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Would like your option of condition of discs and options available to me..

Dear Dr. Kirsch,


I wanted to ask you, I got into a bad car accident, and both my discs in my jaws are displaced.  I went to a Maxillofacial surgeon here in Ontario Canada where I live. The MRI reads that the disc on the left is largely medially subluxed with a component curving posteriorly in its most medial aspect. There is the impression that there may be minimal partial recapture of the disc although it remains largely medially subluxed, and perhaps partially reduces on the open mouth series.  There is limited soft tissue detail of the disc on certain area on the left hand side..  On the right the disc is displaced anteriorly, has mild deformity and does not recapture, and does not reduce on the open mouth series. I have terrible pain on the left with limited movement and can hardly talk or chew or swallow.  There is occasional pain on the right, certainly nothing compared to what is happening on the right.   . I went to both a maxillofacial surgeon,and a neuromuscular dentist (International College of Cranio mandibular dentistry) about this situation.  I was told by the maxillofacial dentist that the discs will never be able to be repostioned, all he wants to do is go in there and do a arthroscopy, to wash out the disc and remove the scar tissue at this point.  I am concerned because I am having some type of neuralgia on the left hand side.  I know that sometimes nerves can be irritatated or inadvertantly injured with this procedure, although it happens rarely.


I will continue this as I have exceeded my word usuage amount...

seekandfind46
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373693 tn?1324485502
MEDICAL PROFESSIONAL
You should exhaust all conservative options such as appliance therapy, behavorial modification, physiotherapy and medication prior to surgery.   Give it no less than three months.

Surgery is the option of last resort.  Don't allow anyone to grind your teeth!


Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
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Avatar universal
Dear Dr. Kirsch,

Wasn't able to complete my question to you, so I will continue here...Just recently I went to a neuromuscular dentist that told me that he can  get those discs back as much as he can in a more comfortable position.  He may not be able to get the left side right back into postion but he said he might be able to help me to get rid of some of the pain.  He wants to use an "ALF APPLIANCE" on the top, he says that it helps to repostion the jaw and skull, and an adjustable splint at the bottom.   I am just feeling confused, after seeing the maxillofacial surgeon, thinking that this may lead to a discsectomy, as there is no guarentee that the appliances will work.. The dentist wants to add braces after all the splint therapy..  Here in Canada, they do not graft fat to use as a replacement disc, they will just file down the bone, and I am really afraid of going that route, its just not reversible. I would prefer to try the neuromuscular dentist's route, but I also wanting to know if its necessary to get rid of the scar tissue that the maxillofacial surgeon saw on the MRI.  I would like your expertise on my condition as I outlined from my MRI, and if I should try with the neuromuscular dentist's suggestions.  I also would like to try the arthroscopy, just to see if there is any changes, since I had that MRI done in July, and was thinking of possibly following up with the Neuromuscular dentist's appliances afterwards.   Would appreciate any feedback you can give me on this subject....

seekandfind46.
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