Jaw Orthotic Update #3

So, this orthotic is definitely getting more complicated. I've been resting my teeth on the front of it as my jaw continues to slowly relax and slide forward. Normally my dentist said she would file it down, but because I live so far, I can't just stop by whenever I want to. So, needless to say I am kind of in an awkward state with my lower jaw hanging forward and my front teeth and orthotic touching, which isn't really a relaxed position.
I'm going to try and tough it out until my next appointment in January...but part of me feels like I should just drive down and get it adjusted...even a little bit. It's kind of a whole day affair, but might be worth just the feeling of relief.
That said...I think maybe I will call them up and see...another three weeks of this might be torturous! Still, I'm very happy with the results so far! The discomfort has really been minimal, so I can't complain. Wish me luck with my phone call! I'm going to see if I can get an appointment sooner rather than later.

Good luck to all of you going through the same or something similar! It's definitely an emotionally draining process, but it will pay off in the long run. Stay strong! You're not alone.

Orthotic Update #2

Tuesday, December 4, 2012

So I got my orthotic on Monday, November 12th, so it has almost been a month since getting it and it is a still a constant process (and improvement!!). It wasn’t until around November 26th (give or take a day) that I was completely pain free in my teeth from the orthotic. It was getting somewhat painful for my teeth. I was feeling pressure in my teeth that would travel around to different teeth pretty much every other day. I stuck with it because I was happy with how it was holding my jaw forward and relieving the pain in my joints. So I decided to just keep wearing it until my follow up appointment. I felt that over all it was helping my jaw.
At my follow up visit on November 28th, which was just last week, I went in for another hour of TENSing. This time I actually fell asleep during it! Which I would've thought could never happen! haha. Just because it's such a weird feeling. I think I was just tired enough from a long holiday weekend with family. I took a long drive down to Long Island and pretty much house hopped and didn't really get as much rest and relaxation as I was planning! Still it was a lot of fun. We got to see Newsies in the city, which is a childhood favorite of mine and the Broadway play didn't disappoint!
Anywho, back to my orthotic! So after the TENSing my doctor put a piece of paper that seemed to have some kind of ink on it and she asked me to chew on it. This left marks on the orthotic and she took it away to file it down.
The reason I had to update today, is because last night I started to notice that my jaw wanted to slide forward so that the orthotic was no longer fitting. I started getting somewhat nervous about it. The idea of having to make a whole new appliance and start all over again sent me into a mild panic.
So, I called up my doctor and she said that she had filed down the appliance to allow my jaw to slide forward. She said this was to be expected, which I was very relieved to hear. Right now I'm resting my front teeth on the "front teeth" of the orthotic. Not sure if I described the orthotic, but basically it sits on my lower teeth and adds height and then sits into my upper teeth holding my jaw a bit lower and more forward than my actual teeth, which pretty much instantly has caused relief to my muscles.

Remember how I mentioned how I had some asthetic goals in mind too? Well I'm so excited because where my jaw wants to fall now is so much better looking than even with the orthotic! YAY! I know most other people wouldn't notice this subtle difference, but for me it's just so amazing. Plus, it just relieves my muscles that much more. My next appointment isn't until January, but I might have to stop in sooner than that to have my doctor file down the front portion of the orthotic, it's just not the most comfortable place that I'm resting it on right now and it's kind of distracting when I'm sitting at my desk trying to get things done...either way I can't complain with the results I've seen in just a few weeks!!

Orthotic Update #1

Thursday, November 15, 2012

This is my fourth day with the orthotic. I picked up my orthotic at 11:00a.m. on Monday, November 12th, 2012. Since then I have been consistently wearing it with the exception of eating and drinking.
At first, I felt some discomfort in my teeth. The orthotic pushed my front teeth back a bit, which caused some soreness, but I continued to wear it because I could feel the relief in my jaw. I still have some soreness in my teeth, and there are some spots where the orthotic pinches, but overall the discomfort is bearable, so I’m going to continue to wear it until my next check up on Wednesday, November 28th, 2012.
This is what I’ve noticed: I feel as though the balance of my bite is still not evenly distributed throughout my teeth. I feel some pressure points on certain teeth in my mouth. Currently I have some pain on my lower right tooth, but I think that might be due to the nails in the orthotic that really anchor it onto my lower teeth. Not sure, but I feel like this is the reason.
The orthotic seems to be most effective at holding my jaw forward which has already reduced the soreness behind my left ear, which is usually very tender to touch. There is still soreness, I would say if it was at a 10, the soreness is now at a 5. It is incredible!
Yesterday I most noticed the relaxation and calmness in my neck and shoulders. My shoulders feel as though they are falling back comfortably. Where as before I felt I had to force my shoulders back and down, they seem to be relaxing into that position naturally, which feels really good. I feel like I want to stand up taller. I think this is again attributed to my jaw being held forward and also being able to rest on the orthotic.

