Ask MetaFilter questions tagged with tmj

TMJ alternative treatment and practitioner recommendations for New York City

Salamandrous — Wed, 07 Oct 2009 06:38:14 -0800

Please share advice for non-dental treatments for TMJ. I've been dealing with this for about a decade, and had a custom made night guard, that I wore religiously, for all this time. Maybe it's slowing down the rate at at which the TMJ is getting worse, but it's still getting worse and I hate it. Osteopathy? Acupuncture? I've heard of both as possible alternative treatments - and my insurance would help pay for them. Has anyone had positive experiences with them? Or can recommend a practitioner (who takes health insurance) in Manhattan or Brooklyn? Or has other suggestions for treatment to explore?

Thank you!

Bioesthetic Dentistry for TMJ dysfunction

not that girl — Wed, 21 May 2008 17:57:49 -0800

"Bioesthetic" dentistry: expensive quackery or my last best chance at a pain-free life? I have chronic pain; specifically, I've had a headache for 13 or 14 years now. As you can imagine, I've been subject to many tests and treatments, none of which have helped; years ago a doctor sent me to a pain clinic, where people learn to live with chronic pain. And I've lived with it, for a long time.

Then I got tired of living with it. Over the past year, my doctor and I have been exploring various options, none of which have paid off yet. Recently, she referred me to an oral surgeon to evaluate me for TMJ problems; he identified TMJ issues as a contributor to my headache. It seems very plausible to me.

For treatment, the oral surgeon referred me to a "bioesthetic" dentist. I had my consultation today. He would like to treat me with a device that would trick my jaw into thinking I have a proper bite, which would let my jaw relax. Over a period of months, he says, with periodic adjustments, my bite, jaw joint, and facial muscles can be returned to healthy position and functioning.

That's Phase I. In Phase II, we would supposedly be able to evaluate steps that could be taken to maintain correct bite without the appliance: jaw surgery, modification of tooth surfaces, and orthodontics are three possibilities.

It all sounds lovely, but I'm skeptical for a few reasons:

1. I've gotten my hopes up before only to have them dashed. Which isn't entirely relevant to the question.

2. Some elements of the dentist's spiel seemed a bit sketchy to me: a bit of excessive reverence for the dentist who discovered this amazing thing; a few references to things "mainstream dentistry" just doesn't want to pay attention to. Rhetoric I've heard before from proponents of unscientific, unfounded alternative treatments.

3. It's tremendously expensive: $4500, not covered by insurance, for Phase I.

4. One website I consulted about TMJ treatment warned specifically against treatments that required the wearing of a bite appliance 24 hours a day for extended periods of time.

Any experience or knowledge of bioesthetic dentistry as a treatment for TMJ problems? Personal stories as well as general info very welcome. If I decide not to pursue this (very likely since, among other things, the money to pay for it just pretty much doesn't exist) what other options might I pursue for TMJ treatment?

Please don't suggest other headache treatments; whatever you know about and swear by that changed your life, I've probably already tried it, and it will only depress me to hear about your miracle.

Is my dentist too crazy to treat me?

schroedinger — Sun, 05 Aug 2007 10:46:45 -0800

I have pretty severe TMJ for my age (early 20s) that has been getting worse. My dentist seems competent (I think), but also kind of . . . kooky. Could other AskMefites, especially TMJ sufferers, weigh in on him and his methods? I have had TMJ since my mid-teens when my braces came off. No grinding or headaches, but my jaw's out of alignment and I've had problems with locking, crunching, and popping that have been getting worse to the point where in the past few months I've gone through periods where it's been extremely difficult to eat or open my mouth because my jaw locks and it takes a good time to move things around enough to get it closed.

I went to my regular dental practice (very good, I love them) a month ago and was seen by a very new dentist who had joined after fifteen years of TMJ work at another practice. I was extremely heartened by this first visit--rather than telling me I'd "grow out of it" (when I certainly wasn't) or that there wasn't much beyond surgery he could do, he displayed a great knowledge of the causes of TMJ, ways to treat it, and basically made me feel like I was being treated by someone who actually knew what they were talking about and could help me. He even made a quick mock bite splint and after putting it in I felt muscles in my neck, jaw, back, and even down my arm relax that I hadn't even known were tight. He said he advocates "chirodontics"--basically treating the jaw as a joint and using chiropractic methods to help treat it. This makes sense, right? He said he couldn't do anything until he talked to the head practitioner of the practice but I should schedule a follow-up. The only thing that kind of set off alarm bells were when towards the end he started talking about "energy medicine" and "clearing out the toxins" and restoring my life energy. But I brushed it away and scheduled a follow-up because of the quality of the rest of the visit.

