January 2, 1996
Web posted at: 12:55 a.m. EST
From Correspondent Rhonda Rowland
ATLANTA, Georgia (CNN) -- Imagine having pain in your jaw, face or neck that doesn't go away, or suffering from a constant headache.
Sandra Garner is just one of thousands of Americans who suffer from such facial pain. Just months ago, Garner wouldn't have been able to share a snack with her daughter like she can now. Everything Garner ate had to be soft. Most of her meals were prepared in a blender because of severe pain in her jaw and constant headaches.
The problem started without warning: She was chewing gum one day and yawned. "All of a sudden, I felt a real sharp pain," Garner said. "The next day, it kept hurting and my mouth was locked closed and I couldn't open it." (111K AIFF sound or 111K WAV sound)
Her orthodontist diagnosed her with TMJ, which stands for temporal mandibular joint, the area of the jaw affected.
Garner started her search for a cure. "I went to a Facial Pain Center in Florida," she said. "I tried everything there was," including physical therapy and bottles of pain killers -- all to no avail.
After much research, Garner tried surgery to ease her pain, and she says it worked.
"The key is basically to operate only on those patients that have specific dislocated discs that are clearly causing their pain," said Dr. Robert Bays of Emory University. "In that situation, I think surgery can be very successful." (179K AIFF sound or 179K WAV sound)
Although Garner was offered surgery to help her TMJ, many patients are not. There's no single treatment that works for every case of TMJ. Doctors strongly disagree on the best course of action -- some believe surgery should never be used.
"There are no studies to show safety or effectiveness (of surgery)," said Dr. Joseph Marbach of the University of Medicine and Dentistry of New Jersey. "In light of that, they should be prevented. There should be a moratorium on temporal mandibular surgery. They shouldn't let it be done." (162K AIFF sound or 162K WAV sound)
Another reason some dentists and doctors don't recommend TMJ surgery is because of its bad reputation during the 1970s and '80s, when certain types of implants were used.
Implants are no longer a part of the TMJ surgery of the '90s, but surgery is still not the answer for all patients with face pain.
Some patients have a problem with their facial muscles, a condition doctors call temporal mandibular disorder, or TMD.
"It turns out that, in most cases of TMD, the problem is not in the joint, but it is in the muscles that move the joint," said Dr. David Haddox of Emory.
Treatment ranges from mouth appliances, anti-inflammatory drugs and anti-depressants to exercises and cortisone-like injections.
Doctors say the first step to finding relief is getting the correct diagnosis. After that, it may take experimenting with several opinions to come up with the right treatment.
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