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surgery for locked jaw ?

I've had jaw problems for about 10 years. I was able to deal with them until about a year ago, when I started developing intense pain that lasted for 2-3-week periods, and then started lasting longer. I saw an oral surgeon who made a splint. I initially experienced some relief, but after wearing it for about six months, I woke up nearly every morning with my loud popping in my right side. I was always able to manipulate my jaw to get the popping to stop.

I was referred to another oral surgeon. An MRI revealed displaced discs on both sides and osteoarthritis on the right side. He suggested I stop wearing the splint. That helped, but my jaw would occasionally lock temporarily while eating, and there was a lot of popping. He suggested an arthrocentesis procedure, saying that it would likely improve my situation and at the very worst, my jaw would remain the same. Well, not exactly. I came out of the procedure with a permanently locked jaw. My previous jaw opening of 56mm became about 35mm. I can't get a sub sandwich into my mouth, or anything really beyond a normal sandwich.

The most recent MRI shows "anterior subluxation of the right temperomandibular disc without reduction" and "minimal sclerosis of the right mandibular condyle (is) suspected." I have no idea what this means in layman's terms, but I know my jaw is locked. My oral surgeon said there are adhesions preventing the disc from returning to its previous position. He suggests three options: (1) he could put me under mild anesthesia and try to manipulate the disc into position (he tried unsuccessfully a few times in the office); (2) he could do a 2-hour surgery in which the disc is pulled back into place and attached to my jaw with a Mitek anchor; or (3) I could wait and gradually my jaw opening would increase but the disc ultimately would tear away, leaving me with bone on bone.

I did some research on the Mitek surgery, and the reports were not good. Some people suffered irreversible nerve damage to that side of their face. Many others found that the anchor tore away. I am reluctant to do any surgery, particularly after this supposedly minor arthrocentesis went so horribly wrong, but I also have been warned that bone on bone isn't good. This is impacting my life tremendously, so I sought a second opinion.

The new specialist said a lot of people misunderstand the discs. They aren't like a train running on a track. They can get out of place sideways, too, and in multiple angles. He says he believes there are some adhesions that are preventing my jaw from opening. He disagrees with the previous oral surgeon, who claims that if I wait too long, the disc will tear away and leave me with bone on bone. He doesn't believe a splint would help me, unless I am severely grinding or clenching, and even then it would do nothing to open my jaw. He also says that although he has done the Mitek surgery multiple times, he has yet to see permanent benefit. He's not big on it and doesn't recommend it for me. He is reluctant to do surgery because he says the joint does not like to be invaded; there is no direct blood supply to the joint.

He says he could do an arthroscopy, but that would be more to see what's there than actually repair anything. He says the downside is that you can't see behind the instrument when it's in there.

A few days ago, he injected painkiller around my jaw and asked me to manipulate it. He then injected it right into the jaw and I did the same. The largest opening I could manage was 42mm.

He said I could just live with this; many do. There might be medical developments down the road that could do wonders. I don't see an arthroscopy in my immediate future. And I DEFINITELY am not going to do the Mitek unless my condition worsens dramatically and I am in severe pain, or if I read more positive reports about it.

Your thoughts? Thanks for any help you can give. Blessings.
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replied January 8th, 2008
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let me just say that im alot like you--i had my discs replaced--not taken out they were put back with out surgery. arthrocentisis iss not very good at treating as it only deals with one joint cavity while there are 2. pm me and we can talk some ore. i dont see a need for mitek--that would probably be your last last option and i highly doubt that it will come to that.
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replied January 8th, 2008
How do I PM? I just joined this site.
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replied January 9th, 2008
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Click on her name or her picture to the left of the messages and that will bring up her profile page. Then click on the link that says "Send her a message" under the profile picture.
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replied January 9th, 2008
I realize that your normal jaw opening is pretty wide...but I was told that most surgeons consider a 35mm opening to be a successful outcome of TMJ surgery!!! In other words, if the patient comes out of surgery, and after therapy is able to open 35mm...that is a success! And just so you know, my "normal" opening is only about 40-43mm because I have a naturally small mouth. Same for my sister. Now, I know that you're in pain too, but I don't think TMJ surgeries are typically recommended just to relieve pain. I am not saying this is the case for everyone...BUT, many people seem to end up in the same amount of pain or worse after surgery! I would think long and hard before having surgery on the TMJs. Hang in there...your opening isn't all that bad...Are you currenly taking any kind of pain medication? I hope things improve, please keep us posted!
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replied January 9th, 2008
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not all end up with the same amount of pain--the whole purpose is to get rid of the pain--im 90% pain free after surgery. surgery is the last resort--when there is no where else to go. you have to do your physical therapy afterwards or its a little pointless to go through it. your muscles will just atrophy and then you have a bigger problem on your hands
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replied January 10th, 2008
MaggieMay78 wrote:
I realize that your normal jaw opening is pretty wide...but I was told that most surgeons consider a 35mm opening to be a successful outcome of TMJ surgery!!! In other words, if the patient comes out of surgery, and after therapy is able to open 35mm...that is a success!