TENSing Unit and finding my Perfect Bite

So when I finally made my appointment, I was very excited to get started! I have to drive about 2 hours and 40 minutes to my doctor, so they offered to take my molds, TENS, and then find my perfect bite. I had an idea of what to expect at this point, but there are few things to know that weren't entirely described.
When I got there they first took molds of my teeth. I was familiar with this, as I had done it before. It's just a a few seconds of minor discomfort as you wait for the mold to set in your teeth.
Then they will ask you to move to chair. If you have long hair that covers your face, you'll want to bring a hair tie, headband, and/or clips. They need to track the movement of your jaw so they need to stick sensors around your face and on the back of your neck. They also will stick a magnet on the front of your lower jaw. It's not painful, but the accuracy of your posture and your movement is important so try to follow directions. They also put this thing on your head that kind of looks like headgear you would wear with braces, but it's definitely not. This was taking a reading of my jaw movement. I had to sit very straight and they were very meticulous in aligning everything.
My doctor asked me to bite down on my back teeth, which I always find painful and difficult to do because I'm most comfortable holding my jaw open. Then they put small foam cushions in my mouth and asked me to bite down again. This showed how much more effective my muscles would be if I had more height separating my teeth.
After getting a base reading, I was able to sit back in the dental chair that is much more comfortable and they stuck the pads on my jaw joints and the back of my neck for the TENSing portion. The TENS unit shoots electricity into your muscles in a mostly gentle pulse. I wasn't sure what to expect with this, and it happened to be much more intense (at first) than I thought it would be. My initial reaction was, "I can't do this for 1 hour!" I was a bit scared to be left alone with the electricity shooting into my muscles every second. BUT, my doctor was very kind and she showed me how to turn it off it was too much. This helped somewhat and I laid back on the pillow they gave me.
Honestly, once I relaxed and just allowed it to do its thing it actually started to feel good. My muscles had been tense for so long that I started to enjoy it. By the end of the hour my jaw was feeling really lose and it wasn't painful. In fact, it kind of goes a bit numb. So if you're worried about this portion of the treatment, just relax, take a deep breath and hang in there. It just takes a little while to get used to.
After the hour, the TENS machine has erased what they call your "muscle memory." Basically my muscles had been straining so long that they were used to being tense and balled up. By erasing the memory of the muscles, they were now able to find the point of relaxation where my muscles could rest.
At this point they asked me to remain as relaxed as possible. They sat be back into the chair and hooked me up to the headgear and everything. I had to sit up perfectly straight and there were two dental hygienists there to help keep me even.
With my jaw hooked back up to the readings, they turned the TENS unit back on to keep my muscles relaxed and to prevent them from returning to the old position. My doctor asked me to just relax my jaw completely and only to move subtly in the direction on her command.
They then put a soft mold material and laid it on my teeth and had me move my jaw very, very slightly while my doctor watch the readings of my muscles.
The only tricky thing here is remaining completely relaxed until the mold really sets. I was able to get it right after the first try, which I guess doesn't always happen. The problem with having to do it over again is you can start to get tired, so you really want to try and listen carefully and get it done right the first time.
Well that was the end of the visit. They said they would call me in when the orthotic came in. This takes about 2 to 3 weeks.

My first Neuromuscular Dentist appointment for TMJ

So like I said in my previous post, I eventually decided to explore the Neuromuscular Dentistry path. This is not commonly talked about in various blogs unless you specifically know what you're looking for. I had to really search for more information, that was just my experience. Once you know about it, there are many compelling videos and the information really applied to me and my situation.
I eventually found a dentist who was somewhat far from me, but who I felt was experienced in this area. I also didn't want someone who would be on the surgery track, because if I didn't have to have surgery, then I really wanted someone who was going to tell it to me straight. Not someone who might have a hidden agenda. This might not be true, but I have heard that because orthodontist in some cases receive compensation for referring patients to an oral surgeon, they may be more likely to push you in that direction. This might not be everyone's opinion, but I wanted to know if the neuromuscular dentist could help me.
At my first visit I brought with me all of the diagnostic records that I had from my previous visits to the orthodontist. The neuromuscular dentist looked at them and said I could most certainly be helped. She said she has seen great progress for someone like me. Admittedly, there was no 100% guarantee, but she felt I could see an 80-90% improvement.
Knowing the risk involved with the surgery route, I felt that this was enough. If I could free myself of most of the pain, I felt it would be well worth the avoidance of the surgery.
I decided to think over my decision. I had already done a lot of research on neuromuscular dentistry and how it worked. At my next visit they would find my perfect bite and have the orthotic made. At that point I was ready to have the orthotic in my mouth, I was experiencing stress daily on my joints. Perhaps it was just the prospect of being rid of the pain that made it even more difficult to wait through, but I couldn't get started fast enough!

My Jaw Story

So, I've titled this Non-Jaw Surgery Blog, because I wanted to be a resource for those of you who might be thinking that jaw surgery is the only option. I'm not a doctor, just someone who was told that they would only experience relief through surgery. I want to share the path that I took instead, which was the non-jaw surgery path.

