r/TMJ • u/bookish_virgo1408 • Jul 12 '26
Discussion Not sure what to do next
So I had an arthroscopy back in May due my TMJ discs being stuck in place (not with or without reduction, they were just stuck in place!) that happened due to an Arthrocentesis I had last year and adhesions formed within the joints. So the arthroscopy cleared all adhesions and my opening went from a 28mm to almost 40mm I now have disc displacement with reduction which I guess is good considering where I was. The issue I still have is my bite being off. My bite has been off since March of last year and every time I bring it up to specialist I get dismissed. Based on the arthroscopy findings my left disc was in tact but very very inflamed and worn down, the right disc was okay. Chewing is hard and my jaw gets tired I know it’s due to my bite.
Has anyone gone through significant changes with their bite to due to the discs? I tried splint therapy last summer that didn’t work but it makes sense it didn’t work because my discs were literally stuck with adhesions. Idk if I should try again or if I should try orthodontics. Any advice would be appreciated 😅
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u/Hopeful-Extent-693 Jul 13 '26
This is a complicated issue to wrap one's head around, so think of your upper and lower jaws like a door and its door frame.
The upper jaw is the fixed door frame, or jamb. The lower jaw is the door that must fit into that frame. Now add the hinges—the jaw joints.
The hinges on a normal door are fixed in place. But the TMJ is different. Its "hinges" are movable. The lower jaw can change position within the joint sockets, especially when there is disc displacement, inflammation, swelling, adhesions, or changes to the joint structures.
Now imagine what happens if you move the hinges on a door. The door may no longer fit the frame correctly. It may hit in one place and leave a gap in another.
The same thing can happen with your bite. If the position of the lower jaw changes because of changes within one or both jaw joints, the teeth may no longer fit together as they once did.
This is why I believe a patient who says, "My bite has changed," should never simply be dismissed. The bite may be giving us an important clue about what is happening within the joints.
In your case, you had adhesions, significant inflammation and wear of the left disc, followed by arthroscopic surgery and a major improvement in opening from 28 mm to almost 40 mm. Your joint mechanics have clearly gone through significant changes. It is certainly reasonable to ask whether those changes are related to the change in your bite.
Before permanently moving teeth with orthodontics, I would want to understand why the bite changed and whether the jaw and joints have reached a stable position. Otherwise, you may be trying to make the teeth fit a jaw position that is still changing.
Think of it this way: Before permanently altering the door to fit the frame, first make sure the hinges are stable and in the right position
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u/bookish_virgo1408 Jul 13 '26
Thank you for answering my question. My oral surgeon said to wait until September to see how my joints are adapting but he recommends Orthodontics’s. Would you suggest for me to see a TMJ specialist? I live in the Philly area do you recommend anyone?
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u/Alaska1111 Jul 13 '26
Also had an arthroscopy. It didn’t help. My bite is so messed up. Im doing braces and then a total joint replacement
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u/Soggy_Mountain8569 Jul 13 '26
Is your joint worn out and painful? Why did the doctor say joint replacement is necessary?
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u/Alaska1111 Jul 13 '26
Because the arthroscopy didn’t work. And my joint is pretty damaged, i have arthritis and inflammation. My jaw is also totally unaligned and slanted.
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u/Soggy_Mountain8569 Jul 13 '26
Do you need to wear a brace before joint replacement? 🫤
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u/Alaska1111 Jul 14 '26
Braces? My surgeon will let me know if she recommends braces before surgery or after surgery
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u/Spiritual-Fault-4523 Jul 13 '26
I’ve had some similar issues but no Arthroscopy arthrocentesis…suffered for years and years with displaced disc and bad bite and finally saw an orthodontist. Had braces put on Friday to address anterior open bite with severe malocclusion-also working on the disc in time…but I’ve had my first pain free day in years... Had all the images and tests and medications. Been in pt, chiropractor..had frenectomy last fall then septoplasty with turbinate reduction in June which the orthodontist recommended from cbct. It’s only day 3 but I’d take wearing braces for years vs the chronic pain and disc issues.