Is my dentist too crazy to treat me?
August 5, 2007 10:46 AM   Subscribe

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?
posted by schroedinger to Health & Fitness (16 answers total) 1 user marked this as a favorite
 
I have TMJ. My ENT sent me to my dentist for treatment. He fitted me for a mouthguard that I wear when I sleep. His experience has been that this usually works for most TMJ patients but in some cases, altering how you bite is necessary. He has a physical therapist that he works with that specializes in TMJ. The PT works with you to help retrain your jaw muscles. It's not complicated, although it may be time-consuming.

I think your situation sounds like one big scam-o-rama, I'd get a different dentist, pronto. I was fitted with a temporary mouthguard my first visit to the dentist. It began working within days as far as relieving my "atypical face pain" goes. You've already been strung along long enough, don't wait.
posted by tommasz at 10:59 AM on August 5, 2007


Run.

Away.

Go to another dentist. Maybe go to your regular doctor and get a referral to someone who is not a quack.

Keep in mind that being intelligent and knowledgeable in a particular field does not make a doctor or dentist immune to falling for quackery.
posted by The Deej at 11:27 AM on August 5, 2007


Forget the channels or whatever, you can cope with someone thinking there's other mystical stuff going on, as long as they're also in touch with the fact that there's normal physical taught-in-school stuff that has to be taken care of.

But someone who can't work with the head dentist? Who tries to send you to his mentor, who he's had a falling out with, for expensive treatments which won't be covered by your insurance? Who generally can't seem to get his act together? Flee... flee now.
posted by anaelith at 11:47 AM on August 5, 2007


I seem to have grown out of the horrendous TMJ I had when I was in my 20s. Either that, or I just wore away all the cartilage. Either way, it rarely pops any more and it doesn't ever hurt. I didn't get any treatment for it.

To answer your actual question, this guy sounds like a grade-a wackjob. Go to another dentist.

(Chiropracty is a scam, too, not just the energy thing.)
posted by empath at 11:51 AM on August 5, 2007


I have been throught the hoops with TMJ syndrome. Standard practice of care with my insurance seems to be:
1) physical therapy (with internal and external massages and exercises to retrain the muscles)
2) bite guard (and yes they can run in the $1000s)
3) referral to a oral surgeon for possible jaw resetting.

That dentist you've seen sounds a little crazy. But, I have heard others with TMJ say they've had some success with acupuncture and other alternative methods.
posted by sulaine at 11:56 AM on August 5, 2007


I have TMJ and have had good luck with just a mouth guard. At 35, it doesn't bother me nearly as much as it did when I was 25. My dad has used one for years, and when he quits for a while, the locking and misalignment problems return for him.

A good friend of mine is currently receiving acupuncture, and reports that she believes it is very effective. I'm skeptical.

Anything involving "toxins" or "energy" is pretty much bunkum.
posted by M.C. Lo-Carb! at 1:11 PM on August 5, 2007


I've had TMJ since my 20's. It flares up occasionally and I've tried all the aforementioned methods (except for what your quack is recommending). I notice that any increase in my level of stress causes the tension and grinding to increase, so I try to take it easy. I try definitely avoid popping my jaw on purpose and avoid caffeine or anything that constricts blood vessels. I take chondrotin and avoid chewing gum like the plague.

I recently tried to quit smoking and used smokeless tobacco exclusively. This caused severe joint swelling because of the constricted blood vessels in the area (caused by the nicotine's direct contact with my mouth area). Wasn't hard to quit that because the inflamed jaw socket put pressure on my inner ear and gave me the absolute worst earache ever (think migraine in the ear). Don't know if anything will completely cure it, I just try not to chew too much or eat food that causes me too (jerkey, gum, well-done steak, etc.).

Hope you find a way to beat it, or at the very least, live well with it.
posted by HyperBlue at 1:23 PM on August 5, 2007


Your new dentist does sound like a wackjob. I would not waste any more time or money on him.

