Klarinet Archive - Posting 000068.txt from 2005/11
From: Juan Francisco Vicente Becerro <juanfran2@-----.com>
Subj: Re: [kl] Re: TMJ
Date: Sat, 05 Nov 2005 18:07:44 -0500
Nancy, thanks for your extensive reply, and next ones. Don't worry about
English and Spanish, I think I have no problems in reading English, (I
hope I'll not miss anything), my problem is only with writing and
speaking english.
My occlusionist gave me more than a month to think, ask other patients,
search information, so, that is what I'm doing (till December 2nd). (By
the time you wrote your message I was using a CD titled 'orthomation',
with lot of info about orthognathyc surgery, TMJ and orthodontics).
I want to thank your patience. I have talked with several patients with
this treatment, but no one plays clarinet, so I will read carefully your
mails.
I've been suffering teeth problems for several years. When 14 I got
hurt, and lost upper central and lateral incisors. (I was studing my 3rd
clarinet year). Dentist implanted my own incisors (both fell out, but
didn't got broken). Something went wrong, and I suffered a several
gingival and bone infection around those teeth. Another doctor had to
extract those incisors, scrape the bone of the jaw, and put a bridge
-and endodontic treatment- from upper right canine & central and lateral
incisors to upper left canine and premolar.
So my problem is not only TMJ, orthotondic treatment needs my dental
bridge to be removed (that's what I was told). I am the chief
coordinator of a relatively big music school and don't have big teaching
working day. Moreover, I accustomed to teach choir, clarinet choir,
musical language, and musical initiation for little childrens, so I can
spend 3 or 4 years without playing / teaching clarinet. But I want to
make things right, because this one has to be the definitive one.
I have been stopping and starting again: My accident, then 9 years, the
infection, 7 years, and now TMJ. I don't want to stop now, and then ,
after re-starting again, stop after 10 years because I have to remove or
change the bridge or make a bone graft.
My "time line", proposed by my occlusionist, is:
-Ferule to achieve a jaw relaxed position
-Exhaustive radiology and cephalometry study
-Determine weather I need surgery or not -and maybe bone graft were it
was scraped-
-Orthodontics to achieve a functional occlusion so that TMJ keeps stable
in its natural position, and then implants or a new bridge.
You are right when writing about european dentists, but I want to
clarify this. A number of dentist study the odontologist-stomatologist
degree, and then a brief specialization course in endodontics,
orthodontics, or implantology. Then they offer "all in one". It's
important not to believe this kind of advertisings. On the other hand,
there are specialist that spend other three years to became an
endodontic dentist, OR (not AND) orthodontic or occlusionist dentist. I
think this works equal in Europe than in USA. This is what I've searched
for, so I visited a team composed of a dentist, an occlusionist -
orthodoncist (by the way, this one studied in USA), an implant dentist,
and an oral and maxillofacial surgeon (with anaesthesist, ...).
Another problem with TMJ in Spain is that orthodontic treatment is
considered (by medical administration, not by doctors) as a cosmetic
treatment. Occlusionists have a big work to make the population aware of
the fact that we need a good dental occlusion to be healthy. At this
time the "seguridad social", a sort ot health insurance all workers have
in Spain, covers surgery, but neither the ferule nor the orthodontic
treatment, even if need my teeth to work.
Maybe after a few days (or weeks, or ...) whe could spend a time writing
this threads in a more organized manner, so that clarinetists whith TMJD
find the medical and personal info separately.
Thanks
Juan Francisco Vicente
Chief Coordinator
Sirinx Music School
Salamanca, Spain
http://www.emsirinx.com
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