| My name is Sherry. I have had TMJD for over 35 years. It all started when I was 13 years old and was in a sledding accident. I was on a sled and slammed into the side of a house, jamming my jaw and injuring my joints and jaw. I wasn't taken to a doctor (35 years ago) because my parents didn't think anything was seriously wrong. As I grew older, I noticed that it was getting harder and harder to open my mouth and that I had a loud popping sound from the sides of my face whenever I opened my mouth. I also noticed that my jaw was a little tilted on one side and my bite was very bad. By the age of 40, I went to my dentist to get my teeth cleaned and my dentist couldn't open my mouth wide enough to do the cleaning. She immediately heard the loud popping and saw the jaw and joint problems and referred me to an oral surgeon for a TMJ consultation. The first words out of my oral surgeons mouth were "You need surgery!" He had me get an MRI which showed avascular necrosis in both joints with a displaced disc in the left joint. Well, I had my first TMJ Major surgery in 1991 which was an open joint (arthroplasty) of my left TMJ to repair and replace a displaced disc. I experienced a lot of bruising (black eyes) and also a lot of scar tissue and adhesions. Within the following 6 months, my oral surgeon performed 3 office procedures (under general anesthesia) on me to help loosen up the adhesions in my joint and try to calm down the inflammation by injecting steroids into my joint. During one of these procedures, he moved my jaw around to try to break loose the scar tissue and during that procedure, he damaged the disc in my right TMJ (the other joint that I hadn't had surgery on). When I woke up from the anesthesia, I was in severe pain (sharp, stabbing pain that wouldn't go away). About six weeks later, he decided to do another office arthrocentesis (joint lavage under general anesthesia) on the right TMJ to help calm down the pain. He did three more of these office procedures on me and then six months after my first TMJ Major surgery, I had to have another TMJ Major surgery to find out what was wrong with the other joint (right TMJ). My oral surgeon did an arthroscopy on my left TMJ to clean out the scar tissue and at the same time he did an arthroscopy and an arthroplasty (open joint) on my right TMJ and found that my disc was ruptured and could not be repaired. He had to remove the ruptured disc and he replaced it with a piece of cartilage from the back of my right ear (auricular graft). He also implanted a temporary piece of Silastic sheeting between my right joint to try to prevent more scar tissue. After this surgery, I was severely bruised (two black eyes) and bruised jaws and ears. After 9 weeks, my oral surgeon surgically removed the piece of Silastic from my right TMJ and found that it had a large hole in it from the wear and tear while it was in my joint. Some of the particles from the Silastic were still inside my joint, but my oral surgeon failed to tell me that. After all this finally healed, I had to have braces put on my teeth to try to correct my bite and fix my crooked teeth. Following about 6 months of orthodontic therapy, my oral surgeon informed me that I needed orthognathic surgery (jaw surgery) on my upper and lower jaws to correct my tilted jaw which grew crooked since I was 13 years old from the sledding accident. With the braces still on, my oral surgeon, working along with my orthodontist, did a LeFort I on my upper and lower jaws and also did a chin augmentation. He also wired a plastic splint to the top of my teeth (so that I couldn't remove it) and I had to leave this piece of plastic in my mouth for about 9 weeks. It caused a lot of problems eating, made me drool all the time and nobody could understand a word that I said when I talked. I was so glad when he finally removed that splint from my upper jaw. It took about a year for me to start getting the feeling back in my face. I also lost about 50 pounds during this time because I was strickly on a liquid diet for a long time and when I finally could chew food, it had to be soft food and I got tired just chewing. After a year, I started having severe pain again in my right TMJ (I guess from all the orthodontics and the jaw surgery). My oral surgeon wanted to do another TMJ Major surgery to find out what was causing the pain so (because I was in so much pain, I allowed him to do another TMJ surgery). This surgery was an arthroplasty (open joint) on the right TMJ to clean out the joint. My oral surgeon found that I had a lot of bony anklylosis (my joint was fused together) and that is why I couldn't open my mouth and why I had so much pain. He broke loose the anklylosis and cleaned out the joint. He also placed another piece of Silastic sheeting between my joint to try to keep down the scar tissue and adhesion. This surgery was a big disappointment for me because it didn't help stop the pain and my oral surgeon was not there after the surgery to check on me. When I asked him why I didn't see him before, during or after the surgery, he got very mad at me and yelled at me saying, "You have no right to ask me that." He also said "I have a right to have an assistant surgeon do my surgery for me if I want to!" Well that did it for me and that oral surgeon. As soon as my final post-op visit with him was finished, I changed oral surgeons. I found a wonderful oral surgeon on the other side of town who was willing to take me as a patient. My new oral surgeon had me get an MRI of my TMJ's and found that I had severe avascular necrosis (bone death) in my right condyle and also in my right glenoid fossa. He had me get another MRI 6 months later which showed more avascular necrosis with thinning of the glenoid fossa. This really scared my new oral surgeon and he called me at work and told me that he needed to see me immediately. He explained to me that I needed a total joint replacement because of my right condyle having AVN and that the condyle was collapsing and breaking off because the bone was dead. He also said that because the glenoid fossa was very thin, I was in danger of having possible brain damage because the brain is directly underneath the glenoid fossa and if my glenoid fossa was to get punctured or damaged in any way, I could leak out brain fluid, etc. Well, this scared me into having the total joint replacement just so that I would have something in there to protect my brain and also something to support my condyle, since it was collapsing and breaking off. I know this sounds a little hard to understand, but my new oral surgeon explained it to me so that I could understand it perfectly. He gave me literature on the TMJ implants and also let me talk to 3 of his patients who he had put the implants in and they were all doing very well with their implants. In 1996, I had the total joint replacement in my right TMJ. This included the condylar prosthesis and the glenoid fossa eminence prosthesis. After this surgery (which went very well), I had NO bruising at all. I had minimal swelling and very little pain. I went through a lot of physical therapy and my range of motion improved to 35 mm (which is the best I've ever been). Also, my bite was now PERFECT. All of my teeth touched and I was very pleased about that. NOTE: Before the total joint replacement, I only had two teeth in my mouth that actually touched. Six months after this total joint replacement, all my pain was gone and I could eat anything I wanted to without pain. It has been 3 years now since the TMJ implant and I am still doing very well with the right TMJ and I am still pain free in that TMJ. I still have pain and arthritis in my left TMJ though and I have learned to manage that pain with conservative treatments like heat, ice, NSAID's, resting the jaw, etc. I presently wear a night guard (splint) every night when I sleep to help protect my joints and I can't sleep without it. I see my oral surgeon once a year now for a yearly checkup on my implant (since he put the implant in, he has to keep track of how it is doing). He's been a very good oral surgeon and I do not regret changing over to him. I feel that my first oral surgeon didn't know (or care) what he was doing. All he managed to do is cause more damage to my joints by doing surgery after surgery. Towards the end, he also got more of a "bad attitude" towards me and treated me like more of a nuisance than a patient. He is still out there doing TMJ surgeries on patients and I can't help but wonder if there is anybody else who has been through what he put me through. Well, this is my TMJ story up to now. I am currently seeing my oral surgeon once a year for follow-up visits and I'm managing the pain in my left TMJ (osteoarthritis and DJD) through conservative therapies only. My right TMJ (with the implant) is doing fine (so far) and I'm very pleased with it. I do find that bad weather affects the way my joints feel but I've heard that that is typical of joints that have had multiple surgeries on them. |
