The process from start to finish of being diagnosed with ICR and TJR surgery can be a lengthy process. Here is a general timeline you can expect and double check with your medical team

1-2 years before surgery

• Being diagnosed with ICR. There might be more tests that you end up doing, like an MRI. You might even want to monitor the situation longer and see if your bite stabilizes/how much larger your open bite grows – depending on how rapidly your condyles are resorbing. This could be years of watching even, completely depends on your own case.
  • My own bite was opening up age 12-18 without pain. Age 19 is when I started having TMJ pain and a more rapidly open bite due to taking birth control pills and maybe from accutane treatment as well.
• Consulting with at least 3 surgeons for second opinions
• Finding your team
  • Orthodontist
  • Dentist
  • (possibly others)
• Picking a surgeon and developing a plan together
  • Most people need braces before and after TJR surgery. Most seem to need braces for a year before the TMJ concepts scans can be taken.
  • Braces could be 1.5 years, 1 year, 6 months or no braces at all before TJR.

1 Year (assuming 1 year of braces pre-op)

• Start braces
• Start process for insurance approval – some people have insurance exclusions towards TMJ. Talk to HR, I have even heard of people switching jobs to get Cigna insurance or other insurance and waiting 6m-1 year before consulting with doctors
• Occlusion is in TJR ideal bite, scans are taken at the surgeon’s office and sent to TMJ Concepts

3-6 months (depending on TMJ Concepts wait time)

• As I am writing this (6/8/2022) TMJ Concepts has been slowed down by the Stryker acquisition and Covid. I had to wait 6 months to get my new joints made, it sounds like the wait time is now 5 months
• Continue to figure out insurance
• If you are a clencher, it is important to talk with your orthodontist and surgeon about how to maintain your bite during this time. You don’t want a lot of pressure on the back molars from clenching at night which could intrude them and mess up the surgical plan a bit. Trazodone before bedtime could be an option.
• Continued efforts with insurance, usually.

2 months

• Start to order things you need, like a wedge pillow, humidifier (underrated but so necessary if you are getting a le fort) and other items on the packing list. Depends if your surgery is out of town also (what you need to pack for hospital vs a stay in an airbnb or something).
  • I ordered all these syringes from craniofacialrehab.com and some of their squirt bottles but I found none of them helpful. The syringes from the hospital were best and a condiment plastic bottle would have been the only thing I wish I would have brought (you can take the tube off the hospital syringe and put it on the condiment bottle). I also had a tiny syringe from my first jaw surgery, but I don’t know where to buy them… it was perfect for my crushed up meds with chocolate syrup. Maybe the hospital would have tinier ones!
• I would recommend buying the book “Prepare for Surgery, Heal Faster” by Peggy Huddleston. She is a psychotherapist and graduate of Harvard Divinity School. Take what you need from the book, some of it might not be for you. I really loved the meditation CD and would play it constantly even post op the first few days. The mind body exercises she talked about I also found extremely helpful.

2-3 weeks

• I started meal planning and ordering any food, protein powder, powdered vitamins like emergen-c or nutritional shakes that I needed. I tried new pureed things to make sure I would like them beforehand.
• I also started planning my blog around this time, which has been a great outlet for me to write and a good way to keep friends and family updated! I think I will also look back on the blog years from now and be happy with my progress made in the vlogs and in what I wrote. Recommend it to others if that is something you are interested in!

• I also wrote a “needs” list for my caretakers, of how I think I might act post-op and the best words that my caretakers could say to not agitate me further lol and how to validate me and get me help if I needed it. Also an apology if I acted rude to anyone. It was a good time to figure out what I thought I needed mentally and prepare my caretakers for what they were about to experience. I have another article for how to have these conversations with your caretakers / what they should expect in taking care of you.
  • My parents and husband have helped me through various surgeries now, and I think we still found it all very helpful to talk about everything and validate each others feelings/ future feelings I guess? It depends on who is taking care of you and how your communication style is as well, I know this might not work for everyone.

Last week

• Is just an anxious week… just do what you can to get through it with prayer, meditating, visualizing your future healing, spend time with people who encourage you, take baths, go on walks etc. Try to get everything you need to get done before this week if that helps you.… or if it helps you to hyper focus and stay busy, spend this time gathering things too!
• I went out of town for my surgery and we bought anything there that I ended up needing so don’t worry there will be items you figure out are helpful to you that you didn’t know before (Like for me small disposable cups were great for some reason?? I was drinking lots of juices and making weird concoctions to drink lol).
• I am glad that final week that I,
  1. Did a photoshoot to remember my old face by
  2. Did a video message to my future self to look back on, talking to my future self of why I decided to do the surgery, the research I had put in, hopes, and other things.
  3. Brought a “TJR” binder with me to put papers and forms in from the hospital and stay organized.
• I do wish that I would have done more videos of how I looked before surgery to make into before and after videos.

Hope this can help you! Big hug as always.