Director's mailbox forwarding
Dear Director Liu,
I once had a jaw joint surgery scheduled, but after an evaluation at the hospital, the cost was estimated at 300,000 TWD, which is not a small amount for me.
Upon hearing the cost, I asked the doctor if not undergoing the surgery would have any impact.
He said it probably wouldn't.
A few months later, during my semi-annual dental cleaning, I asked another doctor what would happen if I ignored it (since I had recently experienced arthritis and had trouble opening my mouth).
The doctor said that my lower jaw had shifted one and a half teeth to the left, and since the muscles on both sides were not being used, there would definitely be issues over time.
I asked that doctor if this would be considered cosmetic surgery, and he said that as long as the function is normal, it could be classified as cosmetic surgery.
I am now unclear about the definition of "normal function." Is this considered a factor of chronic arthritis? My work is labor-intensive, and the last inflammation lasted four days, but previously, I only experienced clicking sounds when opening my mouth and tolerable pain.
Does this mean my current function is considered normal, or does it imply that under normal usage conditions, I should not experience pain?
You, 20~29 year old female. Ask Date: 2009/07/23
Dr. Huang Zhicheng reply Dentistry
Whether the National Health Insurance can provide coverage should depend on whether the diagnosis and treatment align with the covered medical services.
It is difficult to make a judgment based solely on Mr.
You's statement; a comprehensive dental panoramic radiograph and temporomandibular joint X-ray are necessary for a more accurate diagnosis.
It is recommended that Mr.
You consult a hospital with an oral surgery department for further evaluation.
Sincerely, Dr.
Pan Chi, Attending Physician, Taoyuan Hospital, Department of Health.
Reply Date: 2009/07/23
More Info
Understanding the necessity and implications of jaw surgery, particularly in the context of temporomandibular joint (TMJ) disorders, is crucial for making informed decisions about your health. Based on your description, it seems you are grappling with the potential consequences of not undergoing the recommended surgery, which can be a significant financial burden.
Firstly, let's address the concept of "functional normality." In the context of jaw function, "normal" typically refers to the ability to open and close the mouth without pain, discomfort, or mechanical issues such as clicking or locking. If you are experiencing pain, limited range of motion, or audible sounds when moving your jaw, these could indicate that your jaw is not functioning optimally. The fact that your lower jaw has shifted significantly (1.5 teeth to the left) suggests that there may be an underlying structural issue that could lead to further complications if left untreated.
Chronic TMJ disorders can indeed be exacerbated by misalignment of the jaw. When the jaw is not properly aligned, it can lead to uneven stress on the muscles and joints, potentially resulting in muscle fatigue, pain, and further joint degeneration. This misalignment can also affect your bite, leading to additional dental issues over time. The muscles that control jaw movement may become overworked or underutilized, leading to muscle imbalances that can contribute to pain and dysfunction.
Regarding your question about whether this situation could be a factor in chronic arthritis, it is possible. Chronic inflammation in the TMJ can lead to degenerative changes in the joint, similar to what is seen in other forms of arthritis. If the joint is not functioning properly, it may lead to increased wear and tear, resulting in osteoarthritis over time. This is particularly concerning given your history of joint inflammation and the fact that you have experienced episodes of pain and dysfunction.
The decision to undergo surgery should be based on a comprehensive evaluation of your symptoms, functional limitations, and the potential risks of not having the surgery. If your jaw issues are significantly impacting your quality of life, work, and daily activities, it may be worth considering the surgery despite the cost. Additionally, if your symptoms are progressive or worsening, early intervention may prevent more severe complications in the future.
In summary, while your current symptoms may not seem debilitating, they indicate that your jaw is not functioning normally. The potential for further complications, including chronic pain and joint degeneration, should be carefully weighed against the financial cost of surgery. Consulting with a specialist who can provide a detailed assessment of your jaw function and the potential long-term consequences of your current condition may help you make a more informed decision. It’s essential to prioritize your health and functionality, especially considering the physical demands of your job.
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