My jaw

I have been clenching/grinding my teeth in my sleep for well over 10 years now. I would have minor pain or clicking on the right side of my jaw every once in a while, but never thought much of it. Dentists would tell me that they could see marks on my teeth from doing it, but none of them ever had any sort of resolution. Early last year the clicking and pain got worse. I talked to my dentist about it and he suggested I get a mouth guard made to wear at night. I eventually got one and the pain and clicking got significantly better. Then, last summer the pain came back, and this time it was much worse. I went back to the dentist with my night guard. He did some adjusting and filing on it and the pain went away within days! Then, in September the pain came back again. And this time it was almost unbearable. I could barely eat, talk, yawn, etc...without being in serious pain. I went to my dentist again, thinking he could just do some more adjusting on the night guard, and it would get better again. Wrong! He said the night guard was fitting fine and he thought I had probably damaged my TMJ in some way. He referred me to a TMJ specialist.

I went to the specialist in October. He x-rayed my mouth and couldn't see anything significant, so he told me I would need an MRI to be able to fully diagnose the problem. He suspected a TMJ disc displacement. I had the MRI, went back to the specialist, and his suspicion was correct. The discs on both sides are displaced, but the right side is much worse (the right side is where I've always had the pain and clicking, never on the left). I also have limited jaw opening. A normal mouth is able to open 40-45 millimeters. Mine opens about 27-33 millimeters. The disc being out of place is what is limiting the amount I can open my mouth.

I learned that the clicking is from the disc moving in and out of place when the mouth is opened and closed. When the clicking eventually went away, I thought things were getting better. But in reality, it had gotten worse. Instead of the disc going in and out of place, it was out of place and staying that way, never popping back into place. If I hadn't gotten a night guard when I did, I would have started to wear down the joint itself and caused many more problems. This website explains it pretty well and has some good animations:

http://www.tmjarizona.com/animation/animation.php

My situation is like the last one: "Anterior Displacement Without Reduction"

My masseter muscle was also rock hard and needed to be treated as well. That is where a lot of my pain was coming from.The doctor decided to do a steroid injection into the muscle and have me go to physical therapy to work the muscle to try and loosen it up.

I had the steroid injection in early December and went to physical therapy once a week. I went back to the TMJ doctor today for a follow-up/reevaluation. The muscle is better, but the disc is still out of place and still causing a lot of pain. So...the next step is going to be SURGERY!!! I love surgery and all, but not so much when it is on ME!

He explained the procedure to me today. He will make a small incision a little bit in front of my ear to insert a scope so he can look around inside the joint to assess the amount of damage that has been done. He will then make another small incision to allow him to insert instruments to put the disc back in place and hold it in place with sutures. He said that even though the left side has never given me any pain, he would like to fix it as well. Because once the right side is fixed, the left side could start to bother me. The surgery is done as an outpatient procedure (I would go home the same day) and most people are out of commission for about 5 days. The actual healing time takes a few months. Here is a little more about the surgery: (mine would be the "Disk repositioning" surgery)

http://www.mayoclinic.org/tmj/treatment.html

The office is submitting the information to my insurance company to get authorization for surgery. That process takes 4-6 weeks! And then they would be able to schedule the surgery. This is a never-ending process! I am getting so frustrated at being in pain and just waiting and waiting and waiting. I know it will end eventually. But then it will be something else. It's always something! But I have learned that that is life.

I have many other good things in my life that I am very grateful for. I have a wonderful family, husband, and friends. We are able to to live comfortably, we own a house, and I am about to graduate from a top ranked nursing school. Physical pain is something I have learned to live with. I have frequent arm, leg, and hip pain from my car accident that happened 11 years ago tomorrow. That pain will probably never go away completely. I am still able to live a fully functional life and I am especially thankful for that. I could have very easily lost my life (or my leg) that day, but I did not. I am here for a reason. I can deal with physical pain and have learned to live with it. It's not exactly fun, but it could always be worse. I always remind myself of that...it could always be worse. I actually have it pretty good when looking at the big picture.


These are just some of the people that I love and that I know love me. There are many many more. I know there are a lot of people who don't have the love and support I do. Again, I am so very grateful for that! I have it VERY good! :)