indessed roscivs

Yesterday I went to see the Jaw Doctor. He was pretty amusing—very affable and more than a touch flamboyant. He had scarcely said two words to me before he was drawing diagrams on a paper towel and listing off my symptoms one by one, nailing them perfectly.

Turns out there’s a little disc at the ball joint where the jaw meets the skull. On my jaw, that disc is a little out of place, so when I open my jaw wide, the disc blocks the normal motion of the jaw, and either I get a popping sound, or I have to move my jaw “around” it, from side to side, in order to get my mouth fully open. (Or, on bad days, both—and pain to go along with it.) How did the disc get out of place? “Impossible to know,” says the doc. But the important part is that at night, I grind my teeth in such a fashion that the disc gets used to this awkward place during the night, which makes it harder (or impossible) to reverse during the day.

“Wait, what? I don’t grind my teeth,” I insist. My wife perfectly labeled every other symptom I had, which put me perfectly into the TMJ/Sleep Apnea group of folks. But she didn’t mention anything about teeth grinding.
“Yeah, you do,” replied the doctor.
“But the dentist looked at my teeth and didn’t see any signs of wear,” I told him.
“Everyone with TMJ grinds their teeth at night. You grind your teeth, trust me.”

He peered into my mouth and took a look at the molars. He seemed puzzled for a minute—aha! I thought. See? Then he started having me move my jaw around. “Bring your lower jaw forward a bit. Now move it to the side. A little more. Now move it forward a bit more. Yeah. Perfect! The puzzle has been solved!” He brought out a mirror and showed me my mouth.

It was in the most awkward position ever, a strange jutting out of the bottom teeth and shoved to the side. But when I looked in the mirror, the teeth kind of looked like they “fit” in a weird sort of way. There was a little notch or chip on the edge of one tooth that fit perfectly with the others.

I was still unconvinced, but hey—he’s the doctor—he must know something. But it seemed to me that he was trying to find any evidence that fit his conclusion—that I grind my teeth at night—rather than vice-versa. Plus, he was recommending a little plastic device (like a retainer) to fit into my mouth at night to keep me from grinding, and a nice treatment program to the tune of several thousand bucks. He sent me home with some muscle relaxant pills and a page full of things I could do to ease my symptoms, and a recommendation for a sleep test to validate his sleep apnea pronouncement.

For the rest of the day, I tried to keep my jaw in as relaxed a position as possible, just as he’d recommended. (It’s somewhat difficult to keep something relaxed when you’re so concentrated on it, though.) I also did some internet searching of my own, looking at diagrams and recommendations from other doctors and dentists. I found a site that had some cool exercises, and tried a few of those—like opening and closing slowly in front of a mirror, trying to keep the motion as straight as possible. My jaw was going all over the place, left to right then right to left. It was insanely difficult to try to keep the motion pure.

Then, last night, I took a few of the muscle relaxant pills and went to bed. “They’re supposed to make you drowsy,” I joked to my wife, “I can feel them working already!” I’m notorious for my ability to fall asleep within minutes of head hitting pillow.

But last night, tossing and turning into position, just as I was about to fall asleep, I suddenly noticed my jaw moving—moving in a strange way—settling down exactly into that bizarre, awkward, perfectly-fitting-together position I had uncomfortably performed in a dentist’s chair earlier that day! I was instantly jolted awake. He was right!

Every night, my jaw moves into that position and locks there, letting me sleep peacefully—but shoving that tiny disc back into that position it’s not supposed to be in. I tried several times to fall asleep, but every time, my jaw would sneak slowly back into that strange and crazy position, jutting out and locked to the side. It feels so awkward to even try to replicate it while awake, but it was the most natural thing lying there in bed in the middle of the night. I eventually had to change positions completely in order to fall asleep with my jaw in a relaxed position, but I succeeded. I don’t know if I stayed the whole night without my jaw locking, but when I woke up it was still relaxed, and I realized in that moment that every other morning I’d woken up with considerably more muscle tension in my jaw than I did this morning.

As I ate breakfast and brushed my teeth and went about my morning routine with this newfound relaxed jaw, I noticed something very strange. In this position, some of my more awkwardly-positioned teeth were getting dangerously close to my upper teeth. Suddenly I had a flash of insight.

I used to have this problem where, occasionally, when I bit down or otherwise moved my mouth quickly, I’d hit my upper teeth on my out-of-position lower teeth in a terribly painful way. It would only happen a few times a year, but when it did—owwww! It was the worst experience ever. But I haven’t had this problem in years. It’s pretty much gone away completely.

Or had it? The feelings I had back then, of some uncomfortable near-misses, I was starting to remember. “That’s how it started,” I realized. “That’s how it must have started.” After a few of these ultra-painful collisions, my body figured out a way to avoid them—by moving the jaw in a different way. This different jaw motion eventually got picked up as a night-time habit, and the night-time habit eventually moved this disc into its now-uncomfortable position.

And, of course, it still might have something to do with my wisdom teeth removal (the problems started happening shortly afterwards). Perhaps the teeth shifted due to the extra room in the mouth enough to exacerbate the problem? Who knows—it’s all theoretical anyway. “Impossible to know,” as the doctor said. But it certainly seems like a likely explanation.

So now, I want orthodontics more than I ever have wanted them before. It’s not to have a nicer smile. It’s not even for improved dental hygiene. Braces could mean, for me, an entirely different way of life.

This entry was posted on Tuesday, November 13th, 2007 at 11:09 am and is filed under biology. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.