Diagnosis of the problem is paramount. A really well-done MRI is critical in determining the path of treatment, and many times getting good imaging is quite difficult. So here is the first ‘delay’ in fixing the problem, getting an appointment for a well done and well-read MRI. It can take several weeks to get that appointment and quite honestly some people just do not want to wait. I can’t blame them either. Let’s get it done now!

The next delay is just getting an appointment at the office to discuss all the issues. This is where we look at the bone from the CBCT X-ray and the soft tissue from the MRI. In most cases, people want their insurance to pay at least something and that in turn creates the next delay. Next on our list is the fact that with TMJ appliances, they are custom-made. This takes time. They are not something sitting on the shelf, ready to put in the mouth. It takes weeks to make them since they are custom made for each person.

Now let’s get to the next big delay. You have to wear the devices for 12-18 months to give the discs a chance to move back into the proper position. That’s right folks, it takes that long, especially if the discs have been displaced for several years. The discs don’t just fall back into place instantly. It will take time and patience. Of course, some are not willing to devote such time (and patience) to their health, so they do not do anything. That is OK as not everyone is experiencing the same level of pain or discomfort. When it gets really bad, the patient will pursue treatment but generally now the problem is harder to fix, costs more, and takes more time. This is like most things in life.

Finally, the biggest time consumer of all – finishing after the discs are back in place. In most cases, orthodontic work is needed to grow the teeth taller to protect and support the TM joints (the jaw joints). Orthodontics can take 1 ½ -3 years, easily! So here you are, having spent all this time on appliances only to realize it’s going to take another couple of years. You are basically dedicating up to 4-5 years of your life toward fixing a TMJ problem. This is why we always tell our patients phase one is appliance therapy and phase two is finishing. Thus, the question has been answered. Now you know why TMJ treatment can take so long!

The post The Case of: “Why Does This Take So Long?” first appeared on Sleep & TMJ Therapy.

Here we are in the middle of 2022, and I have to admit that every day I am in the office I see incredible things. At this point I am so used to hearing that our patients feel better, headaches are down and they are sleeping. This has become the norm. But every now and then it just does not work that way, admittedly, around 10% of the time I cannot help that person. And sometimes that is just because they need surgery to fix the problem. The more frustrating case is when I meet a new patient and the MRI shows severe degeneration and yet they feel no pain at all!

When there is severe disc displacement and the condyles (top part of the jaws) are eroding, it would only seem logical that there would be pain. Doesn’t that make sense? What I have learned over the years is the discs have been out of place for a very long time and the condyles are eroding due to compression in the sockets.

The body has set in the process of erosion to prevent the condyle from jamming hard into the socket. Think of it this way, most of the new patients I meet really should have had their teeth raised taller when they did braces so that the condyles would not jam up into the joints so hard. Yet, most people never had orthodontic work done in that fashion. The goal was to have their teeth made straighter to look good, a cosmetic case only. And now, years later, the shortness of the teeth has caused the condyles to jam up into the sockets, thus displacing the discs out of the joints. This is what I see almost every day of the week!

The way our body works is that it will always try to protect us from harm. Just like if you get a bacterial infection, the body fights back with chemicals to kill the bacteria. Well, when our body senses the condyles are too high up in the socket and are damaging the discs, sometimes the body will begin to erode away that jammed-up condyle to avoid pain. It’s really quite simple actually- our body is trying to help us. However, this so-called ‘help’ is not what needs to be done. What we really need to do is to make the back teeth taller to open up the joint space and reduce the impact of the condyle on the socket. I hope this makes sense. It seems to work quite well in some patients, but not so much with others. This is why we are human beings, there are many variables at play here. With certain patients, i.e., those with autoimmune disorders, for example, their inflammation levels are already quite high so it is more likely they will hurt due to slipped discs and degenerating condyles. With other patients who have little to no existing inflammation, they are less likely to feel the pain of their situation.

As you can imagine, some days it is difficult to figure out why one patient is hurting and the other just simply does not! Maybe this is what makes us human beings! Please give us a call if you have any concerns about your jaw health!

The post The Case of the No Pain Patient first appeared on Sleep & TMJ Therapy.