Hello again
I have some good news. I had my OPG/TMJ view done yesterday, and the dentist has just phoned me now to explain that he is referring me on to the oral surgeon to have an orthodic made and to discuss surgical options - or an injection that may help tighten the tendons? The joint is slightly displacing, and he believes that perhaps it is intermittently mildly dislocating - similar to my shoulders (loose ligaments I expect?).


I will pick up my referral today and hopefully I will be in with the surgeon in no time at all!

Many women carry the gene for Marfan's syndrome.

This makes tendons loose, and affects other parts of the body, most importantly the blood vessels.

Have you been evaluated for this? One really needs to know to avoid premature death from stroke, or aortic aneurysms.

A quick screening test is to measure the distance between your extended arms from the middle finger to the other arm. If this is longer than your height, then you may have the gene. But this is only a crude test and you may flub it up so, please consider discussing loose tendons with your medical doctor.

Having children while having this gene, places strain on your aorta. And males who inherit it show more physical signs. Females are often silent, but inside you may have problems you cannot see.

I already have one male child who is almost 6 and does not display any form of growth/joint problems. I certainly would not think that my extended arm would be longer than my body, as everything seems to be in proportion, and I am of average size/height - but I will query the doctor on these concerns as soon as I possibly can. I think it may be worth a visit with my orthopaedic surgeon who I first consulted about my shoulders, as she seemed rather surprised that I would have such symptoms in only those two joints at the time that I visited - without them having been injured.
The only troubles I have had with blood vessels, is last year I had 4 haematomas over my hip/thigh area (2 on each leg, exactly the same place) - and I was tested for many blood disorders at that time - all with negative results. It was recommended that I use a topical cream for this, and increase my Vitamin C intake - this seems to have worked!
I have done as much reading as possible about connective tissue disorders, and thus far, nothing fits, except for the sublaxing or dislocating joints...
Perhaps it is purely coincidence?

The gal's sister is clear.

She herself has it (but she is not tall). Her aorta dilated severely with her fourth child, but went back down after. So she was advised not to get pregnant again.

All of her children test positive but only one daughter is tall so far.
This young woman has already had ankle tendon problems and she is in her early 20's. (she is over 6ft tall).

There is a very mixed presentation for it genetically and it remains hidden for many. Anyone with loose tendons, or who are hyper-extendable should be tested just as a precaution.

Right now the gal I know is having mega problems with her knees. She is pretty thin and has no risk factors for OA...but her loose joints/tendons put her in a stress
situation and she has to wear a brace sometimes.

Sometimes a simple thing like your dental work, can be a sign pointing to
something else. I only offer this as a suggestion, so you won't be caught
unawares later.

HI HayleyJ,

Glad to hear that you have gotten the referral to the OS.

A word of caution....... before doing any injections in the ligament or TMJ area, try the orthodic appliance first. Sometimes the worse thing to do is inject into a tight ligament. Besides that, the injections are usually some type of steroid or some other toxic medication. If you can get relief without doing the injection, all the better!!

Please continue to let us know how you are doing!

Bryanna ~'.'~

I saw the oral surgeon today - I don't know that I am truly any better off though to be honest. I was not really given specific answers, but I am hoping you may be able to further explain for me?

Firstly, he explained to me that my problem is complex, and has arisen from perhaps a mixture of trauma from the wisdom tooth extraction and the clenching since that time. There is notable asymmetry in my bite.
Secondly, he began to explain that flat spots have been created on the cartilage between the joints, which creates that rough, painful and loud movement and an inability to close smoothly, without some assistance from my hands manoevering the top jaw.

He told me that the only thing he can recommend is for me to rest my jaw as much as is physically possible. He spoke of a night guard, however thought that would not really benefit me, as he thinks that I simply need to undo my behaviour by myself (i.e. clenching)
However, he did recommend that I buy Mercyndol from the pharmacy as it has both relaxation and pain relief benefits.

So, I left and then started realising that I really don't know any more than when I went in, and I still dont really have a solution - except to continue to avoid things I have already began to avoid due to my pain - and hope that it sorts itself out in time... Is it likely that it could fix itself, being that this has been coming on for around 7 months?!

Should I be basically on a fairly liquid diet? (I have made a lot of wholesom home made soups to get through this!!!) Should I seek a second opinion? Will my bite ever realign by itself? (It is to the right by a whole tooth on close, and slips further upon opening) Or, should I just do as he suggests and wait it out a while and rest as much as possible and hope for the best?!
I am rather lost!

Hi HayleyJ,

My interpretation of what you stated your oral surgeon said to you is this>>>

There was trauma to the jaw joint and the ligament during the wisdom tooth extraction. Your clenching habit is aggravating the injury. Your bite is obviously off because he can see that clinically when he checks the movements of your jaw.

However, the flat spots on the cartlidge at the joint occur from long term aggravation on the joint. I seem to recall you writing that you had a TMJ problem in the past. Is that correct? If so, then that is probably what the flat spots are from and the extraction of the wisdom tooth injured the ligament, misaligning the jaw putting more unnatural pressure on the joint.

People can live their entire lifetime with occassional TMJ popping and infrequent tightness but seldom will it cause them pain until there is trauma to the joint and/or ligament. Chronic TMJ issues will wear down the cartlidge and cause the joint and musculature to become weak. Is this your particular case, I could not tell you for sure, but it may be a possibility.

Do I think you should just wait it out?? IMO..... no. I think a bite appliance to place your jaw in a relaxed position may be helpful.... especially if this IS a long term problem which started before the extraction and if you do clench and/or grind your teeth.

Until your jaw relaxes and your bite lines up again, your diet should definitely be limited to foods that do not require alot of chewing. You should be careful not to open your mouth too widely for any reason.

The medication he prescribed mersyndol, is a very strong pain reliever (codeine) which also has an analgesic calmative to induce relaxation. It is generally used for migraine or tension headaches. It may temporarily help in your situation but I still think you would benefit from a bite appliance.

Do I think this problem will resolve on it's own? No because you have a clenching habit which is aggravating the joint and ligament. A bite appliance will allow you to clench into it without causing any harm to the TMJ. You can then find some form of relaxation therapy, like massage and/or biofeedback, to help you stop the clenching.

Those are my personal suggestions for you. I think if you don't do anything but take the meds and eat soft foods, the cartlidge will continue to wear down.

I know this is very hard to deal with and you really need a dentist to be of more help to you. Did you look at the IAOMT site for another dentist?

Keep in touch...... I hope you are feeling some relief soon!!

Bryanna

I would recommend you take an anti inflammatory and then apply warm moist heat for 20 minutes to the left TMJ area just before you do any deliberate exercises.