### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Just since this June I have been experiencing some problems with what seems to be TMJD.  I get pressure in the side of my jaw when chewing, talking, or anxious.  I have flare ups, sometimes its better depending on what I have been eating.  Im very confused because Ive been getting a lot of different opinions.  My gerneral dentist told me that there isnt much that can be done other than monitoring what I eat, taking anti-inflammatory, using a night guard, and using heat.  An orthodontist told me (at the consultation) that my bite is off and it was causing my TMD issue because it is making the muscle flex constantly because of being out of allignment.  He told me that I need Orthognathic surgery to split and widen my upper jaw before he will consider putting braces on me.  An oral surgeon I went to said that I should not have surgey because it could make it worse and he doesnt detect a joint problem and told me that braces would not help.  Im so confused now, any imput would be appreciated.  Im not concerned with getting braces or fixing my bite unless it would help the TMJ/D.  Im a little concerned about having such a major surgery if there is a possibility I will still have the TMD or worse problems yet, I have a two year old.  Could pulling teeth possibly help anything? Thank you for your time.

### output:

Hello, I have read your inquiry and understand your confusion. I would need more details to give you my opinion. I can tell from the opinions expressed that you must have a large discrepancy between your jaws. Do you have an under bite or overbite? Do you have a very narrow upper jaw? For adults, this is a common jaw relationship that I see which can not be corrected with just braces. In child Chat Doctor.  Yes, as an adult serious surgery would be necessary and braces alone would not be able to alter the jaw relationship. No, pulling your teeth does not solve the jaw relationship, and you risk difficulty with functioning of the dentures. You need additional opinions to decide the risks and benefits of such a surgery. I can not tell without X-rays, photos, models and clinical exam why the surgeon fed there is a risk of your situation getting worse. You are not getting a report of a damaged joint needing joint surgery which means anything you do to prevent stress on the joint is beneficial. Follow your suggestions of your dentist. This is a common treatment that I recommend to my patients. You need to relieve some pressure on your jaw. You most likely grind your teeth at night adding stress. The guard slows down wear and reduces muscle spasms. This can take weeks to notice relief, adjusting of guard and may need a stronger medication for relief initially such as Flexeril which is one for muscle relaxation or steroids. Consider an opinion from the dental specialist called a prosthodontist. Thank you for your inquiry. I hope my opinion gives you some guidance and that I have been helpful. I hope you will feel better with use of a mouth guard.