“My pain was ruining my life. Normal activities were becoming more challenging. Penn Medicine gave me my life back!”
Decades of Pain
Marie was rear-ended in a car accident. That’s when she started having neck pain. She was also going to school and under a lot of stress.
She noticed she started clenching her teeth and began experiencing jaw pain, which persisted and worsened over the next two and a half decades.
In 1988 Marie started a program of physical therapy, medication and oral splinting. But it was not effective.
In 2013, she came to Penn and found out there was more to her story than a neck injury and stress.
She had an inherited condition called hypermobility, which caused her to have looseness in her jaw. The ligaments that held her joint together were excessively elongated, much like being double-jointed.
Looking back, things started to make sense.
“Dentists always told me, ‘You don’t have to open that wide!’ And my jaw got stuck open a few times in the 90s,” Marie recalled.
Now that she had a diagnosis, she needed a plan.
Marie’s Path to Penn Medicine
Marie’s relationship with Penn started when she consulted Tom Sollecito, DMD, Chair of Oral Medicine at Penn Dental School. Dr. Sollecito recommended physical therapy, medication and some lifestyle changes to help decrease her jaw pain.
“He was great, as was my physical therapist, Diana Hearn. This worked for a couple of years, but then my symptoms worsened,” Marie said.
Marie had an MRI, which showed significant joint changes.
Dr. Sollecito referred Marie to Eric J. Granquist, DMD, MD, Director for the Center for Temporomandibular Joint Disease at the Hospital of the University of Pennsylvania.
The Plan
Dr. Granquist diagnosed Marie with severe osteoarthritis and an effusion (collection of fluid) in the jaw joint space. He recommended Marie consider a total jaw joint replacement.
“Marie had such significant joint destruction, it changed her bite and resulted in significant pain and difficulties with jaw function, both of which could be corrected with a single surgery,” Dr. Granquist said.
Marie was in so much pain she couldn’t sleep well. She had trouble eating. The pain and its effects were impacting her ability to do her job. Yet, she was hesitant to have a total joint replacement surgery.
“I was scared. It’s major surgery, and it’s on your face,” she said. “It took me a year to decide to do it. I did a lot of research, got a second opinion and joined a Facebook group of people who have had similar experiences.”
As a retired nurse and patient advocate, Marie had extensive experience helping others navigate their healthcare experiences. Now, it was her turn.
“I asked Dr. Granquist if I really needed the surgery,” she said. “When he validated that I did, I had a lot of questions for him. He was very patient, answered all of my questions and addressed my fears. I could tell he cared.”
Dr. Granquist took his time with Marie and explained everything in detail.
“He showed me images that were hard for me to believe. The rounded end (condyle) of the jawbone (mandible) was shorter and flat instead of rounded,” Marie said. “That bone loss changed the way my jaw moved, put stress on the muscles and connective tissue around the joint and altered my bite and speech. Only two top and bottom teeth on my left side connected. I could only eat soft food.”
Pain-Free at Last
Marie had her left temporomandibular joint replacement surgery on July 23, 2018.
She found the doctors and residents “wonderful” and said the nursing care was “superior.” Having worked in hospitals for decades, she says she could tell they were on the top of their game.
“From the time I was admitted to my room until I left the hospital, I was treated with respect and kindness by every member of the care team, from the nurses, nursing assistants and dietary to the patient care technicians who assisted me with transport,” she said. “The staff's training and experience in the treatment of major TMJ issues was very evident.”
Today, Marie is pain-free and living a better life.
“Now I can chew. I can eat popcorn — my favorite snack! I can eat granola. I can eat a sandwich. I have no pain! Now I can see how much I was affected by the constant pain. I was coping, but it was getting harder and harder,” she said.
“This surgery changed my entire life. I sleep so much better. I don’t clench my teeth anymore because I am not in pain. I’m so glad I did this. I am no longer in pain!”
More Experience Leads to Better Patient Outcomes
At Penn Medicine, our oral and maxillofacial surgeons are internationally renowned and true pioneers in temporomandibular joint (TMJ) surgery. Seeing some of the highest volumes of joint surgery in the country, the Penn Center for Temporomandibular Joint Disease has extensive experience performing complex joint and combined jaw surgeries. This type of experience translates into a better experience and improved patient outcomes.
“TMJ total joint replacement is reserved for patients with end-stage disease who have exhausted medical management and other minimally invasive interventions,” Dr. Granquist said “This procedure can significantly improve the quality of life for this small cohort of patients. Currently, Penn Medicine performs one of the highest volumes of TMJ replacement procures in the country. Utilizing this volume of experience through our nursing, OR and clinical teams, we optimize outcomes for our patients.”
Our team includes oral and maxillofacial specialists who are experts in oral surgery, oral medicine and oral rehabilitation.
At the forefront of medical and surgical science, our physicians and researchers are involved in basic science and clinical research that allows us to continuously improve treatment outcomes, prognosis and prevention of temporomandibular disease.
Need a Second Opinion?
Have you been told you need TMJ total joint replacement? Would you like to receive a second opinion from Penn Medicine’s Center for Temporomandibular Joint Disease?
Through our second opinion program, we offer remote second opinions to patients from the following states: California, Florida, Georgia, Maryland, Michigan, New York, North Carolina, Pennsylvania, South Carolina, Virginia, Wisconsin and Washington DC.