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Oral Surgery/Buccal exostoses, mandibular tori & TMJ issues

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Question
I have always had issues with TMJ.I would often wake in the morning to a locked jaw that would lock if I massaged it.3 months ago, I woke to a locked jaw & managed to massage it open, but it locked again as soon as I closed my mouth. Not completely. I can open it about 1".After seeing a dentist, TMJ specialist & oral surgeon, I decided to try the oral surgeon's course of treatment which included 3 weeks of physical therapy before being fitted for a night guard.I also have what has been described as a very large mandibular tori as well as buccal exostoses above my top teeth.Since my visit to the oral surgeon (I am in week 3 of physical therapy,but I waited a month before beginning PT),the buccal exostosis has grown through my gums & it is extremely sharp & very, very painful.Is it possible that the TMJ issues are a result of swelling from the exostoses & that I should first have the exostoses removed?PT does not seem to be helping so far & I cannot handle the pain.I can actually feel the bone with my finger & a tiny piece broke off 2 days ago.I am not sure if this is under health or dental coverage, so not sure which doctor to go see.I need to know if I should have this checked out & addressed before the TMJ issues or if I should treat the TMJ first.I am very nervous & in so much discomfort and pain. Please advise. Thank you!

Answer
Hello,
The exostosis and tori is unrelated to TMJ pain. So you don't have to worry about that.  The exostosis is a very slow growing mass. If it has suddenly grown, it should be looked at by an oral surgeon soon, specially if it is painful. These may go under medical insurance. The office will let you know which insurance to send to, since every insurance policy has its own guidelines.

Good luck!

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Majid Jamali, D.M.D. Fellowship trained in corrective jaw surgery

Expertise

Diplomate, American Board of Oral & Maxillofacial Surgery Full scope Oral & Maxillofacial Surgery, Orthognathic Surgery, Genioplasty and Anesthesiology I have completed an additional two years of fellowships in orthognathic surgery and anesthesiology field.

Experience

Faculty at numerous hospitals

Organizations
AAOMS ADA ASDA NYSDS

Publications
New York Dental Society Journal

Education/Credentials
Tufts University: Dental School SUNY Down-State Medical Center: OMFS residency Robertwood Johnson Medical Center: Anesthesiology fellowship Lenox Hill hospital: Orthognathic fellowship

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