Should I take the risk?

[thyme4change]

I am suffering from TMJ.  I'm in pain, pretty much all the time, and when my life gets stressful, I clench my jaw, and I'm in terrible pain for a few weeks.  I've been managing it, but it seems to be getting worse, and I'm to a point where it never seems to end for me.  I do have a mouthguard, and that helps with the grinding, but it doesn't really do much to relax the muscle, or relieve the pinch on the nerve that causes the pain.  My ears have been ringing for a couple of years.

Yesterday, I was googling around, and I found a oral-facial pain management doctor (dentist??)  He is probably 35-40 minutes away (in a suburb of Phoenix.)  His website promises relief from pain by using a splint to relax the muscle, as well as other methods, including injections directly into the jaw for both muscle relaxants and steroids to rebuild the muscle.  

I went to Yelp and other sites and read reviews on him.  It sounds like it either worked for people, or it did not.  He had an average of 3.5 stars, but the reviews were either 5 stars or 1 star.  People either said he was their savior, or a scam.  A lot of the complaints dealt with rude or pushy staff, etc.  One website said 70% of his patients would recommend him to others.  So, clearly he is controversial.

I suspect his treatment would be out of pocket, since insurance doesn't seem to cover TMJ.  His website said it was between $2k and $4k.  My husband and I talked about it, and I'm thinking that my dentist was no help, and nothing else I'm doing seems to have any lasting effect, and we have the money.  So, even if it is a total waste of a few thousand dollars, at least I can say I eliminated his types of treatments as a possibility.

Should I take a risk - time and money - to see if this dude is worth it?  What would you do to be out of pain?

[Waffle]

As long as the negative reviews weren't claiming that he made people worse - I say go for it.  It sounds like the worst case would be you'd still be in pain and out a few thousand dollars, where the possibility of no pain and no ringing in the ears would definitly be worth that risk (to me anyway).

[thyme4change]

What if I spend all that money, and I'm out of pain, and I'm still a raging bitch?  Then what will I blame it on? 

[Waffle]

Poverty?

[mmhmm]

Mar 22, 2013 10:27:08 GMT -5 thyme4change said:

What if I spend all that money, and I'm out of pain, and I'm still a raging bitch?  Then what will I blame it on? 

Genetics.

[movingforward]

If I were in constant pain and had the money then I would give him a try.  Dr. Oz did something on TMJ one time and said something about biting down on a wine bottle cork to relax the muscles.  Not exactly sure as I was cleaning at the same time and not paying a great deal of attention to it.  At any rate, best of luck to you.

[Deleted]

Get a referral from your GP to a PT. (Does that make me sound educated?)

The PT will work on your muscles in your jaw and cheek and help move things back where they should go.  They will also give you exercises and stretches you can do to help relax the muscle.  It's weird having someone massage the inside of your mouth but it's covered by insurance.

[thyme4change]

I did PT for it a few years ago.  It helped a little, but not more than just getting a massage.

[thyme4change]

Dr. Oz scares me.

[Tennesseer]

Mar 22, 2013 10:27:08 GMT -5 thyme4change said:

What if I spend all that money, and I'm out of pain, and I'm still a raging bitch?  Then what will I blame it on? 

PMS?

[bean29]

Mar 22, 2013 10:15:54 GMT -5 thyme4change said:

I am suffering from TMJ.  I'm in pain, pretty much all the time, and when my life gets stressful, I clench my jaw, and I'm in terrible pain for a few weeks.  I've been managing it, but it seems to be getting worse, and I'm to a point where it never seems to end for me.  I do have a mouthguard, and that helps with the grinding, but it doesn't really do much to relax the muscle, or relieve the pinch on the nerve that causes the pain.  My ears have been ringing for a couple of years.

Yesterday, I was googling around, and I found a oral-facial pain management doctor (dentist??)  He is probably 35-40 minutes away (in a suburb of Phoenix.)  His website promises relief from pain by using a splint to relax the muscle, as well as other methods, including injections directly into the jaw for both muscle relaxants and steroids to rebuild the muscle.  

I went to Yelp and other sites and read reviews on him.  It sounds like it either worked for people, or it did not.  He had an average of 3.5 stars, but the reviews were either 5 stars or 1 star.  People either said he was their savior, or a scam.  A lot of the complaints dealt with rude or pushy staff, etc.  One website said 70% of his patients would recommend him to others.  So, clearly he is controversial.

