Ortho Consult and Treatment Options
Hey everyone! I've been experiencing TMJ symptoms for almost a year now, but over the past 2 months they've really progressed in terms of the variety and the severity of symptoms. I've been eating only soft foods for about 6-8 weeks now, being careful about the movements I do with my jaw, and taking steps to reduce inflammation (which help a little bit) but the symptoms still managed to progress quite rapidly. I'm currently experiencing:
- Lower (right) jaw popping, cracking when I make a chewing motion. Sometimes associated with sharp pain.
- Grating when I make a chewing motion (occurs 3-4 days a week)
- Throbbing across the whole right jaw area, specifically below the cheekbone and near the masseter (not sure if muscle throbbing or wisdom tooth)
- Tinnitus & flicking sound in ear
- Bad headaches
- Facial Tension
- Inside of my ears hurt, throb and feel full
- Occasional sore front teeth
- Sinus pressure
- Muscle spasms right jaw
- Louder snap followed by crackling sound in ears which only goes away if i sleep (occurs 1-2 days a week)
- Pain and throbbing on left side has begun today
I've gotten a CT scan which showed no damage, but if it has any relevance, my dad got diagnosed with TMJD about 3 weeks ago. His symptoms are more based on facial pain, with no cracking of the jaw, however I have cracking in my jaw when I make a chewing motion.
I've been to 2 dentists and a surgeon, but none of them were sure about what could help with my symptoms. There is a lot going on with the alignment of my jaw and teeth. I have impacted wisdom teeth that need to be removed, and I also have an underbite, crossbite, crowding, and a midline deviation (which isn't always a problem but could be). The only thing that's been recommended to me in terms of treatment is orthodontic work, but as I said before, the doctors are very reluctant to say that anything will lessen my symptoms.
I had my ortho consult today and spoke about my problems and he laid out 2 plans to fix the problems. When I asked if this is likely to alleviate my symptoms, he said "it can help with the pain, but the popping's never gonna stop." My options were:
- Orthodontic camouflage: I would need to remove 2 premolars and wear braces for 18-24 months in order to fill the gaps and bring the teeth into their correct position. I'd then have to sleep with a retainer for a while, followed by a permanent retainer. I was told that this will not help the jaw misalignment.
- Orthognathic surgery: I would still need to remove 2 premolars & wear braces at some points, but this option will fix the jaw alignment, reducing the stress on the jaw & improving facial symmetry.
Where do I go from here? I'm not against having surgery, and I'm sure it's the better option of the two, but I know that it won't necessarily fix the TMJ symptoms, although it can't be good for me to allow the misalignment to continue to put stress on my face. I would like to make it clear that my first (and only) priority is the jaw function, not really cosmetics.
I'm pretty uneasy about extracting permanent teeth because I've heard about the problems that it can cause, but can I fix the crowding without removing teeth? I'm planning on contacting some specialists in my area, but the main question is, should I even consider the options that the orthodontist has given me?
Pictures of my teeth & jaw from consult (Warning: ate lunch right before photos were taken)