Yes, but this wasn't really surgery. It was arthrocentesis -- termed a "minor procedure" designed to rid my jaw of the popping and temporary lockups. I was told that there was no chance that it would do anything but help or keep my jaw the same. So when you come out of it with a locked jaw and 35% reduction in jaw opening, that's not a success.

I took Voltaren for awhile, but it was disruptive on my digestive system. My mom told me about this Christian company called LifeSource. I bought their product called, "Arthritis Relief Joint Rebuilder." Each tablet has 100mg of glucosamine, along with 28 other ingredients. The company's Web site says it picks up where glucosamine and MSM leave off. It claims to be the "biggest selling arthritis relief on the market" and it claims that it "helps rebuild the joints, tissues and tendons, as well as lubrication of the joints." I've been taking them for a few months with pretty good results.
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replied July 12th, 2012
I am going on 4 weeks tomorrow that I have had partial lock jaw. It has gotten a little better but I still cannot eat any kind of sandwich or even a banana. I have to suck my food off of a fork or grab at it with my mouth because I can hardly get anything higher than the fork in my mouth. This happened from the needle hitting my nerve or my muscle and it spasmed. The pain is unbelievable to the point you feel like crying trying to eat and shaking after it is all over from the pain. The dentist wants to put me under anesthesia to finish the root canal which he was doing when this happened. I'm scared about being under knowing all the pain I feel awake, how is my mouth going to feel after waking from anesthesia when they have had my mouth opened further than it can normally now? today is Thursday and this is supposed to happen Wednesday. I am supposed to confer with the dentist again on Monday. So please can anyone help me with this decision? I am currently on oxycodone and I still have flexeril. I think I will ask the pharmacist if I can take both (not at the same time). My husband has glucosamine here, so that sounds like a good idea to take it.
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replied January 11th, 2008
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its still considered surgery
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replied June 19th, 2010
Arthroscopic jaw surgery
i have to have Arthroscopic jaw surgery is 2 weeks, what can i expect when i get out the dentist told me i would have to take steriods after for 10 days, is there much pain with this "minor" surgery
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replied June 23rd, 2010
I'm 26 and my jaw locked 3 weeks ago. Immediately after I saw the surgeon he suggested arthroscopy. I can barely open my mouth to eat a banana or ham and cheese. I'm wondering if I should consult another doctor or go on with the surgery. From all I've been reading, the outcomes are not very pleasing. Facial nerve damage?! Hearing loss?! I think I'd rather live with a locked jaw than that! I don't know what to do. Arthroscopy sounds so scary and life changing. I need advice.
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replied June 26th, 2010
my jaw locked up ten months ago on the right side. The MRI showed the disc to be infront of the jawbones, hence the lock up. My oral surgeon is suggesting surgery to remove scar tissue(arthroscopy) between the joints and to try to open up the area a little while I am under. He will also fill the area with cortisone to try to relieve the pain I am experiencing. The disc will not go back into place from this surgery. My opening now is around 30mm. Hoping for a little more. Is anyone else with this problem experiencing mind blowing migraines? Feels like my head is in a vice, especially in the morning when I awake. I know I clench and grind in the socket while sleeping. I do have a splint, but it does not help with pain, only with saving me from crushing my bottom teeth. This is my worst symptom from this problem. Taking pain meds, but realize I can't take them indefinately. Have tried every migraine medicine out there, including prescriptions. No relief. Any ideas? Should also mention I've suffered from TMJ for over 25 years as well as bruxism. Teeth are ground down and I'm sure discs are both trashed. Age 38.
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replied June 26th, 2010
If by orthosis you mean a "Tanner" splint, I did. I wore it at night for one year and in my opinion it's the reason the disc slipped, or displaced. After all I've been reading about arthroscopy I am now reconsidering whether or not to procede with the surgery. I saw a TMD specialist before the maxiollfacial surgeon and he wanted to make yet another splint which would slightly increase my opening and may or may not relieve the pain. Kind of seems like playing poker. Also, he said the splint only lasts a year or two. Rather expensive for the rest of my life. Besides surgery, not seeing any other options. Live in Ohio. Open to ideas from anyone who's gone through this...
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replied July 24th, 2012
Hi, I had Surgery about 5 years ago on my jaw(for TMJ) and part of my surgery involved moving The Disc Back into place. Let me Tell you It was Wonderful, for about 4 months(for about 1.5 months i couldn't eat solid food though, again, The disc was only part). My Disc went back to where it was, and I can only move my jaw to 1 side ( if I try to move it to my left it goes right, but i can push a little with my hand). I was going though PT this whole time, and for awhile after. But, Those 4 months, while hard on my muscles were The most pain free I had been in years. But it didn't last long. Its gotten to the point where Unless the pops are really bad, I don't even notice, but my average pops can be heard by anyone within 5 feet. Everyone is different, and if you think it will last for you, or want to at least hope for it, I say do it. But some food for thought: Most insurance companies consider surgery for TMJ cosmetic.
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replied February 21st, 2013
other options than jaw-surgery
I see that a lot of people take the surgery route, I opted to go to a neuromuscular dentist and not go through the surgery, although multiple doctor's recommended it. I've been documenting my experience with the non-surgery route and so far I've really had a 90% pain reduction without the recovery or risk. This is my story, I was hoping it might help others who are facing the same questions/fears
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