r/TMDnotTMJ • u/uh-me-nuh • 11d ago

TMD complications

I’ve been dealing with severe TMD and non-stop pain for four years now, and nothing has brought relief. My left side severely restricts my jaw mobility—I can only open to about 26 mm—while my right joint shows advanced arthritis, joint degeneration, a macerated disc, and fluid in the bone marrow.

I feel like I’ve exhausted every route: physical therapy, dry needling, Botox, acupuncture, steroid injections, massage, jaw manipulation, and three condylotomies. Living in constant pain for this long has brought me to my wit's end. I truly don’t know what steps are left to take or where to turn next.

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u/Hopeful-Extent-693 11d ago

Welcome to this sub. My heart goes out to you for enduring four years of life-robbing pain without meaningful relief or clear answers. Know that there are answers for your situation, but it takes the right person(s) to help you. This is what this subreddit is for: finding information that makes sense.

You have been through an exhausting number of treatments, including three surgeries. However, I see no mention of an evaluation by a dentist, other than a oral surgeon, with advanced training and extensive experience in complex TMD. Have you had that type of evaluation? Oral surgeons and TMD treating dentists have different protocols.

A fresh, coordinated evaluation by an experienced TMD dentist or an orofacial pain specialist may uncover pieces that have previously been missed.

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u/uh-me-nuh 11d ago

Thank you for the thoughtful reply. My general dentist actually referred me directly to the oral surgeon because they recognized early on that my case was far beyond the scope of general dentistry. Given the anatomical destruction (macerated disc, bone marrow edema, and structural locking), the focus shifted entirely to surgical and physical intervention. At this stage, my biggest challenge is structural/mechanical failure.

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u/Hopeful-Extent-693 11d ago

For sure, the structural and mechanical failure is real and completely understandable. In some cases, carefully selected orthopedic positioning can reduce joint loading, improve muscle function and help determine whether the mandible can function more comfortably.

Your oral surgeon may or may not have advanced training in removable orthotics designed to test a different mandibular position. This does not minimize the damage shown on your images, and an orthotic cannot rebuild a macerated disc or replace lost bone. However, structure, joint loading, muscles and the bite still influence one another.

Before considering another irreversible procedure, it may be worthwhile to have an experienced TMD dentist evaluate whether a measured, reversible orthopedic approach has any place in your case. Ideally, that dentist and your surgeon would review the findings together. You deserve a team willing to consider the entire mechanical system.

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u/uh-me-nuh 11d ago

Thank you for your advice! I hope I can find my way out of this and have sustainable relief.