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Please Read! Has my orthodontist properly corrected my lower jaw? Im experiencing bad TMJ pain!  

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p_iet
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Hi all, I would like to receive help in regards to my current orthodontic treatment. It’s a bit of a long story, but I am so desperate for help I can’t explain in words. My orthodontist would like to remove by braces in a few weeks but i do feel that there is something very wrong and would like to see if there is anyone out there that has any advice to offer me. I am experiencing extreme TMJ pain but my orthodontist practice wants to remove my braces. My teeth are straight, but I believe that my jaw alignment is not. I am really desperate for help, and I am hoping there is someone who will read this and give me advice.

To get the story started, it’s important to know that the orthodontist that i am under is a well known orthodontist in Australia and currently has a lot of studios around Sydney. He is a very knowledgeable man - however, because he owns so many orthodontic practices I basically never see him and have only met him twice. The first time I saw him was two years ago, the very first day I got my braces on and spoke about payment plans, and the second time I have ever spoken to him face to face was a few days ago at my recent appointment where he said he wants to remove my braces because ‘my teeth are straight’. All the other appointments I have had, I have always had a totally different person from the previous one, and all of them are young adults which to me seem like they are inexperienced and probably still currently studying at uni. It is extremely frustrating because they are really rude and do not bother to listen to what I have to say, no matter how many times I try to voice to them my concerns.

Now to the issue..

So when I first met him, he told me that I had a class II malocclusion, and that my front top teeth were entirely covering my bottom teeth. I was suffering greatly from TMJ jaw pain, and my jaw would always pop and it would be always sore. He said to me that my bottom jaw was small and recessed which is why I also had a receding chin. He said after my braces he would be able to greatly reduce my TMJ pain, and would be able to bring balance to my side profile. He then made me wear the MARA mouth appliance for quite a few months, and basically it was intended to advance my lower jaw and allow for my lower teeth to show. Whilst I was wearing it, my TMJ pain was gone entirely, and a lot of people were telling me that I was beginning to look better in the face and I looked refreshed and not tired. At this point in time I was really happy with how it turned out and was glad that I was finally going to have my TMJ pain go away. Then eventually the workers at my studio said it was time to remove the MARA, and then they removed it. After that appointment, my jaw dropped back into my face, and straight away I began to experience tremendous amounts of TMJ pain, worse than what I originally had. The next appointment, they then applied putty ledges to the back of my front top teeth. Basically these ledges made my front bottom teeth bite onto them, which resulted in all of my back molars having a gap. I asked the woman that put them on what was the purpose for them and she told me it was to increase the vertical length and open the bite, and eventually my back teeth will erupt and they will touch again. After this appointment, my TMJ pain had gone and I no longer had pain.

But overtime, these ledges have been wearing away due to eating etc, and it has resulted in them becoming shorter and shorter and my TMJ pain becoming gradually more prominent. Then one day a big piece on the right one had chipped away, and because of this when I bite down my whole jaw would slide to the right! I am telling you now, It was the most uncomfortable and painful thing in the world, I seriously wouldn’t wish it on my worst enemy. I had to deal with this for so many agonising months, no matter how many times I tried to explain to my orthodontist’s workers about my concern, they would not care and just say “maybe the worker at your next appointment can look at it”. It was a constant cycle of ‘wait till next appointment’. It is like they were too lazy to do anything about it.

Eventually It got to the point where I refused to get up off of the chair until they booked an appointment with my orthodontist and he had a look at my teeth. They eventually gave in, and booked an appointment and asked me to have an xray done of my teeth the day before the appointment. A few days ago I finally had an appointment with my orthodontist, and straight away he said it is time to have my braces removed and my teeth are straight. I then told him I am not sure if they are ready because my jaw slides to the right. He then decided to look in my mouth and see if he could find an issue and then he said “The ledges on the back of your front teeth are not the same size, and they are also too short. I think if we repair them it will fix your issue.” I then told him I have been trying to explain this to his workers for so long, and that I also have bad jaw pain. Then he told me that the jaw pain is probably from stress. I asked him why my back teeth are still not touching, but he told me that it is because of the putty ledges behind my teeth. He said the ledges was to stop my top teeth from biting down on the brackets on the bottom row, and once he removes them I will then be able to bite down on my back teeth. He then called in one of his workers that took me away to the operation room and they fixed up the ledges behind my teeth. My talk with him was so short, and he never properly answered all of my questions and ended up leaving in a hurry.

I currently have no TMJ pain, but i am so scared that once he removes my braces and putty ledges my whole jaw will drop back and cause really bad TMJ pain, worse than before.

Attached below are some comparison photos. The ones on the left is when the majority of the ledge was eroded away, and on the right is a recent photo I took after they repaired the ledges. As you can see, It looks like my entire jaw beforehand was sinking back and up into my face, which I think is why i am getting painful pressure in my TMJ. But what scares me is that when he decides to remove my braces and ledges, is my jaw going to drop even more and be more painful than before? Even when the majority of the ledges were eroded away, my back teeth still were not touching, which means my jaw still has potential to drop back even further.

I suspect that the problem might be because my back molars need to erupt more so then the gap between the molars close, so then when my braces and ledges are removed my jaw won't sink up and into my face as much. I decided to do some research online, and then read that the reason why im experiencing pain is because my vertical dimension is too short, and needs to be expanded to remove pressure from the jaw joints. All I can find online is that the only way to fix the issue is with either ‘orthodontic treatment, or to build up the back molars with a dental material so then it fills in that gap and removes the jaw pressure’.

I know I am no expert, but this is what I think might be the problem. I just really want help and advice on what to do. I have an appointment in a few weeks, but I am not 100% sure if it is with the orthodontist again, or with one of his annoying workers. Does anyone have any information or advice that would be helpful?

I desperately want to get rid of my pain. I am 16 years old, and about to start my year 12 HSC to get my ATAR. With the jaw pain I cannot concentrate in school, It gets so bad that I have to take pain relief to get rid of the agonising headaches. The next year is such an important year to me, and I don't want to have TMJ pain ruining my studies. This orthodontist is charging a lot more than other orthodontists in my area, but I decided to go with him because I trusted him when he told me that he would help me. My parents are making me pay for the majority of my braces, as I work multiple shifts a week to pay off the costs. It just really annoys me because I believe I am not getting proper customer service, and I feel like there is nothing I can do.

 

SIDE PROFILE PHOTOS.

PHOTO SHOWING THE GAP BETWEEN MOLARS WHEN I BITE ONTO LEDGES

 

 

This topic was modified 1 week ago 2 times by p_iet
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Posted : 11/09/2019 5:41 am
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As you undergo correction in the near future, please consider keeping records for your own sake and for others. Pictures of dental impressions, scans, medical reports reports can be very helpful even with all personally identifying information blocked out.

Your input could help many, many people

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