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TMJ, OSA dental appliances, and chin straps: watch out!


Posted by Mile High AirMan on October 14, 1999 at 19:57:27:

In Reply to: Re: Possible causes of headaches posted by kim on October 14, 1999 at 17:58:33:

Basically, the cartlidge discs in my TMJ are completely gone, but I'm really fortunate that it only causes me minor trouble since I was treated. I suspect my TMJ woes started as a teen when I had orthodontia that used rubber bands to force my lower jaw towards my neck. When I was about 40, poping and locking of the TMJ forced me to seek treatment that involved using a smooth "splint" to cover my lower teeth. This prevented my upper and lower teeth engaging, causing the lower jaw to move forward on its own back into its "natural" position. When this happened it was extremely painful for a couple of days until the muscles got used to the new position. I then had to have a removalbe orthotic made to wear at all times over my lower teeth so my teeth would engage properly. Without the orthotic, my front teeth would line up without any over or under bite, and there would be a 3/16 inch gap between my upper and lower molars. Attempting to chew without it (which I don't do) makes me feel like how Bugs Bunny does when he munches on a carrot.

Because of my sensitivity to TMJ issues, I have an EXTREMELY dim view of ANY OSA treatment that involves a dental appliance that stresses the TMJ, which I believe most will do to one degree or another. I think that the ones that force the lower jaw forward will ultimately prove to be deadly to the TMJ. Also, personally, I would discourage anyone from EVER having surgery on the TMJ unless it was life or death. Overall, my conclusion about TMJ surgery is that it essentially is a very poorly understood field, much like the surgeries for OSA, though the consequences to quality of life for a botched TMJ surgery are much more serious than the effects of a bit of carving on the soft palate.

Back to CPAP issues, aside from the bit of shifting from inner ear pressurization, I think people with TMJ should be VERY careful with chin straps or anything else that stresses the TMJ. That's why I use tape and a cellophane wrap to keep my mouth sealed and shut at night instead of a chin strap. I recently posted about that, so look down a bit in the post list and you'll see these posts.

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