Back from consult.

[Neya]

Wow. That was a long visit.

So essentially here's what I could gather. Muscular tmj, very unlikely joint degeneration. Muscles are super tight - ESP on right hand side. Clenching definite, possible grinding.

Ortho: class 1, class 2 (75% I believe?). Lower social six are too extruded an molars too intruded - hence invisalign not an option. Midlines are fine. A couple tooth slightly rotated.
Really didn't give me any info on ortho side, or even cost.

Said he wouldn't move a single tooth until I'm no longer tmj symptomatic. Recommends special imaging and splint for 3-4 months to losen then re-eval. Imaging + splint = over $3k

Gosh.

[ashesgap]

Holy cow! Thats not including anything to do with braces? That's a lot, is that normal?
Are you going to get a second opinion?

[Neya]

Holy cow! Thats not including anything to do with braces? That's a lot, is that normal?
Are you going to get a second opinion?

Yeah, not including anything to do with braces. When my muscles loosen up they would revaluate the joint for degeneration as they were too tight to tell for sure. If everythings a-ok I could then go forward with new consults and molds for braces as my bite would surely change with tmj splint. Braces eval was/is free. Tmj eval today (which was only exam) was $255.

I might do another consult, but from what I've read /heard this guy is the go- to for tmj issues (hence price?). Today was supposed to include a full ortho exam but he cut it mostly to just saying current issues and wouldn't give me any ideas on treatments, costs because things will change.

[drgnchsr36]

Will you be going forward then with this one consult? I was thinking you may want another one just to see if the opinions are the same.

Did you ask any questions? Did he state that there would be major work for braces after the TMJ was fixed?

[Neya]

I talked it over with my dad, who got the same positioner for grinding from our lifetime family dentist for $600. So we're going to ask his point of view.
I'm a bit bummed I dropped $255 for what I thought would be more than an physical exam. I thought it included Imaging and such but that's actually extra.

I may do more consults. I do think he was right about at least getting the tmj more comfortable before bracing.

He couldn't/wouldn't state at all what work may or may not be needed after except fixing the deep bite IF it was still present post tmj splint. He said my muscles might lax into a different bite position. I know long term use of splints also can cause open bite.

[lilone]

I'm suspicious that this is a price gouger. He may genuinely know his stuff, but at $225 with imaging/records not included I really wonder who his first priority is. What valuable information did he actually give for this fee today? A general dentist could tell if you clench and grind from looking at your teeth and they always have me open and close and move my jaw from side to side to check tmj at every regular check up....for free. I know it isn't as comprehensive but we're talking free vs $225, here. Refusing to talk about ortho until you have paid 3K for tmj stuff almost seems like he's holding the info for ransom. A good massage therapist could go a long way toward loosening those muscles too.

I don't know. Maybe it is worth having someone who really knows TMJ but I'm a little suspicious, personally.

[Neya]

It was actually $255 when I got there. They had told me 225 over the phone or maybe I misunderstood.
The only thing he told me that was different from what my general told me (for free) was that he thought most likely it was all muscles and not an injured joint (but then when on to say he couldn't tell for sure without imaging and when the muscles lax.

I was also thinking the same as above op.
I told the secretary I would not do months of tmj splints before braces (my insurance wot cover any of it) but she said u had to dothe tmj appt- whereas I think I could've gone in for free braces consult and he just could've said the same "I won't move a tooth until....".

[Neya]

Well my dentist said the ortho I went to knows his stuff and he likes his work a lot (and that I made a good choice). He however also stated he understands why he recommended the exact splint but it carries a much higher cost due to extensive calibration and customizing (plus expertise/special imaging machines he only has).

My old family dentist offered to check me out and see if maybe he could save me 1/3 the cost on a similar splint. He's really great with jaw joints and splints. He said he would let me know during our meeting if it was possible (if it's really just tight muscles it should not be an issue) or if I should stick with the Ortho. He's also a family friend, and has never tried to up-sell or price gouge me.
I could try it out for several months and decide then if I want to go back to the ortho and get braces to fix the bite OR wear the splint forever.

Could end up being both either way, if I get braces after splint therapy I may still have TMJ issues and need a new splint (splint could later cause open bite post braces). Im really confused. I think I'll meet with him and discuss.