Medical Questions > Conditions and Diseases > TMJ Forum

Dislocated disk treatment

Hello everyone - I've been reading through and getting clues here and there from other people's issues (and smiling at the kindness shown to everyone).

My main issue is that my bite is off after a dental procedure to prep for a crown in which a bite block was used and I was sort of biting hard into the block to hold it in place. This was in October 2007. A few days later, I noticed my teeth were hitting weird, with my lower front teeth hitting into the top teeth. Only my front teeth and one molar on the left are actually making contact. My dentist tried to work with me with a bruxis nightguard, in consultation with a TMJ specialist, but there was little improvement.

I'm investigating what to do from here. I've recently gotten a diagnosis of a dislocated disk on my right side. This diagnosis is from a dentist specializing in TMJ and was based on transcranial x-rays, joint vibration analysis and reflex testing.

His plan is to do a lower splint to put the joint back in place (presumably so the disk will have room to slide back?) for 3-5 months and then try to wean off it. A lower splint is to be worn at night forevermore.

He believes this treatment will realign the jaw joint (to be tracked and verified with x-rays) but cannot say how this may affect my bite and left open the possibility of me needing orthodontics or other work to then fix whatever's left of my bite problems. To me, this is a pretty big black hole of expense and not knowing what "success" will look like.

I've been reading up on all this and it seems like there may be some different schools of thought and I'm wary of choosing the wrong one.

For example, the first TMJ specialist recommended by my regular dentist proposed only an upper splint (referred to it as an "A+" splint?) and said he thought he could get my teeth to touch again in three weeks and then go about three months of regular adjustments until my bite naturally came together without the splint and I would then just wear it nightly or if my bite felt "off."

This guy didn't do any actual testing of anything and actually only looked at my mouth one time in three appointments and he contradicted himself a few times, blah, blah, blah -- I don't have a lot of confidence in him and didn't really "like" him. But, what if he's right? He talked a lot about other dentists who do stuff that leave people "splint dependent" and still needing lots of orthodontic work. Is it possible that he can actually know better what to do without ever doing any testing and hardly looking at my mouth? His diagnosis was that I had a muscle/ligament problem (but the x-rays seem pretty clear to me that the joint and disk are not in place -- is it a matter that both statements are true and treatment would be the same regardless?)

I feel like every dentist has their "thing" that they do and that's what they sell. How do I know the difference?

Also, what's up with TENS (Transcutaneous Electrical Neural Stimulation)? One specialist I researched touts this as being more effective than joint manipulation.

Anyway, I appreciate any feedback from folks who have been through their own version of sorting through this stuff.

Madeline
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replied February 3rd, 2008
Extremely eHealthy
Id agree with what you said about tens being more effective. I know it has helped me way more than arthro ever did.

Its difficult to "know the difference" you have to find a doctor that knows what he is talking about and trust him. this is difficult i know. IVe been through a million doctors it seems and have finally come up with a very good one.

Id stay away from the orthodontics unless you are goint to do this with a neuromuscular dentist. often these braces cause more trouble than they are worth.

a splint need not be worn for forever more. usually the people that end up wearing a splint all the time dont have someone that knows how to take the treatment further.

yes it is a pretty black hole of expense--esp since insurances exclude it. ive spent more money than i ever care to spend on anything.

If i were you id go with the nmd and do some roms on myself. often if you do the jaw exercises often it goes back into place by itself. Mine did.
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replied June 12th, 2010
dislocated jaw on one side
Where do you find a good nueromuscular dentist? I live in Atlanta, Georgia?
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replied June 29th, 2010
I am looking for a good NM dentist in Decatur, GA at zipcode 30033 - am willing to drive distances to get to a good NM dentist.
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