I suspect his treatment would be out of pocket, since insurance doesn't seem to cover TMJ.  His website said it was between $2k and $4k.  My husband and I talked about it, and I'm thinking that my dentist was no help, and nothing else I'm doing seems to have any lasting effect, and we have the money.  So, even if it is a total waste of a few thousand dollars, at least I can say I eliminated his types of treatments as a possibility.

Should I take a risk - time and money - to see if this dude is worth it?  What would you do to be out of pain?

Thyme I did this and it has helped a lot.  I am horrible about using my spint but my jaw is much better.  I am starting to have some problems again so I know I need to start using it again.  My Dad has gone to my same Dr. Too, and has had success using the splint.  I also had PT massage of my jaw.  My insurance paid for the PT-- the physical thereapist told me how my doctor had to write the referral for PT to get it covered by the insurance.  The first time it was written they denied it but the Dr. re-wrote it the way she wanted it worded and they came back and said it was covered!  I will see if I can find a copy of that prescription/referral in my files.  

They expected them to pay for the full jaw x-ray too but I think they refused to pay for that.  Remember that you have a lot better income that most people.  What is worthwile for you is different than for someone who is chosing between medical treatment and beans and rice for the week.  I know you can afford this.  For you a 50% chance it will work is probably worthwhile.

My jaw was locking up and I had a constant headache.  Even though I say m TMJ is worse again, I am not back to that point. 
www.tmjtreatmentcentersofwi.com/aboutus.html

[thyme4change]

How is the splint different from a mouth guard.  Mine looks just like this, and this is what I got when I googled it.



It goes on my bottom teeth.

[justme]

Yes! I see an oral and maxillofacial Dr for my TMJ. The splint has done wonders - though it hasn't erased the pain completely. I do wear it every night, with the rare occasion of forgetting it. My splint is both top & bottom (my first was top only), hard acryllic especially made for your teeth. The Dr adjusts the way they fit together so the splints position your jaw back into the right spot - I see mine a few times a year and he looks at the splints to see if they need readjusting. Since with the splints you have two smooth, hard surfaces touching each other any grinding will slide back and forth easily (which I guess eases the tension or something) instead of hurting your teeth.

I do still have bad episodes where the pain spikes bad or my jaw almost locks, so far treated with taking naproxeen for a few weeks. My Dr has suggested a minor surgery if I want (there's a lot of increasingly more intrusive/difficult surgeries for TMJ if the previous step doesn't help the pain) where they'd flush out the joint and then inject steroids into it. I haven't decided to do it yet since the pain is managable and the surgery could not improve the pain at all, or improve it for a very short amount of time (also a risk of making it worse but the Dr I see says he's never had that happen with any of his patients).

I've been dealing with this TMJ Dr for 3 years and had another one before him for several years too. If you have any questions I'm happy to answer them, assuming I can.

Oh! My mom also has TMJ and just has the upper splint (we both got them from the same Dr before I moved) but she has also had marked improvement and still wears hers every night too.

[thyme4change]

When I read about the splint, they were critical of mouthguards, so I stopped wearing mine.  Now I'm wondering if I actually have a splint.  Hmmmm.

I found another lady who is a lot closer, but doesn't mention the injections, etc. on her website.  She has no ratings anywhere on-line, but her website says "25 years solving TMJ" - so why is no one, anywhere reviewing her?  Weird.  



She says you have to wear your splint 24 hours a day - eating in it, talking, everything.  Does that seem excessive?

[bean29]

Thyme I have a sil who also has TMJ from having an untreated broken jaw as a kid.

She has had two surgeries.  She does not recommend surgery.  She does use a splint.  My Mouthguard is the hard plastic molded thing too.  It clamps/fits onto my upper jaw but I am not sure if it is consider whole moth or jus upper.  Yeah I used to go have it adjusted regularly but I got sick of running back and forth.  It works and I am not sure how valuable the minor adjustments are.

The surgery to my understanding is the treatment that has questionable results.  The Dentists are doing less invasive treatment of the TMJ trying to move you joints back into the right spot.  I also understand that the grinding etc, caused the joint to deteriorate and it needs to build back up.  If you don't use the splint you will get arthritis in the joint and it will get worse.

Yeah, I really need to put that splint in every night.

