Choosing a doctor for TMJ

Doctor or Dentist?

For many years I had severe jaw pain, my jaw was locked (at least partially) shut, and I didn’t know what to do.

A knowledgeable dentist will be able to rule out tooth decay, or any gum disease or infection that might mimic the symptoms of TMD.  My dentist actually did a lengthy exam to figure it out.  At the time I thought I had a toothache, and just wanted my tooth pulled (thank goodness he didn’t do that).  I also had migraines, but didn’t think much about them.  He made me a night guard, used for bruxism, even though I don’t clench or grind my teeth because he thought it would help.  I was also given steroids and muscle relaxers.  It took a couple of weeks and the pain got much worse before it got better, but I heard a loud snap and it went back in place…at least for awhile.

After years of problems, I was told to see an Oral Maxillofacial Surgeon.  Using my insurance, I looked up local surgeons in my area and found a man.  I made an appointment, and he did an exam.  It consisted of measuring my opening, which was around a 10-12mm.  Then he pressed on the TMJ and had me open and close.  He determined right then and there that I needed arthroscopic surgery to have my joints flushed and I would be cured.  This was music to my ears.  I set up the surgery right away, and had it done.  Within a couple weeks I recognized the surgery was ineffective.  My opening might have improved a bit but it was not anything noteworthy and I was still in pain.  He decided that the best course of action would be disc repositioning and I would probably need to stay in the hospital over night.  Once again I was told this would cure my problems, and I was very ready.  The surgery was scheduled, and I was optimistic.  The day of the surgery, the doctor explained everything to my parents and myself.  When I awoke in recovery, I was shocked and horrified to find that he had just cleaned my joints again.  He explained that sometimes the joints need to be cleaned several times before they get better.  I was disappointed and didn’t believe him.  Needless to say, the surgery didn’t work.  Looking back, both of those surgeries were unnecessary.  I heard the word cure and blindly put my faith in a man who was obviously not looking out for my best interest.

I began to do research and ask around.  My orthodontist referred me to an OMS in Miami, which is about an hour or so from my house.  This time I looked up the surgeons name on the Internet and asked around.  The reviews for this doctor were wonderful.  I made an appointment.  During my first appointment, they took pictures of my teeth, did a panoramic x-ray, measured my opening, and ordered an MRI.  This made a world of difference because I knew exactly what was going on with my jaw when he read the MRI report with me.  Not only that, but he ordered a CT, checked me for rheumatoid arthritis, and checked my hormone levels.  There might have been other tests as well, but I can’t remember. 

When choosing a TMJ/TMD specialist, start with the doctors and dentist you know and find out what they recommend and who they recommend.

Research all doctors and dentists, and see what their patients say about them.

Find out if your insurance covers the doctor/dentist.

If they do not thoroughly exam your jaw and try to find the underlying reason(s) this is occurring, it is a red flag!    Most will send you to an ENT doctor, check hormone levels, check for arthritis, and sit and discuss any trauma.

An MRI is vital to fully understanding what is happening with your joints!  If a doctor doesn’t order one, it is a red flag.

If your doctor promises to cure you, it is a red flag.

Make sure you are comfortable with your doctor or dentist.

Prepare a list of questions for your doctor/dentist. 

Are the people who work in the office friendly?  This includes secretaries, nurses, and the insurance specialist.  This may not appear to be important, but when you call the office, these are the people who will work with you.

Get a second or third opinion (or as many as you would like).

Once you find a specialist you feel comfortable with, call your dentist, orthodontist, primary care doctor, etc and ask about that person.

It is vital to remember that you are your own health care advocate.  I know many people are in pain, but often there is no quick fix and you don’t want to have unnecessary procedures done.