Medical Questions > Conditions and Diseases > TMJ Forum

Arthroscopic Surgery , Anyone Had It ?

I had a splint made and fitted for me by my orthodontist to fix my TMJ problem, which from what I can tell is a fairly bad case of TMJ. The splint is the first major thing that I have ever had for TMJ, I now realize that things I tried in the past such as a night guard, icing / heat pad and muscle relaxants (prescribed to me by my general physician) were basically doing nothing for me.

The splint is working fairly well, other than difficult talking and eating with it in (and I want to wear it 24 x 7 because this TMJ problem had been severely affecting my life in a number of ways). My orthodontist told me that the splint is the first step but that he thinks I may need arthroscopic surgery, judging by my limited jaw mobility and other factors.

I want to do whatever I can to best fix this problem, I am wondering if anyone here has had arthroscopic or any other type of surgery for TMJ and what the outcome was. I appreciated my orthodontist's opinion as he is admitting that he may not be able to solve the problem for me and out of all the doctors I have seen for TMJ he seems the best qualified to deal with it. Any input would be appreciated.
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replied June 6th, 2007
Supporter
Hi Cali-guy,
I got all worked up when I read both of your postings; this one last. Please, please check out other TMJ dentists. The fact that you still have TMJ after braces, and that a splint controls the pain, means the orthodontist did not do his job. I'm sorry to be so emphatic, but I've been thru this long enough to know something is wrong here. Braces used to be put on us kids to make our teeth look straight and perfect but now they know (or should know) that the primary function of braces is to *** balance *** the bite. This is extremely important. If our bites are not balanced and our bodies can't compensate for it, we get TMJ. Yes, other things cause TMJ but the balance part is basic.

Now if you had told me that the splint wasn't making any difference, then I would say that the "root" cause of your TMJ hasn't been found yet, but that splint is a giveaway. The splint stabilizes and balances your bite. The braces were supposed to do that.

Now that I hashed that to pieces - again, please, please do not have arthroscopic surgery or any other type of surgery. Especially at this point where your splint is helping you. Please, ***.N.O*** surgery.

I told you I got all worked up. Sorry, I don't usually come on so strong, I don't think. But to continue...

If I were you, I would look for a dentist who specializes in Functional Joint Orthotics. Again, I usually don't tell people exactly who do go to, but you are such an obvious case of needing your joint and bite balanced. I've been very impressed with the research I have done. It particularly seems to be helpful in younger people (which includes you). I don't want to take a lot of time here to explain it, so I would highly urge you to research on the net. From what I've been told, you can wear one of their splints 24/7 but the real purpose is to go thru three phases to correct the problem (almost always without surgery).

Yes, I could be all wrong, but I don't see where you would be hurt at this point if you seek another opinion, especially from a FJO dentist. Be very careful in your search for a dentist. They should focus a lot of their practice (if not all) on FJO (or TMJ). They can be found on the Internet and I'm sure California has many. If you think you want to go this route and have problems finding such a dentist, please PM me your city and I will help you search.

I will pray that you find the help you need.
God bless...
Carol
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replied June 6th, 2007
Extremely eHealthy
Hey
I kinda got worked up reading your post carol. Surgery is sometimes necessary for tmd. It is never the first thing that you do though. The orthodontist did do his job. His job was to straighten teeth which he did. One thing that orthodontists dont pay attention to is the correlation between the muscles and the bite. by straightening the teeth they mess with the harmony of muscle and bite which are supposed to work together.

The splint isnt balancing or stabilizing the bite at all. It is merely putting space between the teeth so that pressure cannot be put on the joints. however the regular orthodontic splint is based on the old philosophy--not the new. a orthodontic splint compresses the joint releiving pain for only a while. Teeth are what the bite is made of. if you take out the splint and the bite is the same =--where have you gotten?nowhere. the teeth are supposed to balance and stabilize not the splint. a splint may help to draw the jaw to a point where the teeth can balance and stabalize.
The new philosophy works---neuromuscular dentistry falls into that category. Im glad to give any info to anyone that needs it. Ill give links etc.

cali-guy---I can help you find a good doctor. I let you make the decision. A neuromuscular dentist will put you through the phases of treatment---I will not say almost always without surgery because that isnt true. I had to have surgery. However you want that to be your last option. Sometimes surgery is necessary. GO through all the options first. Physical therapy, massage therapy etc. keep in mind that all people are different and not one thing will work for all. It will be your challenge to find the thing that works for you. neuromuscular dentistsry has a 99% success rate(thanks unfortunately to me)

Arthroscopic surgery is simple. There is a small incision made in front of the ear and a small camera or arthroscope is inserted. from there they can see what is wrong and fix it. It is minimally invasive. However from the sounds of it and arthrocentesis would do the trick. this is merely having range of motion done while you are under general anesthesia. I went for that for limited opening and was a pre op 19 mm to a post op 33mm. You should get an mri done keeping in mind that an mri is only roughly about 20% accurate. It will give an idea however of what your bonestructure is like(wear etc.)