[justme]

My TMJ Dr said during flare ups and bad days I should try wearing the splint all the time and that should help. Haven't done that yet since I can't talk with the damn thing in. My splints look quite different from yours Thyme. Was your split adjust for your mouth? Meaning they had you close your mouth with markers to see where/how your teeth hit the mouth guard and the adjusted it so they would hit in the correct position? Or was it just molded to your bottom teeth and the part that your top teeth hit is the same as when it was made?

That's how my top one looks. It has a bottom one that's just like it. There's several milimeters of the acryllic built up on the bottom so when the splits touch my teeth are quite a bit apart - I think it helps by not allowing your mouth to close all the way, you can't clench as much if your jaw is still a little open maybe? Oh, and it's not that big of a difference that I can't close my lips or anything.

[thyme4change]

Mine was adjusted for my mouth, but I haven't had it re-adjusted.  I'm 100% positive if I take it to a "specialist" they will tell me I need to get another one, and it will probably be pretty similar.  I know it will piss me off that they are going to charge me another $500 to give me something I already have.  I wonder if I will trust them after that.  

Maybe I will just try wearing my guard for 14 hours a day.  I can't talk in mine either, but I might get used to it if I tried for a week or so.  If not, I sit alone at my desk a lot.  I can wear it, and then pop it out if the phone rings.  

I also have a book with exercises, I could probably do them religiously, and see if that brings me any relief.  If I tried that for a month or two - no excuses, then at least I have a basis to start the conversation with a new doctor.

[justme]

To be honest, when I went to this guy I kind of rolled my eyes when he said the top only mouth guard wouldn't do as much as top & bottom. The guy I went to before seemed quite knowledgeable and helped me out quite a bit, so I was like yeah sure my $1k splint isn't good enough so buy TWO $1k splints instead. My current Dr mentioned that the two splints was a newer method, especially for those that grind their teeth. When I found out my insurance would cover it (I'm still dumbfounded, since they make them in-house the splints only cost me my $25 copay) I went ahead figuring it wasn't much to lose if it didn't work. The two splint system did marketly improve my pain over just one. Probably because after having the one splint for ~3 years I had started to wear groves into the splint where it was grinding against my bottom teeth.

[973beachbum]

Mar 22, 2013 10:29:38 GMT -5 movingforward said:

If I were in constant pain and had the money then I would give him a try.  Dr. Oz did something on TMJ one time and said something about biting down on a wine bottle cork to relax the muscles.  Not exactly sure as I was cleaning at the same time and not paying a great deal of attention to it.  At any rate, best of luck to you.

The thing that works for my TMJ is an ice pack.  The ice numbs the muscle and stops it from spasming, which in turn stops the pain.  Biting on something would make it worse I would think.

I will admit to having people think I am strange when they see me with a cold bottle of soda or whatever I have on hand at the time against my face, but if it stops the paid I'm fine with it.

I have known people who had the surgery.  Some did much better but it does have some serious risks if it doesn't go well.

[bean29]

Mar 22, 2013 12:02:50 GMT -5 justme said:

To be honest, when I went to this guy I kind of rolled my eyes when he said the top only mouth guard wouldn't do as much as top & bottom. The guy I went to before seemed quite knowledgeable and helped me out quite a bit, so I was like yeah sure my $1k splint isn't good enough so buy TWO $1k splints instead. My current Dr mentioned that the two splints was a newer method, especially for those that grind their teeth. When I found out my insurance would cover it (I'm still dumbfounded, since they make them in-house the splints only cost me my $25 copay) I went ahead figuring it wasn't much to lose if it didn't work. The two splint system did marketly improve my pain over just one. Probably because after having the one splint for ~3 years I had started to wear groves into the splint where it was grinding against my bottom teeth.

Wow, you got a pheonomenal deal on that.  Sadly we don't have dental insurance.  If I did I might look into a new splint.  Mine sounds more like your first one.

[thyme4change]

The surgery seems to have a dubious record.  I'm not sure I'm ready to commit to that, without it having a better shot.

[thyme4change]

The thing that works for my TMJ is an ice pack.  

I have a heating pad on my face right now, so I can't imagine that an ice pack would look any weirder.  Nor do I care.  [/span]

[973beachbum]

Mar 22, 2013 12:38:42 GMT -5 thyme4change said:

The thing that works for my TMJ is an ice pack.  

