Oral Surgery/TMJ

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Question
I am a 60 year old female.  Three months ago, I had an MRI which confirmed that I have bone spurs, disc fragments and flattening of the condyle in the left TMJ.  The right TMJ is fine.  For the past 6 months, I have been experiencing muscle spasms, grinding, crepitus and intermittent sharp pain on the left side of my face.  I also have signifant osteoarthritis, narrowing of the neural foramin and bulging discs in my cervical spine. I don't actually have pain in temporal mandibilar joint but a lot of discomfort in the temporalis tendon and that annoying clicking and grinding when I chew or talk.  I want to avoid surgery due to the questionable results. Are there less invasive interventions that can be tried?  I have read that over time, the jaw can accommodate to arthritic changes. What are the odds that my jaw can accommodate?

Answer
Amy - It is true that there can be an accommodation of the jaw to changes within the temporomandibular joint. Many who have sustained arthritic changes has existed with these changes for many years without complications.  Unfortunately, a significant number of individuals who have similar changes do develop fucntional problems and pain. When the temporalis tendon is uncomfortable, it usually indicates an imbalance or dysfunction of the jaw, its bite or muscular imbalance.  With these possible causes, it is important to have a skilled dentist or oral and maxillofacial surgeon examine you.  The temporalis problem may be the only one that develops, but with the many functional abnormalities that develop from an altered TMJ function, it is important that you be properly examined to hopefully prevent other changes.  

For that reason a proper evaluation would be beneficial for you.  I don't know where you live, but there are many skilled doctors who could evaluate you.  If you wish, you can get back to me, let me know where you live and I could send you names of appropriate doctors.  

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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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