For this you may want to get the opinion of an oral-maxillofacial surgeon. More than one opinion is always good. Make sure that the doctor listens. Its no good if they wont listen or ramble on about how good they are. its usually just a self confidence speech and they arent very good. (beleive me ive been there---Ive been through everything possible with this. Have had it all my life--tried every option and have done oodles of research and have a doc behind me that wont give up on me)

pm me if you need me or you can email me at [removed]
good luck and let me know how you get on.
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replied June 6th, 2007
My orthodontist said that he does a lot of work with TMJ patients, the braces that I had did not cause my TMJ, they were from years earlier and I stopped wearing the retainer I was given after my braces because I lost it, I believe that the fact that I stopped wearing my retainer had something to do with my TMJ as well as other factors.

The splint that I am wearing is supposed to correct my bite by bringing my teeth into a position where my jaw does not click, it sounds like I am on the right track with this split, right? I am planning to go back in a week or two to have it adjusted so I can hopefully talk with it in
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replied June 6th, 2007
Supporter
Yes, cali-guy, you sound like you are on the right track with your splint. That is the problem with the Internet. We only get a short snippet of what someone is going thru, which is usually why I don't come right out and tell people, "do this." I had read your case that you were wearing a bite splint right out of braces. I did that and it was little help. But yes, it does sound correct if your ortho is trying to put your teeth back to where they belong (and the bite is balanced; orthodontist are suppose to do this).

I'm sorry dyan, but I can only condone surgery after a TMJ sufferer has spent years trying any and all other types of treatment (and of course because of a trauma injury). The reason I even found ehealthforum and other TMJ support sites was because I almost gave up about 3 years ago. I got online and starting doing all the research I could find because I wanted to finally have arthroscopic surgery. Finally a surgery to help me. 23 years of this had been enough (I did have some breaks during those years but got much worse about 5 years ago).

What I found disturbed me. I only found one person where arthroscopic surgery had helped but even scarier were the number of people who had surgeries and were worse off because of it. And even more alarming were the repeat surgical procedures, again, with no help. I was finding no one where surgery helped their pain (function, yes). I vetoed the surgery and took the information I received from support sites and got the help I needed without surgery. I praise God for that!

I do believe that neuromuscular dentistry helps TMJ patients. I've just been more impressed with FJO because it goes right to the joint and fixes what causes the muscular problems. But, I have not had FJO or gone to a neuromuscular dentist and I am pain free a good 90% of the time. What helps one person may not help another, but we still need to share what we know to help someone else make their own decision.

Cali-guy - your ortho may be able to adjust your splint so you can wear it 24/7. There are splints made to do so. The bottom splint I currently wear at night I could wear 24/7 (with a slight lisp when I get tired), I just don't want to.

Please let us know how the adjustment goes. Ask your ortho that other than arthroscopic surgery, what might be the next step? Also, research both Functional Joint Orthotics and Neuromuscular Dentistry. You must pick what's best for you.

God bless you,
Carol
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replied June 7th, 2007
Extremely eHealthy
Hey
I have had this for 23 years as well. I have been through every possible treatment and surgery is sometimes needed. Not all the info that you find on the net is true or even remotely true. I have a doc that i have approve of all i say ---hes one of the best. im not a doc myself. surgery yes is the last option but sometimes it is necessary--if you look for bad things that happen you will find that. you dont hear much of success because they dont have to be in places like this anymore. Surgery is not a bad thing. sometimes it is needed and a very good thing.
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replied June 8th, 2007
Thanks, well I'm going to try as much as possible to get an MRI done, from what I have been told there may be a way to get it covered under my insurance so this would make it possible for me to do it soon. I think that an MRI will give further information as far as what I should do next.
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replied June 8th, 2007
Extremely eHealthy
Hi
Good luck---I am praying for you. I sure hope and pray that you can get your insurance to cover it. Most insurances wont cover it at all. Ive spent way over 20k on treatments---insurance cut me off at age 12 Exclamation . If you find a way to make them pay for it let me know----Id be interested in trying it.Smile Im praying for you ----let me know if you need anything.
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replied January 6th, 2009
does anyone know if there are any new types of surgery/treatments that they are workng on?
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