My TMJ doctor wants me to have my wisdom teeth pulled in order to help realign my bite (which seems to have been caused by my MVD surgery). I'm very afraid this will bring on major ATN symptoms again. When I shared this with him he said this wasn't true and seemed frustrated with me that I didn't simply agree to what he advised. I did what my neurologist and brain surgeon advised and am not happy that I did. I'm not going to rush into something again that I'm not comfortable with. I've read so many examples on here where dental work aggravated ATN/TN. Why then does my doctor say this isn't true?
Your instincts are spot-on, Jamie. Dental work is often associated with flareups of either or both types of TN pain. Likewise, removal of your wisdom teeth might help realign your bite, but the greater issue is whether your bite even NEEDS realignment. You need a second opinion on that before you permit anybody to do major extractions.
In my opinion, your TMJ doctor needs his head examined(figuratively) with a hammer! No way did an MVD have any effect whatever on the structure of your TM joint. That's just out and out nonsense. If you choose to stay with this guy, then demand that he show you published case reports from medical literature which establish a cause-effect relationship between MVD surgery and later TMJ problems. I know this literature pretty broadly and I seriously doubt that he'll be able to show you a darned thing. TMJ disorder is one of the most over-diagnosed and ill-treated medical entities in medical practice. Some of the serious problems with such diagnoses are illustrated in a paper referenced on our Face Pain Info page:
National Institutes of Health, “Technology Assessment Conference Statement -- Management of Temporomandibular Disorders” (1996).
The following note is from the Painmed.org article:
"A 1996 NIH-sponsored Technology Assessment Conference on the Management of TMJ Disorders concluded that there was no consensus on what pain in the jaw signifies; what the condition should be called; and who should treat it. Conference members determined that it was impossible to know what treatments are effective due to the lack of clinical trials and that many people were being harmed by treatments.[ ] Today, we understand that this is a highly complex disease involving genetic and hormonal influences as well as a myriad of complex biologic factors."
I haven’t had my wisdom teeth out but my dentist tells me I need to have oral surgery to have extractions of my back teeth. I haven’t done it because of being scared it will trigger an attack and I was actually nervous about getting any dental work done on my other teeth as well. The only work I had done that bothered my TN was a crown in the back, but I am lucky to have a super dentist. He did tell me that I needed to have my bite realigned because it may be making the TN attacks worse. He admitted it certainly wasn’t the cause of it, but said it may help tremendously, but is totally understanding about my hesitation to have things done that aren’t absolutely necessary. I have encountered so many doctors that told me there wasn’t anything wrong with me at all and just use some nasal spray and tylenol, that I feel very lucky to have found doctors that are really understanding, including a dentist. They are out there and I wouldn’t continue to see any doctor that would try to pressure me into something that I didn’t feel was right or comfortable with! There are doctors and dentists out there that are very understanding, sometimes they just take some time and effort to find, but it’s totally worth it. Good luck to you!
Thank you Jennifer for your message. You encourage me to not give up hope on finding a good, caring doctor/dentist.
jennifer321 said:
I haven't had my wisdom teeth out but my dentist tells me I need to have oral surgery to have extractions of my back teeth. I haven't done it because of being scared it will trigger an attack and I was actually nervous about getting any dental work done on my other teeth as well. The only work I had done that bothered my TN was a crown in the back, but I am lucky to have a super dentist. He did tell me that I needed to have my bite realigned because it may be making the TN attacks worse. He admitted it certainly wasn't the cause of it, but said it may help tremendously, but is totally understanding about my hesitation to have things done that aren't absolutely necessary. I have encountered so many doctors that told me there wasn't anything wrong with me at all and just use some nasal spray and tylenol, that I feel very lucky to have found doctors that are really understanding, including a dentist. They are out there and I wouldn't continue to see any doctor that would try to pressure me into something that I didn't feel was right or comfortable with! There are doctors and dentists out there that are very understanding, sometimes they just take some time and effort to find, but it's totally worth it. Good luck to you!
My dentist only does the work needed to keep my teeth healthy ,I would consider changing your dentist ,the thought of having healthy teeth extracted is a bit freaky to TN people .and as for blaming the MVD ??
hey jamie. sorry to see that you are still having problems with yours. Following my MVD surgery my jaw was messed up too. I went to a prosthodontic before my MVD to make absolutely sure it wasn't a nerve in my mouth or jaw. We did a ct scan before I had the surgery. He did several checks and said it is common after surgeries. They typically put a tube in your mouth so the whole surgery your mouth and jaw is wide open. That had to have been what caused mine. He said I didnt have TMJ it is just retraining until it goes back to normal. He did some pressure measurements and gave me a couple small soft pieces of plastic to use several times a day. By just biting on it for a while over time my jaw is fine now. No problems at all. Before I even thought about having any extractions you may want to check on this.
Hi Vicki! It’s good to hear from you. How have you been feeling? I will have to bring that up to my doctor about the plastic pieces. That sounds a lot easier than what my doctor is recommending. It made sense to me also that the surgery would cause my jaw to be messed up. Who knows what went on with our bodies while we were under anesthesia!
I hate to rain on anybody's parade, but any tube placed in your mouth during MVD surgery would probably have required that your mouth be CLOSED, to operate properly as either a ventilator or saliva pump. The mouth is not deliberately held open for this type of procedure.
This may be true Red, although I do believe in order to get the tube inserted the jaw may have been opened more widely than accustomed to, and for how long or intense that was, we do not know.