In my first year at university, I developed problems with my jaw a lot like the ones you describe. They worsened to the point that I could hardly open my mouth to eat. I went to my dentist, who sent me to a specialist. She said it was TMJ; the solution was a custom-fitted bite guard to wear at night so I would stop clenching and grinding my teeth. The bite guard worked immediately to unlock my jaw, and I have worn one at night ever since as a preventative measure.

Every so often, when my old one wears out or doesn't fit anymore, my dentist fits me for a new bite guard. The last one cost about $350 CDN, nowhere near $1000. I have to wear it every night or else my jaw starts to feel painful. Like Hyperblue, I also avoid chewing gum.

Good luck. TMJ isn't fun, but it is treatable. I'd say your current dentist doesn't sound very helpful and does sound rather strange.
posted by hurdy gurdy girl at 3:29 PM on August 5, 2007


When I was first diagnosed with TMJ (about 15 years ago), my dentist made me watch this short educational video, which mentioned that TMJ is the only dental problem that is sometimes prescribed psychiatric treatment, since it is often a result of stress. (This, for me, is true - when I'm unstressed I don't clench/grind.) So the idea of relaxing and de-stressing is totally legit.

On the other hand, your dentist sounds like a wackjob. If you don't trust him and his judgements about the wacky stuff, then you won't trust him about anything. Get ye to another dentist, postehaste.
posted by Kololo at 7:14 PM on August 5, 2007


Here's a link to Quackwatch.com's front page. The 'General Questions' section there is designed to help folks like you decide whether or not your practitioner is legitimate or a "quack." I'd specifically call your attention to 25 ways to spot a quack.

The reason I call your attention to this page is because some of the things you mentioned raise red flags to me. Those red flags suggest to me that further investigation and thought about whether or not this guy is a quack is probably warranted. However, I wasn't there and I don't know your practitioner; you're going to have to figure this out yourself. Go armed with knowledge.
posted by ikkyu2 at 8:03 PM on August 5, 2007


The TMJ is a amazingly complex joint and you really want to avoid any unnecessary treatment. Get some more opinions from other dentists. I'd actually try to get an appointment with the principal of the practice that you are currently visiting.

In my limited experience, the principal would appreciate hearing about your time with his associate. Secondly, he will already have your dental records, OPGs and some understanding of your case.

A controversial dentist will hide any radical ideas that he might have from his employer, especially if the employer is a conservative dentist. It is really hard to determine what kind of dentist someone is from an interview.

Finally, a splint is not a radical treatment. Any dentist straight out of school should properly be able to make a good one.
posted by dantodd at 10:58 PM on August 5, 2007


I did the mouthpiece for my TMJ. It was uncomfortable at first, but then I got used to it. Eventually, my TMJ went away without surgery. Yours may not, but the treatment itself isn't unusual or strange, and can be effective.

The rest of it, all the mystical stuff? Yeah, I'd go get my mouthpiece from someone else.
posted by davejay at 11:04 PM on August 5, 2007


Yes. Next question.
posted by alby at 1:36 AM on August 6, 2007


Scam. Don't go back to him. Don't feel any obligation to see this guy ever again.

I've had TMJ off and on for years, and those in the know will tell you that it's almost always caused by stress, so in that sense it's the symptom of a larger problem--whatever's causing the extraordinary stress in your life.

As for the mouthpieces: I had a dentist make one for me that cost no more that 30 or 40 dollars--I don't remember at all, actually, but if it had been 2,000 I certainly would remember that. I've even bought one of those generic mouth guards you can find in any drugstore. Not a very good fit, but you can grab a pair of scissors and cut out protruding areas. And that's all just a couple of bucks.
posted by zardoz at 4:58 AM on August 6, 2007


Scam. Not only is energy medicine a scam, vague claims of "toxins built up in the system" are a huge hallmark of BS alternative medicine. He's choosing to operate like a chiropractor instead of a real medical professional. Run.
posted by abcde at 1:06 PM on October 12, 2007


Also, even if you think you could coax some quality treatment out of him or his hokey affiliates, it's unethical to fund this kind of thing.
posted by abcde at 1:15 PM on October 12, 2007


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