Granted, this isn't the right choice for everyone and I really feel for those of you who must undertake that very long and difficult process. I was preparing myself to face this not long ago. However, for those of you who might be able to take a more conservative route and just don't know it yet, (Like me) I would like to be a resource for you!

I will start with my story. At about 14 years old, I got an injury to my jaw. I was kicked in the face during an innocent martial arts class. It was an accident, but it really hurt like hell! I spent the next week or so unable to fully open my jaw and then the following months I would wake up in agony and frustration.

Eventually this subsided and it had appeared that my jaw healed, but from then on I think it was never quite the same.

Flash forward to about 18 years old. I started to develop an open bite. It wasn't painful per se, but it made it very difficult for me to bite and chew properly. I grew concerned that the issue would progress so I went to an orthodontist that was recommended by a dentist who was a family friend of ours. She took quick pictures of my jaw, and didn't really look at my bite up close. She came in and sat down and basically told me that my lower jaw was too short and that it wasn't that bad of an open bite. 

My main concern and question was whether or not this would get worse. She told me it would not. Further more she told me that the only option was braces and that even after getting braces, I would need to constantly wear something to prevent the teeth from moving again.

Feeling somewhat defeated, but accepting that I would have to simply live with this open bite situation, I began college and just learned to compensate with my other teeth.

It was sometime during my freshman year in college that I realized my jaw was slightly askewed. It was tilted downward to my right side. This caused me some distress as I thought something was terribly wrong. This wasn't something that I had ever noticed before, and I felt it was a developing problem. 

My family assured me that it was just the asymmetry of the body and I tried to accept this as well. It wasn't very noticeable from my face unless I picked my chin up, so I once again tried to ignore it.

Flash forward to just a year ago, I was about 24 years old when I decided to take matters into my own hands. It was very clear to me that something was wrong with my jaw as I had begun to experience painful TMJ for a while now. Throughout college I would be out of classes from tweaking my neck. I would have terrible muscle pain that would have me nauseous and unable to move. It would take me a week to heal. This progress to having stabbing pains in my ears. 

I thought this would just due to have some neck sprains, and just thought it was something I would have to deal with. However by the time I was 24 years old, my jaw really began to tense and become painful. The stabbing ear pain was becoming unbearable at times, and I was starting to see my jaw shift further backwards and also the cant was much more noticeable. The aesthetics was becoming a personal distress as  my face began to change. It was subtle, but my profile was different than I remembered. My jaw was beginning to become recessed. Something that only I seemed to notice, but I think when you know yourself you noticed these things much more.

Ultimately I decided that I need to revisit an orthodontist. I made my appointment and went in. What was very validating for me was that the orthodontist could see what I was seeing, but my family and friends were unable. She saw that I was in pain and that my bite, jaw, and TMJ was the problem. This was a relief, that the pain I was going through was valid and not in my head. However when the possibility of surgery came up, the fear set in. There are many things that can go wrong with surgery, not to mention the cost, the healing time, and the amount of money leading up to the surgery that would include an orthotic and braces for at least a couple years. 

I started researching and learning as much as possible about it. To be honest I kept coming up with the same conclusion, in order to move my jaw forward to its ideal spot, I would need to have it broken and reshaped. At this point I began to just face the reality of the situation. The years of orthotic to braces to recovery, how I would afford the cost of everything, having to dedicate years of my life to this was depressing plain and simple. I pretty much tried to surrender to this idea.

My family was very much against this from the beginning, but I was certain that something had to be done. I didn't want my current state of pain and discomfort to continue, and judging from the doctor's analysis, to increase and get worse. I wanted to deal with it now, but how?

After getting a CT scan, they could see how the left condyle was longer than the right, which was the cause of the tilt to my jaw. They also could see how my joints were degenerating, the tops of the condyles were pounding down and rounded, possibly from hitting into the joint for so long. It wasn't the worst she had seen, but it certainly wasn't great, and the degeneration was that of someone perhaps twice my age. 

Scared and wanting to just get the process started, I began pushing towards surgery. My family pushed back though and I'm very grateful for that. We began researching further and the term Neuromuscular Dentistry came up. Now, I want to be clear that I am completely unbiased. I do not work for a dentist and I'm not endorsing them in any way. This is simply the route I took and I was not asked to write about it or promote it for any ulterior motives.

Well I'm very glad I looked into this further. Neuromuscular Dentistry looks into how the muscles are being affected by the position of the jaw. I began to see visually in myself that it wasn't so much my jaw that had to be broken and grown, it simply needed to be shifted forward. However my current bite was preventing it from sliding forward. Wear and tear on my teeth had given me this uncomfortable bite and it was affecting my joints and muscles. 

With this conservative approach I would be able to find the ideal comfortable position of my jaw in a non-invasive, and reversible (if need be) way.

In my next post I'll explain to you what happened at my first appointment with the Neuromuscular Dentist.