The next step in this seemingly never ending process was the treatment plan appointment with the dentist and my home sleep study.
Ready for a not so restful night after my husband hooked me into my home sleep study.
Home Sleep Study
All of the dentists suggested a sleep study to check for sleep apnea. There was a belt that went across my chest with a monitor. Attached to that was a cord that ran to my finger for pulse, and a tube that ran to my nose. Those cords and tubing was attached to me with tape. I'm not sure how they expect you to actually sleep all hooked up to that thing, but I gave it my best shot. At 5am when I woke up yet AGAIN with my face intensely itchy from the tape so I turned the thing off and got some decent sleep for a few hours. I don't have the results yet, but will update when I do.
Dentist Treatment Plan
Met with dentist #3 for my treatment plan and report of findings.
The radiology report was LONG and very detailed. Here are some highlights:
I have some retained baby tooth fragments between #19-20 and #29-30. Not causing pain right now so nothing to do here.
Because my jaw is situated back too far, my TMJs are not situated properly. They are pushed back towards my ear canal and not sitting in the center of the joint. This is causing popping and ringing in my ears and sliding of the joint with reduced opening.
The articular disk in my TMJ is also not sitting properly. The mandibular head is probably sitting behind it and when I open my mouth it will slide on to it. This can't be seen on the CBCT but it is our best educated guess as to why the jaw is not sliding smoothly when it opens.
Mucosal thickening is noted in my sinuses. Most likely from irritation and/or because my airway is reduced due to high palate and tongue tie. My palate is very high reducing the size of my sinuses. We may need to pull in ENT to further investigate some of the other sinus findings down the road.
My tongue pushes back into my airway due to the restricted frenum, but the measurement of my airway is JUST ENOUGH to allow for a tongue tie release without palate expansion first.
Treatment plan:
Tongue tie release
Mandibular neuromuscular orthotic & Bionator to move the jaw forward and push the TMJs back into the proper placement. There is one nighttime orthotic and one daytime. They are worn 24/7 including with eating for 6-9 months. Once the jaw is in place the teeth no longer line up so orthodontics would be needed.
Phase 2 of treatment would include palate expansion and orthodontics.
My thoughts on this plan are varied. The orthotics are extremely expensive and right now I do not have pain or symptoms that would warrant spending that much (or quite honestly enough money). I'm going to start with the tongue tie release after another month of myofunctional therapy and then see how I feel. When dealing with adult tongue tie, TMD and orthodontia there is always more complicated things to consider. I am looking for some reduction in symptoms that would justify the expense. Right now I'm not seeing that with the orthotic. Stay tuned for my tongue tie release entry in a couple months!
Daytime Orthotic
Nighttime Orthotic
This blog post is in no way medical advice and just my personal experience.
Local to the Milwaukee, Wisconsin area? Need to get your older child assessed for oral ties? Book a visit with our Occupational Therapist, Julia!
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