TMD treatment experiences?

March 11, 2004 9:08 AM

I have TMD. My oral surgeon gave me two choices - remove the fluid and debris in my jaw joint (via needle) and then inject steroids, or a hard mouth splint worn at night (not covered by insurance, so it'd cost me $650). He could give me no guarantees that either solution would be a permanent fix.

Haven't ruled either out yet (yay for tax refunds) but I am wondering if people have had experience with either and would share their experiences.
posted by gnomeloaf to Health & Fitness (12 answers total)

My dentist tried putting me on one of those mouth splints when he thought I was grinding my teeth while sleeping ... (he said he was seeing alot more of that, post 9/11). The one he made fit over my uppers, and I found it impossible to wear. I'd take it off without realizing it as soon as I'd fall asleep. Can't say you'd have the same issues, though, but there's no way to tell without having it made. (Also, the sizing of the thing, with that goopy, bubblegum pink casting gloop was beyond claustrophobic.)

If it were me, I'd go with the injections. Presumably, it's covered, and you might even be able to get some laughing gas for the procedure. A little bit of intense discomfort is better than longterm mild discomfort, if you ask me.
posted by crunchland at 9:19 AM on March 11, 2004

Have you tried relaxation techniques? They helped my RSI much more than cortisone or splints. (I know RSI isn't the same, but it seems similar.)
posted by callmejay at 9:25 AM on March 11, 2004

I've worn the bite guard for two years now without much problem. only thing is that your morning breath gets worse. It has definetly helped my jaw, as I use to wake up with headaches in the morning from grinding my teeth all night.

I didn;t really notice at first because I felt normal in the mornings, but after not wearing it for a week over the christmas holidays (forgot it when I went to visit the folks), the difference is clear.

I was never actually diagnosed with anything, though, I just complained about headcahes and a sore jaw and that's what they gave me.
posted by Hackworth at 9:52 AM on March 11, 2004

I have a TMJ problem, and the biggest help was relaxation techniques (your jaw, neck and shoulder muscles are all closely related and we often don't realize how tense those muscles can be - my shoulders' default state is "tense enough to bounce a quarter off") and acupuncture (and I'm not normally a fan of alternative medicine, but the difference it made to my TMJ pain was simply amazing). I even stopped grinding my teeth at night once I learned to relax my shoulders and neck (and had the acupuncture). I've heard enough horror stories of TMJ treatments gone badly wrong that I'd exhaust the other options long before I had anything done directly to the joint, but YMMV.
posted by biscotti at 9:54 AM on March 11, 2004

also, if you do the needle and steroid thing, is there any guarantee that the fluid and debris won't just build up again? If the mouth guard could work for you, it could also prevent reocurrence in the future, as long as you wear it. But, I am no doctor, so you should ask your dentist more specific questions.
posted by Hackworth at 9:56 AM on March 11, 2004

My sister had an acute bout of TMJ problems a few years ago - so bad that she went to the emergency room thinking she'd ruptured something in her throat. She was fitted for a night mouth guard thing and it did provide some relief, although ultimately her symptoms completely disappeared when she got out of what had been a very stressful living situation.
posted by TimeFactor at 10:21 AM on March 11, 2004

Your insurance should cover 2nd and 3rd opinions from qualified physicians. And the stress relief has no downside.
posted by theora55 at 10:36 AM on March 11, 2004

I had surgery to relocate my condolye 4 years ago, after trying splint therapy first. The surgery helped a lot, but the splint is good, too.

I have had a lower splint and now I have an upper splint. The upper works much better, but you will not be able to speak clearly with either of them in.

IMO, go for the splint, because it should last forever. Make sure that you have it adjusted by someone who knows what they're doing, and then again in a couple of weeks.

The fact that you're seeing an oral surgeon might mean that you'll end up going the surgical route anyway eventually. The goal is to do as many non-invasive, non-permanent things to help you in the meantime, and maybe even eliminate the need for surgery.
posted by Coffeemate at 10:38 AM on March 11, 2004

I got a custom 'night guard' several years ago. It's great. Worked like a charm, I don't even have to use it now.

Always try the non-surgical approach first, I say... better not to cut.
posted by daver at 10:49 AM on March 11, 2004

If you get a second opinion, go to a non-surgeon. Surgeons tend to recommend surgery not necessarily out of self-interest but because that is the solution they know. I seriously doubt your TMJ is caused by fluid or debris in your jaw joint so why would removing it cure it? What happens when the cortisone wears off?

Try to get the problem treated, not the symptoms.
posted by callmejay at 11:00 AM on March 11, 2004

and remember, mouth surguries can go wrong. i know a girl whose doctor nicked a nerve with the needle (putting in ana...anasc...novocaine) and ended up with permanent nerve damage in the bottom right side of her face. she was a beautiful girl, but a few years later was an odd looking woman.
posted by taumeson at 12:18 PM on March 11, 2004

Response by poster: Thanks for the stories...lots to think about.

The needle thing isn't surgery in an "anasthetic/cutting open" sense; that would be a very last resort, according to the oral surgeon.
posted by gnomeloaf at 1:43 PM on March 11, 2004