And So it Begins

January 4, 2018
As I previously mentioned, some big changes are in store this year. The first of which has begun. I'm embarking on what's to be expected as a two year (maybe three) journey to correct my bite and provide relief and (hopefully) repair my temporomandibular joint. About seven years now, I've had TMD symptoms, but the severity has worsened in recent years. It's become a daily burden. Back in August, my symptoms became pretty severe hindering every day activities like chewing, yawning, kissing, etc. No matter what I tried to ease the discomfort, nothing provided relief. I was referred to a TMJ Specialist. I underwent a series of exams, tests and imaging. My issues were clear from the very first panoramic xray and everything else supported the diagnoses. First, I have a Class II Division 2 Malocclusion. My overbite is so bad, my upper teeth completely cover those on the bottom. I've chipped a tooth and the one next to it has become loose. My lower jaw has receded over the years. I also have significant damage to the left TMJ joint and both joints show signs of arthritis. The left disc is displaced and the condyle which is the bone that fits into the joint has been worn flat. Normally, these are rounded. When my jaw opens and closes it shifts to the side sort of like a misaligned jewelry box. This causes pain in the joint, ear, tension in the neck and shoulders and headaches. I have bone deposits on my skull from the tension - the muscle on the right side of neck is tight like a banjo. No amount of manipulation releases it. It is literally a constant pain in the neck.

My treatment plan includes multiple appliances over the course of a year (or two) followed by another year in wire braces. Or in other words, I'm on my way to gilding yet another joint in gold. Yesterday, I received my first expansion appliance. This is a custom fit, with three sets of screws. I will turn only one for now once per week. This will push my two front teeth outward. Down the road, I'll start adjusting the other two which will expand/grow the roof of my mouth. Which is much too narrow. Once the expansion takes place, I'll transition to a twin block which will encourage forward growth of the lower jaw, and finally the braces will align everything as it should be. Correcting the bite will allow the joint to sit in the proper position which should promote healing. I'm told I should feel relief from TMD symptoms shortly because it will be under less stress.



I'm only a day in, but right now, it seems unfathomable that it will feel comfortable to have equipment in my mouth 24/7. The only saving grace is that the appliance is removable. If it were fixed, it'd be a deal breaker. I'd have countless panic attacks if that were the case. I'm only to remove the appliance for cleaning when brushing my teeth. Currently, I have an abundance of saliva. I'm told this will improve. It is difficult to swallow and a challenge to speak. I keep practicing so I'm hopeful for a quick adjustment. Eating is the most difficult task. Only my front teeth feel free so little bites are all I can handle. But, I can't really push food again the roof of my mouth. It just gets stuck around the appliance. It feels awful and it is utterly disgusting how much gets caught up in the crevices and around the screws. There will be a large learning curve.

Fortunately, sleep came easier than I expected. I thought for sure I'd drown from the amount of saliva and inability to fully clear it. But there was no gagging - so some of my troubles are more anxiety driven. Usually, I wake with a sore jaw and teeth. This morning my jaw felt more relaxed which was nice. However, I have a weird sensation in my ears. They were clicking like mad this morning, but it's improved throughout the day. My nose, upper lip have felt tingly and today I feel a lot of pressure behind my front left tooth. The tension in my neck feels higher today than usual and a headache set in last night and hasn't let up. Below you can see how differently my mouth closes in a resting position. I have sensitivity on the left lower molar that's new. Hopefully, it is only temporary.

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