Am I developing TMJD?

[pcspinheiro]

Me again,
so, after the ordeal with wisdom tooth extractions I find myself wondering if I'm not on the way to develop TMJD... ever since that lower 3rd molar was pulled (causing excruciating pain for several days) that I have constant discomfort on that side of the TMJ (it's been many months now)... Often, like today, I have this mild but annoying pain that also affects that side of the face/head. It's not like this every day but I also find it hard to open my mouth as much as I used to do effortlessly... It also constantly makes some noise when opening and closing my mouth. Could it also be because my bite is too off and I seem to clench after I got my molars extruded by elastics to open my bite? I guess my mind found it weird to bite like that and fought it by clenching... Should I go see a specialist ASAP? I'm even not going to bother mentioning it to my current ortho, and I'm probably going to be seeing a new one anyway, since she never cares about anything that I complain about... I mean, I even have brackets that are glued all wrong (like 2 mm from the tip of the tooth on one side and over 3 mm on the same tooth from the other side. It's just so obvious that the arch wire makes a different curve on that side but she says she can't see it!)

I never had any problems before, apart from the occasional cracking sound, so I'm fearing the worse...

[assertives]

My guess is that over the years of having a bad bite, your TM joint has started to wear out, hence you hear the cracking sound. (Just take a look at your xray, you can see if the joint is no longer in a nice round shape)

This was what happened to me, except that my symptoms has not include pain. My ortho said that in my case, the wearing out of the joint was due to parafunction. I have a clenching habit too, and find myself clenching more ever since I got braces. But I do it to kinda counteract the pressure I feel from the tension in the braces.

Anyway, if the pain is starting to bother you, you should definitely go see a specialist to have them access it.

[pcspinheiro]

Thanks for your reply!

Yes, the pain is starting to bother me... it's not a strong pain (yet...) but it's constantly there and also causes mild headache. I also constantly have neck pain... The thing is, I have not had any pain before I got teeth extracted (specifically that one lower third molar...). And before that I could open my mouth very wide without any problem or discomfort, just the occasional pop, but no pain. I only clench after I wore those damn intercuspidation (triangle) elastics, that extruded my molars enough so that now I can't find a comfortable resting position for my jaw/teeth. I now believe wearing those elastics is a huge mistake because they change the position where the teeth/mandible rests (and have done so for decades), now causing unconscious clenching to reach the usual resting position. Regardless of that, I only seem to have problems on the side I got the tooth extracted and wonder how much the dentist forced my jaw around to pull it out... it was quite inaccessible and growing onto the mandibular bone that rises to meet the TMJ, but I was very much anesthetized and couldn't feel a thing there and then. I also had MAJOR pain in that area after the extraction, even before the anesthesia wore off, and for several days... I think I'm going to talk to the new ortho that I'm seeing in 9 days about this, as I'm frankly unhappy with current one... for the very reason that she doesn't care about anything I say and will likely also dismiss this complaint of mine...

[pcspinheiro]

Just an update on this, for those interested; I am, unfortunately, diagnosed with TMD, the root of which is yet to be determined. The specialist I saw about this thinks that many factors could have been leading to it: possible trauma to my TMJ when extracting a lower wisdom tooth (that was EXTREMELY painful around the joint area, not the tooth extraction area) + extrusion of molars to open my bite (a bad idea according to her, since my rest position could no longer be with the teeth slightly apart, leading to constant clenching and stress on the joint) + my constant anger towards my former ortho for lying to me and leading me to extract healthy teeth when it was TOTALLY unnecessary (most second opinions I got were not very verbal against what had been done, mostly nodded in disbelief, but the last one said that extraction of such large premolars and retraction of front teeth would ruin my face) + bad posture at work (everything is connected, she says, and bad sitting posture in front of the computer will affect neck muscles and in turn jaw muscles, leading to unwanted tension)

I did see a physiotherapist specializing in these matters and his (painful...) massaging and manipulations have helped a lot (together some muscle relaxants and anti-inflammatories), so now I can again open my mouth to a somewhat normal range

There you have it, all happiness here... and all I ever wanted was to straighten my crooked upper front teeth and stop them from wearing out the lower ones... Now I have one less pretty, totally healthy tooth that I dearly miss, a lot of work to do to correct this horrible mistake (and others...) and TMD...

[pcspinheiro]

Sorry, but I did forget to mention that the TMJ specialist said there might have been some pre-existing parafunction due to overbite and retruded mandible, and all the manipulations with braces could have been the precipitating factors. She will have a better idea when she looks at all the pre-braces documentation, which I already requested at my former clinic.

[pcspinheiro]

Just another update, even though it's turned into a monologue (may serve someone, sometime): I'm getting my lower braces off to see if my bite resets and my TMD improves. The top canines hit the bottom brackets, forcing my mandible to bite and rest in a retruded position. Actually, I need to get an MRI of both TMJs so I might get the upper off too very soon. Weren't if for the ugly a** extraction gap and ugly a** smile and it would stay off! My objectives are fulfilled: my lower incisors no longer wear out against the upper ones.