Hi "ihavetmj,"
it really depends on what your tmj is doing to aggravate you and how you are responding to it. If it is occasionally popping when you open your mouth and that's it, you could ignore it. But any more than that and if there is pain involved, you might want to see your dentist or a tmj dentist. Many people can have the tmj disc out of place and be just fine, it's how it is affecting you that matters.
Yes, tmj can be so painful that people think of suicide. It's also the lack of caring by medical people, family and friends that almost kills. I know I don't have the worst case, thank heavens, as I have not lost much function or had surgery. Those are scary.
I have had tmj for 25 years. I just woke up one morning in excruciating pain and jaw locked. I was dx with tmj right away but was not treated properly, I don't believe, and permanent damage resulted. I had braces but later vetoed down surgery. I saw several different "specialists" trying to get "cured" as I had just got my master's degree in music to become a professional wind musician (bassoon) in a symphony orchestra.
After the first few years of shear h*ll, I did start getting breaks from the continuous pain because of a wonderful chiropractor and bite splint therapy. I advocate massage or physical therapists, though, over chiropractors as I don't think cracking is particularly good. Massaging inside my mouth by the chiro (and massage therapists) has been the best method. The older I have gotten the more the tmj affected my neck and shoulders so therapeutic massage is very necessary for me. I've never lost function but experience various kinds of pain that range from a level 2 to 9 (10 is dying in my book).
At one point about five years ago, I thought I was "cured" as I didn't have pain for over a year, but I now know it was because I was working a very unstressful job that I liked, on a completely liquid diet, and had just started taking an anti-depressant.
A little over two years ago, my tmj flared up nastier than ever and I have a much more difficult time coping with the pain now being older I guess. Finding pain management help has also been a nightmare. So few medical personnel take tmj very seriously. My primary doctor finally did (after many crying breakdowns) and found a neurologist who knows nothing about tmj but was willing to try and help. After many trials and errors with medications, I take prozac, small dose of buspar for night-time clenching, lyrica (a nerve pain med that I don't think really does anything) and vitamins daily, and take vicoprofen, zomig and zanaflex when needed for pain. I've been to physical therapy but just started going to a wonderful massage therapist, I wear a bottom bite splint (the most comfortable and best one i've had), use heat, ice, tens & ultrasound at home when needed, and very important - changed jobs again from a very stressful one back to the one I liked that wasn't and isn't very stressful. I also very recently had my bite balanced for the first time by my tmj dentist by filing some of my teeth. I watched him very closely, though, because this can backfire if too much filing is done. I finally feel like i'm getting this back under some control even though i'm smart enough to know it will flare up when I get under too much stress or tire the jaw muscles too much.
I have done a lot of research on tmj and related problems with all the books I can find and the wonderful internet. Healthboards or support sites are a great source of information also.
Okay, so much for boring you. When I mentioned relaxing your muscles, it's more than just muscles but trying to relax the whole jaw/face/neck area. The disc is cartilage but ligaments, bones and muscles are all important for efficient use of the jaw; similar to a knee joint but much more complicated and used more. Sometimes relaxing muscles helps, sometimes it doesn't. Zanaflex is the first muscle relaxant to help me. Others haven't touched me.
Tmj is probably one of the most misunderstood, misdiagnosed, and mistreated physical problems that exists. One treatment may work for 200 people but make it worse for another 200. Stress highly effects it and appears to be the only joint in the body that surgery has too high of a failure rate to risk it in my opinion. And sadly, the medical and dental communities are all over the board when it comes to good treatment, which usually means tmj patients have to spend more money than should be necessary to find the right treatment.
I could go on and on but this is far too long. I hope I have helped a little bit. I really do have a passion to help fellow tmj sufferers. No one should suffer with this, and go through all the bad information, doctors and dentists out there, and the lack of support that so many do sadly.
Take care of yourself and god bless...
Carol