The second visit a month later got wackier. Much wackier. The entire visit he talked about the necessity of maintaining my energy flow and how toxins were building up in the bad jaw joint. He said he couldn't use the chirodontics because he hadn't convinced the head dentist, and creating a bite splint would be over $2000. He then said I could go to his trained-by-the-head-physician-of-the-Emperor-of-Japan mentor--with whom he'd had a huge falling out so I wasn't allowed to mention the dentist's name--and get a bite splint there. The splint would cost much less, but it would be followed by $300 "energy healing" treatments, herbal treatments, and adjustments. He warned me it would be a nightmare getting an appointment, I'd be spending hours in the waiting room on the day of each appointment, it wouldn't be covered by insurance, but after six sessions of $300 each (plus the bite splint) I'd feel like a million. He then sent me on his way, chalking up my recent tooth sensitivity of the past two weeks to the TMJ too rather than even looking at the possibility of cavities or anything else.

What the heck? Now what do I do? On the one hand, my new dentist seems like a wack job, in between the energy healing business and the sheer amount of drama that seems to be following him (the troubles with his mentor, the hot water he's in with the head of the new practice after only one month). On the other hand, he definitely seems to know what he's doing--that mock bite splint felt great and when he kept out of the energy healing explanations he seemed competent at diagnosing and treating TMJ. So I don't know if I should try to get the super-expensive splint from him, get the cheap splint from the mentor and not do the adjustments, or find someone less crazy. I know I need a splint, and I want to get one from the best to make it less likely to fuck up my bite even more, but I also am afraid to deal with a crazy person.

What has worked for you? Should I drop this guy and find someone else? Just go with the splint? This energy healing stuff is hoo-doo, right?

Can you recommend someone to treat my TMJ problems?

underwater — Tue, 26 Jun 2007 10:37:39 -0800

Can you recommend someone to treat my TMJ problems? Can anyone recommend someone to treat my TMJ in or around Atlanta, GA? Details of any personal experiences with specific people and their approaches are welcome. Thanks.

Blush ain't cutting it.

Anonymous — Sat, 26 May 2007 16:21:25 -0800

Silicone cheekbone/jaw implants: advice or experiences about shaping a new skull? After fairly extensive upper and lower jaw surgery in my early teens to correct the effects of serious TMJ syndrome, I lost what elusive bone structure I had to begin with. The result is that my face is strangely balanced, with a smallish chin (I had a subtle implant as part of the surgery - they did a good job, but it wasn't enough to balance the rest of my face), total lack of jaw definition, and slightly saggy and puffy cheeks that, along with genetic dark circles, make me look constantly tired. I love my facial features, I just don't have the bone structure to support them. I'm female, young (just out of college), and generally happy with myself and my body in other respects; this is just something that I know can be changed, and I can see that if I don't do anything the effects are going to cause me to look older than I am over the next few decades. So I'm wondering: have you had experience with facial implants, and if so, are you happy with the results? Is there any semi-scientific way of predicting the outcome? Any big disadvantages? What sort of recovery times did you need? Is the result very obvious, or will a dramatic new haircut reduce the shock to acquaintances? I've had the chin implant, and was happy with that, but because it was part of a larger surgery I don't feel like it was really a good predictor.

Seeking chronic pain treatment facility

bilabial — Mon, 12 Feb 2007 06:11:48 -0800

My boyfriend's mother has suffered from a variety of chronic pain issues for roughly 15 years and is in the process of trying to find a facility that is best suited to her needs. At the moment, her main issue is TMJD, accompanied by severe fibromyalgia, digestive problems, recurring candida, and what some doctors have suggested is Sjogren's syndrome. Needless to say, this is all accompanied by severe depression.

