There are many factors that must be considered when TMJ/TMD and facial pain patients wonder when their pain will be resolved. It is difficult to put a “realistic” time frame on things when there could be multi-layered issues involved.
Note that improvement doesn’t mean “cured” or total resolution. Most cases with chronic pain (depending on the pain problem) can improve within 24-48 hours when wearing a properly fine-tuned and adjusted lower anatomical orthotic. Other chronic pain cases (depending on their problems and conditions) may take longer.
It’s hard to predict how each individual case will respond to treatment. Not all muscles, not all joints, not all teeth/occlusal schemes and not all CNS systems function the same. Some cases have other factors such as stress factors, emotional factors, biochemical factors that play into the picture. There are no guarantees for neither the patient nor the treating dentist and other health care professional involved in the case to know how the patient will actually respond to treatment. In general, however, most cases respond well and patients experience improvement. Most patients can improve in some aspects of their condition, and need more time than others, and follow-up visits are usually scheduled in order to adjust the orthotic as the body naturally and dynamically changes as a result of the treatment.
All patients are different and may respond quicker or slower to therapy, especially when it comes to compliance. If the appliance is not worn as prescribed, changes and improvements can be significantly slower. Alternatively, many patients can respond quickly, and as muscles adjust, and postural improvements occur, additional adjustments may be required in order to manage the bite and continue to stay on top of the changes that are happening.
How much change will occur? – there are no specifics on this.
How many visits will be required? – there is no set number; as the body adjusts and seeks a neutral position, changes occur and adjustments may need to be made.
Each case is individual and will vary depending on the conditions and various contributing combinations of problems in each case. This is what makes diagnosing and treating TMD so complex and patients need to accept the unknowns and the patience that is required in order to resolve and treat their condition.
WHAT MAKES A TMJ CASE MORE CHALLENGING TO STABILIZE:
- Missing teeth like bicuspids (less teeth make the occlusion less stable and more challenging, but not impossible)
- Missing upper molars or missing lower second molars
- Clencher type, high proprioceptive detailed aware person
- Narcotic medications or SSRI medications that contribute to clenching muscles
- Cervical neck (atlas, axis) and occipital instability
- Pelvis and lower back problems
- Severe restricted mouth opening
- Biochemical imbalances (nutritional deficiencies)
NOTE: Not all TMD problems are the same. Just as individuals are unique and may also have a unique set of problems that are different than others individuals. Some TMD cases naturally will require certain skills, understanding, knowledge, effort and additional time.