TMJ treatment in Europe ?

Hi,
I am in Switzerland, and am using a bionator to control TMJ. This is basically a night splint. It's a palliative measure rather than something that is expectde to fix this permanently, but it seems to control the symptoms.

What kind of intervention has been proposed as a permanent fix?

Arca

Hi,
Thanks for your comment. I am looking at images of bionators. I have not seen anything like that before - interesting. I wear a gelb splint during the day and an acrylic night guard which fits over my top teeth entirely and has a plane not dissimilar to the bionator on the bottom. One thing i see with the bionator photos is they all seem to close the bite - i need drop, more separation between my top and bottom, about 4 cm, because that helps keep more space between the back teeth as well and also because i don't have enough room for my tongue in my mouth - if i don't give it adequate space it partially blocks my breathing.
I wonder if you know if that kind of space is possible or is the bionator something that must keep the top and bottom teeth fairly close?

As a permanent fix I have been proposed A. mouth reconstruction - veneers, very expensive and not going to happen because i don't want to sacrifice my teeth, B. Braces, also very expensive, or C. A permanent daytime splint costing about 3,500 USD and fabricated out of titanium or high grade porcelain with a layer of gold for a comfortable bite.

I need to wear a gelb repositioning splint or the proposed permanent appliance to eat, though it's been suggested i could wean off the day splint at some point, only using it for sports and eating.

Thanks again for your insight - as i plan to move to Lyon I feel the therapy you are receiving would approximate the care i should expect in Lyon.

Would you suggest starting with a neurologist or a pain specialist? I wonder if their is a medical doctor who could deal with all of my symptoms (nerve pain, bone degeneration in TMJ, muscle overactivity, blocked breathing, sleep apnea from nerve issue caused by the TMJ...) and who could refer me to a TMJ dentist.

What kind of dentist/doctor do you see for this, in French, please? Thanks very much!!!!!

or in german or italian *blush*

been going through TMJ problems for little over 9 years now. of course little more complicated doings for myself.

first thing i would suggest is get stress free.
take notice of your posture as well. and don't stand/set doing some activity without taking breaks and streaching and/or relaxing.

ya ya i know above, tends to be repeated alot. but its one part of it all.

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as far as splints, there is a wide varity of types.
from soft to hard plastics, top and bottom, front and back splints.

there is also getting each splint adjust just right, which this alone is a pain in the rear to do. do to it normally requires a visit to the doctor that can take up to 20 minutes to a couple hours. and it could mean any were from a few visits to 20 plus or more visits trying different adjustments.

also each adjustment to a splint, it can take a couple days to a couple weeks to become re adjusted to the splint. this goes along the lines of your muscles and tendons re-adjusting to things. and dealing with muscle spazems, cramping, soreness, swelling of the muscles and tendons as they re-adjust, to the adjusted splint.

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if you grind your teeth. as i do at night. i would prolly stay away from the full U shape splints and/or splints. that allow all your teeth to touch. reason i say stay away, is that at night you will be able to put more pressure on all grinding and put more stress and wear on your mussucles and and in that your TMJ as well.

instead, if you grind teeth at night, what i use. *don't know correct term for type of splint it is*. it fits over your front 2 or 3 teeth. (top or bottom, either or) and there is a trinagle shape that your (other teeth (top/bottom) slide on.) basicly. what it does. is it seperates your teeth in the back. but as you grind. your teeth. it uses your own muscles to do bio feed back. to keep you from over grinding and using extra stength in your muscles.

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day time and grinding your teeth. i would suggest a full U shape splint. it is easier to speak with a full U shape vs the above mentioned splint that i wear at night. and it provides a bit more sturdness. when i am more likely to be in more high stress situations were i might un-concionsouly grind or simply clamp my teeth together tightly.

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as far as finding doctors and such. no clue. i am in USA. would suggest opening up the phone book. and look up "ear, nose, throught", "dentists", "teeth", etc.... and just give them a call up and ask the receptionist if they make splints. just flat out ask them. some do some do not. no way of finding out if ya don't call the local places directly.

Bogs - I've been on the TMJ road for 18 months. My posture has changed to where if you drew a line from between my feet straight up, it used to fall on my left ear. Now I am 100% vertical with a couple rotational issues in my frame that are still unwinding.

I wish I could tell the splints you are talking about. is the night one you wear an NTI?
I have been advised to stay away from this as it can lead to an open bite in front (i.e. you can no longer touch your front teeth together). If you are wearing an NTI I'd be curious to know for how long and if you have experienced this or any other side effects.

At night I clench more than grind. The nerve issues caused by the TMJ and structural problems were so extensive that I had sleep apnea from kicking my left leg. Thankfully, that's stopped, and I sleep now, for the most part.

For the day - are you talking about a gelb splint?
mine is like this except 3 wires on each side to hold it down and the top is molded for my bite - so i can eat, as my malocclusion is so bad i can't eat without a splint.

As far as Doctors it's a Neuro Muscular Dentist that i see. What's the name of the type of Doc/Dentist you see? What state are you in? If you know one way or another whether your Dentist is of the LVI school (Las Vegas Institute), I would be curious to know that too. Thanks!

Hi,

You can definitley get bionators that open the bite- my own problem is casued by a deep bite, or a class 2, so the bionator I have opens the bite so that the teeth at the back are not in contact.

I don't actually wear anything during the day, as I find the bionator pretty heavyweight and something I can only really cope with at night.

In the French-speaking world, you are problaby going to be looking for someone competent in 'orthopedie dentofaciale'. I also saw some doctors advertising themselves as specialised in 'occlusodontie', which was offered as a solution to TMJ. My own doctor works in Basle, which is not too far from Lyons.

In my case, the problems I have now are probalby caused by poor orthodontic treatment when I was younger. I'm originally from the UK, so in a way you don't really expect that much from what you get free. However, it makes me fairly sceptical about doing anything too invasive, and as i see it the bionator is a good solution.

Arc

Thanks Arc!

It's very helpful to hear the terms associated with the treatment in French. I had never heard the term occlusodontie and did a search and found a doctor supposedly working in occlusodontie in the same arrondisement where i will be living. Thanks!!!

My TMJ was also partly caused by poor orthodontia. It mystifies me how we start changing kids bites, for me at 13, when their lower jaw continues to grow into the early 20s!

Thanks again, very helpful info!!!!