I have a heating pad on my face right now, so I can't imagine that an ice pack would look any weirder.  Nor do I care.  

[/span][/quote]
Try ice instead.  The heat can make it worse but drawing blood to the muscle.  the ice will numb it and stop the spasms.

[thyme4change]

No ice at work - I'll do that when I get home.

[justme]

Mar 22, 2013 12:37:25 GMT -5 bean29 said:

Mar 22, 2013 12:02:50 GMT -5 justme said:

To be honest, when I went to this guy I kind of rolled my eyes when he said the top only mouth guard wouldn't do as much as top & bottom. The guy I went to before seemed quite knowledgeable and helped me out quite a bit, so I was like yeah sure my $1k splint isn't good enough so buy TWO $1k splints instead. My current Dr mentioned that the two splints was a newer method, especially for those that grind their teeth. When I found out my insurance would cover it (I'm still dumbfounded, since they make them in-house the splints only cost me my $25 copay) I went ahead figuring it wasn't much to lose if it didn't work. The two splint system did marketly improve my pain over just one. Probably because after having the one splint for ~3 years I had started to wear groves into the splint where it was grinding against my bottom teeth.

Wow, you got a pheonomenal deal on that.  Sadly we don't have dental insurance.  If I did I might look into a new splint.  Mine sounds more like your first one.

I know! I plotz when I was reading through the health insurance at my new job that they covered TMJ. I think I called about 5 different times to confirm that they did cover it - the lady I talked to said more insurances were starting to cover it, but I haven't heard more people mentioning it. Even then I was expecting the splint to go towards my deductible instead of being covered by my copay.

I'm guessing since most people don't have insurance for TMJ they have you buy the balls, but my insurance only paid them about half what they billed for the splints and what they billed is what they quoted me without the insurance. It was still a lot of money, but it made me wonder since it doesn't seem like they negotiate for out of pocket patients.

[busymom]

Thyme, back when I had TMJ my splint looked like the image justme is showing.  It was made just for me, & I wore it overnight every night.  Eventually, my jaw started to relax some, & then some of my back teeth were reshaped (with a dentist drill) to allow my teeth to have a proper "resting" position.  (Apparently, when my mouth was closed, the teeth weren't lining up properly, so the muscles didn't have any "rest" time.)


Reshaping my back teeth worked, because I haven't had a problem with TMJ for years.  No surgery either, which was fine with me.    I'd at least go visit the new doctor/dentist, & get his opinion on what he would do to correct your TMJ.  Then, you can decide if his method sounds reasonable (or not).  Best of luck, because I still remember what that pain felt like.  Ugh!

[Peace77]

If you don't have ice at work, freeze a few plastic water bottles full or nearly full of water. Take them in an insulated bag if you have one.  I did this for a trip out of town one weekend.  It really helped.

note:  if you freeze a full plastic bottle of water, it will bulge at the bottom and won't stand up any more.

Yes, I would spend the money and consult the specialist.

[KaraBoo]

Thyme - I help to credential doctors in my job right now (basically, I make sure the doctors are who they say they are and can do what they say they can do).  

I would recommend to you to look for a doctor that is "Board Certified by the American Board of Oral & Maxillofacial Surgery".  If the doctor you are thinking of seeing is boarded, that's a good start!  If not, I would recommend you keep looking - even at the one that doesn't have any "on-line" reviews.  The fact that the one you are looking at has an "on-line" rating of 70% and either 5 stars or 1 star reviews would worry me.  In my line of work, "controversial" is not a good thing.

Go to this website to check out the physicians: 

www.azmd.gov/GLSPages/DoctorSearch.aspx

As a consumer, it won't tell you everything I would be able to find out if I were to do an "official" search in my line of work, but it is a start (sorry, I can't check for you...ethics and all that crap.... ).  A quick glance at the public side of the link for Maxillofacial Surgery physicians currently registered in the same county as Phoenix shows one of them has a Medical Board Action against them - that's what you want to look for and steer clear of (I won't say who, so I'm not influencing you for/against).

You should also be able to call your insurance company and ask for a referral to who they cover in this specialty.  If that doesn't work, call the hospital system near you, ask for their Medical Staff Office and ask for either a Physician Referral line or if they can give you a list of physician who are on-staff with them.  The physicians who are on-staff at a hospital have to be vetted in a certain way to meet industry standards.  

Good luck!!  I hope you get relief soon!