TMJD - which I've come to
realize means absolutely nothing. It's a
term they give you when you come to them
stating something is wrong with your
temporomandibular joint. They slap a D on
the end, and call it a disorder. I've
recently discovered why they use such a
generic diagnosis for patients with these
complaints: the TMJ is quite possibly the
least understood joint in the body, and
perhaps the most avoided topic in medicine
and dentistry. Okay, so I have no pain...
slightly limited mobility, annoying - but
manageable popping sounds. Why am I here?
Why do I need advice? Well you can thank
my Family Dentist for that. Extremely well
intentioned, this guy found something
interesting on a routine panaramic x-ray.
My right condyle looked considerably
shorter than the left. When he went back
through my records, he saw that I was a
TMJ patient and immediately brought this
to my attention. At first I thought, wow,
someone has actually validated an issue
I've been having for ten years... then I
thought, so now what? Well...
appointments, MRIs, consultations... and
ultimately a proposal of surgical
intervention. HOLD UP... I didn't come to
you about my TMJ, you came to me. Now
you're proposing surgery? I have no pain,
I'm fine... a tad bit asymmetric - which I
NOW notice everytime I look in the mirror,
but really? Okay, so the doc has other
reasons... like the fact that the
cartilage in my right TMJ is barely
hanging on - which he BELIEVES is the
reason for the stunted growth of the
condyle (AKA osteochondrosis). By the way
he explain this condition, he had me
totally sold on correcting it by surgery.
But I have to admit... I'm a GA (Google
Addict). And now... I need to get some
discrepencies cleared up. Everything I
read about TMJD treatment stresses surgery
as a LAST RESORT. Why is it my first???
And actually, why is it considered a last
resort?? My dentist showed me my MRI that
clearly (haha) revealed there was very
little (if any) cartilage left between my
joint - an unknown amount of "chews" away
from bone on bone contact. How could
conservative treatment such as splints,
therapy, even orthodontia repair my
cartilage?? I know this sounds
backwards... I seem like I am agreeing
with my dentist, and arguing the
conventional point of view that shouldn't
even concern me since I'm not going that
route. But that's the thing... it's the
conventional route. Am I being completely
short sited in accepting the proposal of
my first opinion - one that is cutting
edge, and questionably experimental? If
you are interested in knowing the type of
procedure they are proposing, it is a fat
graft - by a very experience surgeon. I
apologize for this post being kind of
all-over-the-place, but this ordeal has
left me a bit scatter brained. I would
just really like to know what you think.
Surgery for someone with NO PAIN, but a
displaced disc, slight facial asymmetry
and possible (likely) worsening of the
condition - medically and cosmetically -
over the years? Or are there other
conservative treatments I am not aware of
that will address this problem? All
opinions welcome!!! Thanks.
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Tmddyan
Moderator
Joined: 13 Jun 2006 Posts: 4440 Location: post falls, id usa
Thanks: 102
Thanked:68
Posted: 05-21-08 13:16pm
surgery is always the last option because
it is irreversable---you cant take it
back. you should try all possible
conservative methods first
chiropractic,
massage
neuromuscular dentistry(i highly
recommend)
braces(dont bother ---makes it worse)
accupressur
accupuncture
splints
craniosacral therapy
arthrocentisis(less invasive surgery)
arthroscopy( more invasive)
arthroplasty(open joint surgery)
orthognathic surgery(major head surgery)
there are simple things you can do
yourself too
heat
ice
massge
exercise
soft diet
anti inflamitories
watch your posture
etc
i know im forgetting something somewhere
any questions feel free to ask.
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gradgirl
New User, Becoming EHEALTHy
Joined: 20 May 2008 Posts: 3
Posted: 05-21-08 15:19pm
Thanks for the info, but what would all
these things be treating? The point is I
don't have any symptoms. My dentist is
suggesting surgery for anatomical reasons
- my disc is dangerously thin and my right
condyle (the actual bone) is too small.
So, the whole thing with trying more
conservative treatments first... what
kinds of conservative treatments would
repair a damaged disc and enlarge a bone?
(i think none). My dentist keeps saying I
have a serious issue with my joint that
NEEDS to be addressed, sooner than later.
He says its degenerative and could lead to
major problems. But in my research, I've
never heard of anyone taking preventative
measures - conservative or surgical - for
TMJ. Does anyone know what I'm saying? I
feel so alone because no one else agrees
with this method of treatment, but my
dentist is very convincing that surgery
can fix it, and that it is the only way. I
need some more validation, or perhaps
another option... thanks for all your
time!
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catswold
Supporter
Joined: 10 Oct 2005 Posts: 404 Location: Flint, Michigan
Posted: 05-21-08 21:09pm
Gradgirl - get another opinion from
another "specialist." Get two or three or
more opinions from various specialists
BEFORE making any major decision such as
surgery.
Many people don't have perfectly healthy
discs but yet live that way with little or
no problems. Most people also do not have
perfectly symmetrical faces. Surgery
opens up a host of possible problems,
scarring being the biggest (even within a
tiny little joint using tiny scopes, etc.)
I can't stress to you the importance or
seeing others first. I know it might be
costly, but some might see you for little
or no fee, and remember, this is a quality
of life issue for you. Seek out a
neuromuscular dentist in your area for
their opinion. See other dental
specialists (Oral & maxillofacial
pathologist or surgeon, Orthodontics or
Dentofacial orthopedics, Endodontics, DDS,
DMD) and get their opinions. Do NOT go to
a specialist that your current dentist
recommends. They'll just agree with him.
I hope and pray that you will find the
help you need.
God bless...
Carol
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gradgirl
New User, Becoming EHEALTHy
Joined: 20 May 2008 Posts: 3
Posted: 05-22-08 04:22am
Thank you so much!
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Tmddyan
Moderator
Joined: 13 Jun 2006 Posts: 4440 Location: post falls, id usa
Thanks: 102
Thanked:68
Posted: 05-22-08 12:31pm
yes i would get a second opinion---all
those are to treat the jaw disorder.
regardless of weather is anatomical or not
things can change with out surgery
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simplyinvalid
New User, Becoming EHEALTHy
Joined: 22 May 2008 Posts: 6
Posted: 05-22-08 23:55pm
Hi there,
Facing surgery can be daunting - I had
surgery (an eminectomy) for a TMJ problem
that was diagnosed after 4 years of
chronic pain (complete with headaches,
neck pain, nerve pain, eye pain/blurring,
tinnitis, the whole works) and jumping
from specialist to specialist... finally I
had an MRI and they found it was an actual
physical issue that could only be
corrected with surgery. The disc in my
right TMJ was displaced and needed to be
sutured in place. Since the surgery in
August 2007, the pain has greatly improved
and my opening has tripled... my point
here is, while of course surgery is the
last choice, sometimes it is the only
choice when it comes to physical,
anatomical issues that need to be
repaired, and other treatments that often
work for TMJD patients merely helps
temporarily. It certainly can't hurt to
get a second opinion, and obviously every
individual TMJD case is unique, and mine
is different from yours... but by the
sounds of it, the problem you have is
causing significant damage to your joint,
and it's important to get treatment
rolling for that. Good luck!! You're lucky
to have gotten this far with such minimal
pain... I sure envy you!
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Tmddyan
Moderator
Joined: 13 Jun 2006 Posts: 4440 Location: post falls, id usa
Thanks: 102
Thanked:68
Posted: 05-23-08 12:37pm
just remember that surgery is the last o
ption and you dont have to face it untill
youve tried everything else--and then we
are here for you
