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Oral Surgery/TMJ - Burning sensation

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QUESTION: I have had TMJ since a kid on both the left and right side, but worse on the left side.  Now, at age 44, my jaw on the left side wouldn't open all the way and I had arthroscopic type surgery on the left side about 2 months ago and have been wearing a splint at night.  My jaw has felt very tight since that surgery and makes a crackling sound on my left side as I open and close it.  I can open it though.  Neither side was popping after the procedure (but the crackling sound on the left side has been there ever since the procedure).  The doctor said the crackling is from scar tissue.  (really?)

A few days ago, I yawned and my RIGHT side popped and ever since then I have an intense burning feeling on the right side TMJ joint.  I feel like I must have torn something on the right side, or possibly damaged a nerve.

Could it be nerve damage or could I have ripped a ligament or muscle?  I'm in constant pain.

Thank you very much.
Christine

ANSWER: Christine - you might have sustained an injured nerve, but most likely there is damage to the cartilage in the right joint.  The cracking sound on the left side is not normal after the arthroscopic surgery.  Most likely there is now tissue displaced and trapped that is not allowing the left joint to work properly.  The problem on the left has now put additional stress on the right side causing your burning.  

My suggestion is that you seek a second opinion from a different board certified oral and maxillofacial surgeon.  The surgeon should initially arrange for an MRI of the joints to fully disclose the internal derangements in the joints that are causing the burning on the right and the crackling on the left.

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QUESTION: Thank you very much. I will do what you've recommend.

If it is a damaged nerve, will that show on the MRI?  Can nerve damage be healed?

Do you know any board certified maxio/oral surgeons in Florida that you would recommend?

Thank you again,
Christine

ANSWER: Christine - A traumatized nerve will not show on MRI, but if there is damage to it, there is a chance.  Moreso, the MRI will better define the overall cause of the problem.

As far as surgeons in Florida, get back to me, let me know where in Florida you live and I will try to find appropriate surgeons near you.

---------- FOLLOW-UP ----------

QUESTION: Thanks Dr. Teig.  I'm in the West Palm Beach area, but willing to travel, if necessary.

I wanted to ask you - if there is damage to the nerve, do nerves heal?  I'm worried about having this pain forever.

If it is damage to the cartlidge, muscle, or ligaments, what is the typical healing process for that?

Have a great weekend.

Thanks,
Christine

Answer
Christine -  I need to be honest with you and let you know that I am not familiar with any of the listed doctors in your area, but they have been written up for their TMJ evaluations and treatment.

1) Palm Beach Oral and Maxillofacial Surgery Associates - (561) 833-6880

2) Oral and Facial Surgery -  (561) 439-6600

3) Wellington Center for Oral and Maxillofacial Surgery - (561) 790-0206

I wish you well and hope the above doctors can help you.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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