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Dental appliance for TMJ

I've been using a dental mouthguard at night for the last few years because my dentist said I was grinding my teeth at night.  The first one broke, and the second one has a large crack in the same location.  I've also had TMJ problems, mainly in the right jaw joint, for many years.  A couple years ago these got much worse, and I had more jaw pain and migrane-like headaches.  However, I stopped chewing gum, started wearing the dental mouthguard, and I believe improved my overall joint health by taking vitamin D since I had a deficiency.  The TMJ problems have gone back to being the lesser problem that I've had for many years, with my jaw sometimes popping and getting mildly sore, but no migrane headaches and generally relatively mild jaw pain.

When I was at the dentist yesterday for my regular teeth cleaning, he had me see an associated orthodontist who recommended I get a dental appliance for treating TMJ.  He thought that it was a bad idea to wear the mouthguard with a crack in it, as it could break while I'm asleep.  He also said that the appliance he could give me would have less chance of cracking, since the mouthguard goes on my bottom teeth and the appliance would go on my top teeth (in his experience, mouthpieces on the bottom teeth crack more).  He also thought that the appliance would treat my TMJ problems more than the mouthguard.

However, I didn't get a good sense from him on exactly how the appliance works and how it differs from the mouthguard I have now.  Would I still only have to wear it at night, or would I need to wear it during the day as well for it to be effective?  Also, since my TMJ problems aren't severe right now, is it a good idea to try to treat them at all, or would that run a risk of making it worse?  Would it work just as well at keeping my teeth from being worn down from grinding at night, or is the simple mouthguard I have now better for that?  If anyone could give me any advice on whether I should go with the appliance he recommends or just stick with a mouthguard like what I've been wearing, I would really appreciate it.
5 Responses
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1035880 tn?1282034159
Hi Calathan,
I've only been using a mouth guard for 4 weeks and I hate it and it has made no difference at all. Mine is on the upper teeth, as is most people I know and I've never heard of it being on the bottom before.

I'm no expert but I guess anything is worth trying. I'm interested to know how this device works and how it differs from the mouth guards, (which do seem quite primitive really).

The dentist is right in saying that you shouldn't wear a damaged guard though.

I'm due to go back to my consultant who wants to do a procedure so I'm putting it off a while.

Let me know what you decide and if you have any luck with the device if you do decide to try it.
Helpful - 0
136956 tn?1425606272
I was told my mouth guard is what caused the damage to my jaw,, Who knows. I know I cant sleep unless I have it in.
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Avatar universal
Without personal evaluation it is not possible to give a complete or comprehensive diagnosis  and you should follow the treatment suggested by your provider. I wouldadvise that an MRI be taken to determine whether or not your discs are dislocated. Ususally this is prominent with clicking or popping in the joint. With a normal mouthguard it only helps prevent occulsal wear with a minor improvement in the TMJ. Specialized mouthpieces (orthotics) is designed to create space in the TMJ to allow the discs to normalize. It needs to be worn 24/7 for without that your muscles will not adjust to the new position it needs to allow disc normalization and you will be wasting your time.
As previously mentioned in another post TMJ symptoms get worst at a rate of 3-7% per year. I believe a lower orthotic is best because if made correctly it allows the tongue to be in a better position and open the airway and allow better sleep. Also it allows the cranial bones to not be restricted with rhymic breathing patterns as an upper orthotic would. It does not break anymore than an upper appliance.
It may help in the discontinueance of your grinding but that you must discuss with your provider. Good luck and God bless.
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Avatar universal
I did eventually get the new mouthguard, but it seems to be almost exactly the same as what I had before except that it goes on the upper teeth instead of my lower teeth.  It seemed to me like my TMJ was slightly worse for a couple weeks after I first started wearing the new mouthguard, but now it seems just like it was with the old mouthguard.  The orthodontist did suggest that it would do something more than what I had before, so I'm a little annoyed that it doesn't seem to be any different.  However, I needed a new mouthguard anyway because the old one had a crack in it, and since my TMJ still seems to not be bothering me too much, I'm fine with this mouthguard.
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Avatar universal
I know this post is old but for anyone who is interested...Everyone's different. I wore a mouthguard custom made for me by Dr. Risto Hurme in San Antonio, TX. He is exclusively devoted to treating TMJ patients.

It really helped me. I felt more refreshed in the mornings (Dr. Hurme explained that this was because my air passageway had opened up more) and I had less headaches or no headaches at all sometimes.

Now I'm looking for a permanent fix to my TMJ problems which is why I have chosen to go down the whole ALF/braces path with Dr. Dana Hodge King (also in San Antonio.)
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