In the past she has been an outpatient at the Mayo Clinic (Florida and Minnesota) as well as an inpatient at the Johns Hopkins Chronic Pain Treatment Program. She lives in a fairly isolated part of Florida, and as such, her access to specialists is limited. Nevertheless, she has traveled extensively to work with jaw specialists, endocrinologists, rheumetologists, and has tried a wide variety of alternative and complementary medicine including massage, myofacial release, rolfing, reiki, aromatherapy, all sorts of natural supplements, yoga, and meditation (she has a strong connection to Buddhism). None provide her much relief.

The several month regimen of detox and physical/occupational therapy at Hopkins made an improvement on her pain level, emotional state and stamina, but it was short lived, lasting for only a few months after her stay there ended. She also felt that their approach was too clinical and narrow for the complex web of problems she has. What she's looking for at this point is a place that has the medical credibility and technology for safe diagnosis and detoxification (she takes a few pain medications and an antidepressant, all to very limited effect), a strong emphasis on alternative/complementary medicine, and an approach that can address the depression (as well as other emotional issues) associated with chronic pain. On the other hand, she's concerned about the lack of standards at certain cure-all spiritual detox centers outside of the U.S. The fact that many of those places don't take insurance is also an issue. My boyfriend's mother and father aren't poor, but a place that takes insurance is highly desirable. Traveling is also taxing on her, so she's looking for places within North America. However, all options, both on and off the continent are welcome.

She's working to address the depression, but again, the resources where she lives are limited. We'd like to keep the discussion focused on the treatment options rather than the validity of her sypmtoms and previous diagnoses.

What's the deal with craniosacral therapy?

peppermint22 — Sat, 18 Nov 2006 00:24:24 -0800

What is a typical craniosacral therapy session like? Please share your first-person experiences. Also, any recommendations for a practitioner in Nashville? For a few years I've had an terrible teeth-clenching habit, and now I'm starting to get face and jaw pain. I'm looking for nonmedical/nonsurgical ways to relax my face. My sister is a dentist (in another state unfortunately) - she suggested craniosacral therapy. What is a typical session like? I'd love to hear from folks who've been on the table.

Prolotherapy for TMJS?

Scoops — Sat, 02 Sep 2006 10:52:52 -0800

My Girlfriend is considering Prolotherapy as treatment for her TMJ Syndrome. Anyone have any experience with this? Good or bad?

What should I do with this TMJ pain?

Ash3000 — Wed, 21 Jun 2006 07:20:14 -0800

Please give me your input on a TMJ quasi-emergency. Long story short, I have TMJ problems. Both joints have clicked, crunched and popped since early high school, partially a result of bruxism (itself likely from stress as the past decade has been a rough one), partially as a result of a skeletal malformation (severaly short maxilla)/underbite I'd had since birth. In my last year of high school, I had surgery to lengthen the maxilla, thus giving me a proper overbite. In the three years since, my basic treatment to deal with the residual problems has been to wear my night-guard, which I'm iffy on - I'll do it for stretches, and then forget for months. (Yeah, I'm a fuck-up/irresponsible.) About a week ago, my left TMJ has gotten much more intense suddenly: I can't move my jaw completely to the left without searing pain, and when I bite, my left ear/TMJ aches. When I move my jaw up and down in "that way" which aggravates the joints (I'm guessing most TMJ people will know of what I speak), there is pain almost exclusively on the left side.

I'm totally ashamed to go to the doctor and have it apparent my retainer-wearing has been iffy, and I've taken in the past few days to not only wearing the retainer at night, but ocassionally during the day. While the pain might be slightly better now, it's only slightly. I know this is probably a pathetic question, but, do I keep with the retainer and see if it improves? For how long? Do I contact the doctor (who I won't see until, in a perfect world, a week from now at the earliest)? I probably just need someone to tell me something obvious, but this is an ultra-tough time in my life right now, and I barely have time to deal with judging these sort of things.

My jaw has shifted

karmaville — Tue, 28 Feb 2006 21:30:41 -0800

It seems as if my jaw has shifted forward about an inch. How is that possible? On waking Sunday morning, I noticed that my jaw had shifted forward. It took me from a very small overbite to a pronounced underbite. My teeth no longer "fit" together properly.

