What is TMD?
TMD (Temporomandibular Joint Disorder) is a common disorder that affects almost 10 million Americans. According to WebMD: “Your temporomandibular joint is a hinge that connects your jaw to the temporal bones of your skull, which are in front of each ear. It lets you move your jaw up and down and side to side, so you can talk, chew, and yawn. Problems with your jaw and the muscles in your face that control it are known as temporomandibular disorders (TMD).”
Symptoms of TMB include: pain in jaw, difficulty chewing, headaches, facial pain, jaw clicking or popping, neck pain, or even locking of the jaw.
I have a less common form of TMD, where my jaw is actually in a “closed lock” also known as jaw displacement without reduction. This makes it so my jaw range of motion is very limited.
My TMD/TMJ Story
Ever since I can remember, my jaw popped, but it never really hurt or bothered me much.
About 2 years ago (in 2016), it started popping more frequently. My jaw would occasionally get sore, but not enough to warrant going to the doctor. Every few months, my jaw would completely “lock up” where I couldn’t open it more than a centimeter. This freaked me out, but it would always resolve on it’s own within a few hours.
In August of 2017, my jaw locked up again, but it didn’t resolve on it’s own. After about a week, I decided I should see a doctor. I went to the dentist, and all they told me was, “this is beyond me, you need to see a TMJ specialist”. I started searching for a specialist, but they all told me that they were booked out for months. Finally, I got an appointment for 2 weeks out.
My right jaw pain and migraines continued to worsen during this time, and my range of motion stayed at about 1 centimeter (Normal range of motion is 4 centimeters).
After the 2 weeks passed, I went to see the specialist, he examined me, and quickly said “your jaw is dislocated”. He was shocked that I had “waited so long” to see him, as this was time sensitive. I wasn’t aware that it was an emergency, so I just took the next available appointment.
He continued to explain that I my jaw was dislocated on the right side without reduction, which means that the condoyle can rotate, but the disc is out of place making it so it is not able to “translate down”.
This doctor scheduled a procedure for the following morning, where I would go under anesthesia while he manually reduced the jaw back into place. At the time, I didn’t realize there were other options, so I just went ahead and scheduled it.
Unfortunately, the procedure actually left my jaw opening worse, where I was only able to eat liquids and rice for a few weeks. I started physical therapy, and they weren’t able to make much progress.
I saw several TMJ specialists, and they all had different opinions, but I got the impression that surgery on the jaw should only be done for a last resort. It’s really frustrating when all the “best of the best” doctors have strongly different opinions and treatment options.
My physical therapist suggested I stop seeing him until I have some sort of surgical procedure, because he didn’t think we could make any more progress.
Unfortunately, I have several other chronic illnesses that took precedence over my jaw problem, so I put off treatment for about 6 months.
At that point I had several doctors tell me the next step was to undergo an athrocentesis, which is the lowest level of “surgical intervention” for TMJ. The recovery is quick and there isn’t much risk involved, so I decided to go with it. We knew going into it there wasn’t a guarantee it would improve my jaw, but it wouldn't make it worse.
The athrocentesis was not a success for me, but it definitely did not make my problem worse. The recovery was less than 1 week. I’ll make another post with more details on that.
My next treatment step is TMJ arthroscopy, which I will hopefully do next year, once I get some of my other conditions under control. Right now, I have mild-moderate right side jaw pain every day, but it is manageable. My opening is quite limited, but I can open just enough to fit most foods in if they are chopped up. Hopefully one day I’ll be able to eat a hamburger again :)
If your jaw is locked, please seek immediate medical help, or you may end up in a situation like me, with it still locked over a year later!
Before considering jaw surgery, all other options should be exhausted: physical therapy, splinting, massage, etc.