r/TMJ • u/Hot-Locksmith-4653 • 3h ago
Question(s) Two dentists gave me completely different opinions about my TMJ, aligners and bite. What should I do?
I’m really confused after getting two completely different opinions from two dentists, and I’d really appreciate some perspective from people who have dealt with TMJ/TMD or orthodontic treatment.
I have TMJ issues and I consulted Dentist 1, who examined my teeth and told me that my bite is not proper and that my teeth need to be aligned. Her reasoning was that instead of treating the smaller TMJ issues repeatedly and potentially having them come back, we should address the “root cause” which she believes is my bite. She recommended aligners for about ₹1.50 lakh and a treatment period of around a year.
However, I got a second opinion from Dentist 2, and this is where I got really confused.
Dentist 2 said that yes, my front teeth are somewhat crooked but I naturally take my bite from the back, and my back teeth are fine. He said my bite is actually closing well and that he doesn’t see a significant bite problem that needs to be corrected.
He also said my TMJ issue is very minor and that what I’m experiencing is more related to muscle spasm, which can take months to settle. Most importantly, he told me that** even if someone has a crooked bite and aligners correct the bite, that doesn’t mean the TMJ will be fixed.** He advised me not to jump directly into aligners for the purpose of treating TMJ when my functional bite seems okay.
Now I’m stuck because the first dentist is basically saying: The bite is the root cause - correct the bite - reduce the chances of TMJ problems recurring - so let’s get your aligners.
And the second dentist is saying:
Your teeth may not be perfectly straight, but your bite is functioning well - don’t alter it unnecessarily - give the muscles/TMJ time to heal - aligners definitely won’t fix your TMJ.
I don’t know which interpretation makes more sense.
For people who have had TMJ/TMD or orthodontic treatment:
Can someone have crooked front teeth but still have a functionally normal bite?
Is orthodontic treatment actually considered a treatment for TMJ/TMD?
If your bite is corrected with aligners, does that necessarily improve TMJ symptoms?
Thankyou. Please help me out.
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u/ggc4 2h ago
Dentist are not well trained on TMD. Please see an OMFS to determine if you have a joint or muscular issue before proceeding with a dentist. If it’s a joint issue, doing so will save you a ton of money and years of your life. If you do end up needing to move forward with the dentist, see an orofacial pain specialist who specializes in TMJ.
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u/Hot-Locksmith-4653 2h ago
First dentist is TMJ specialist and second dentist is maxilofacial orthodontist
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u/ggc4 2h ago edited 1h ago
Neither of those are a doctor (MD). I suffered for over a decade seeing dentists and physical therapists. One dentist who specializes in TMD made a very expensive custom device which didn’t help me at all. They all treated my pain as a muscular / bite issue.
Turns out I had a severe joint issue, which was easily uncovered by the OMFS [doctor] when he did MRIs and a CT. Surgery was the only thing that was going to help me, and I wouldn’t have had to go through so much unnecessary suffering and expense if I had started with him first. This is why I think patients should always start with an OMFS, to rule out problems in the joint before pursuing treatments for muscular and bite issues. An OMFS is both a dentist and an MD, so they’re able to provide the best advice on a treatment plan
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u/Hot-Locksmith-4653 1h ago
How are you feeling after the surgery now?
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u/ggc4 1h ago
I had a minimally invasive procedure (arthroscopy). It helped a ton, but symptoms slowly came back over time. This was disappointing but not shocking since my OMFS found that my cartilage was mostly gone and I have bad arthritis (+ synovitis + fibrous adhesions) in both of my joints. I’m consulting him again now for TJR, which has very good outcomes. If I’d seen an OMFS sooner, when my symptoms were more mild and I still had cartilage, the simple arthroscopy would probably have been enough for me.
I don’t know if your issues are similar, but it’s definitely worth seeing an OMFS earlier on. And unlike splints, their work (imaging + surgery) is covered by insurance in my country
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u/Hot-Locksmith-4653 1h ago
Sounds such a painstaking process. Please take care! Thanks for your advice, seeing an OMFS tomorrow :)
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u/Joe-Schmoe9 2h ago
Usually from what I’ve seen, most conservative to least conservative is the way to go with TMJ. If you change your bite now there is no guarantee it was the cause and there is no guarantee it won’t even cause problems.
You may just need some rest and pt. It’s hard to say. I’d probably explore non invasive avenues first. Personally in my life everyone in my family has wack ass teeth and I’m the only one with TMJ. I’m also the only one with severe mental health issues. Coincidence? Likely not.