I have had some minor jaw pain recently, TMJ-like, from a flare of chronic arthritis. It felt like a ball bearing stuck in the hinge causing pain when I bit down. I still have a slight burning sensation and some tightness under my right ear. This has been going on for about two weeks after stopping an anti-inflammatory due to side effects.

Unfortunately, I have neither access to neither my rheumatologist or a dentist for at least a week or so. Is it possible that the joint inflammation is pressing my jaw forward causing the problem? Have you experienced anything similar? Should I seek emergent care?

My jaw is making my ear hurt.

junkbox — Tue, 14 Feb 2006 13:09:07 -0800

What sort of specialist should I visit to examine/treat me for TMJ? For the last few years, I've been experiencing intermittent pain centered in the cartilage in front of my right ear. I also think I have some mild hearing loss in this ear, which may or may not be related to the pain. I finally went to my PCP, and a nurse practitioner examined me, said everything inside my ear looks perfectly normal, mentioned the possibility of TMJ, and referred me to an ENT specialist.

I feel pretty sure that my pain (and maybe the hearing loss as well) is related to TMJ; I have a history of jaw-grinding, the pain responds well to heat/warmth, etc. Should I go ahead and see an ENT, or is there a better type of specialist who would be more qualified to treat me?

Although I have a physician's office, my trusted PCP is unavailable for a few months. I turn to the collective wisdom of AskMe to explore alternatives to the nurse practitioner's recommendation of an ENT.

NTI appliance for TMJ?

crapulent — Thu, 01 Dec 2005 05:26:00 -0800

Has anyone had an experience with an NTI appliance for TMJ? Or possibly a similar device for dental/jaw pain? I am thinking about purchasing an NTI Deprogrammer for my TMJ pain because I currently have a mouth guard and it has shown no improvement. I am interested in any personal experiences with this device or with other methods that have improved your TMJ.

I realize that this is a long shot, but I am hoping that maybe someone out there has this device.

Disease-specific insurance coverage?

Anonymous — Mon, 27 Jun 2005 15:33:55 -0800

I work for a small business and they told me I can pick my own insurance plan. I'm really having trouble narrowing the field. Is there a method for determining which insurance plan would provide the best coverage for certain diseases? I have nothing to go by here except for the price. The plan has to be somewhere in the vicinity of $100-200/month. (It can be higher, but I will have to pay the difference myself.) I've looked at various sites and I am thoroughly overwhelmed.

Info: I am 25, no kids, and live in Missouri. So if any Missourians would like to recommend a plan or provider, that would be extremely helpful.

Mostly I need prescription drug coverage. But for the near future, I will probably need TMJ treatment and I am hoping to have ETS surgery. Both of these are treatments that insurance companies do NOT like to pay for. I found this, however it wasn't very useful because there is no mention of Missouri and some of the plans are from 2003. How can I pick an insurance plan that will be most likely to provide coverage for TMJ and ETS? Has anyone had particular luck in having these conditions treated? (The TMJ treatment might fall under the realm of dental insurance, therefore recommendations for plans that include dental or recommendations for separate dental plans would also be valuable.)

I know this question is fairly convoluted and far-reaching, thus any advice at all would be truly appreciated.

Jaw Surgery

scody — Mon, 09 Feb 2004 14:22:40 -0800

Any MeFites have experience with jaw surgery? (More inside, as you might expect.) I've been in braces a little over 5 months with the expecation of having orthognathic surgery about halfway through the process (i.e., somewhere around the 9-month mark or so). My orthodontist hasn't yet referred me to a maxillo-facial surgeon, but is expecting to do so soon. From what I understand, I'll probably have a LeFort osteotomy for the upper jaw and a saggital split for the lower. Anyone else had related procedures who would care to share their experiences? What should I expect from the initial surgical consult (and any questions I should be prepared with)? What was your recovery time like after the surgery? Any thoughts on the whole liquid diet/soft food thing? (Everything I've read on this count basically says "one of the unexpected benefits to jaw surgery is that you'll lose 10-15 lbs. during recovery, and gee, who wouldn't want that?" Well, I wouldn't, for one -- my weight problem is a perpetual struggle to gain weight, so I really don't have 15 lbs. to spare.) I'm also curious about the psychological side of having jaw surgery -- how did having such a change in appearance affect you?