TMJ, teeth-grinding and night guards help

First off: I have no dental insurance.

OK, now that I got that minor issue out of the way, I have TMJ — had it for almost 20 years now. Started out as clicking and limited opening of mouth. Since then the clicking’s stopped and I can open my mouth wider, but my bite feel like it’s gotten a lot more crooked, and there’s more frequent discomfort on my left jaw. Back in ‘93 I went to see a specialist about it, who wrote in his letter to my dentist:

“The treatment…will be initiated with a removable mandibular orthopedic repositioning appliance. This will prevent dislocation of the menisci and will initiate healing of the interarticular tissues.”

Well, I never did get that “appliance,” and now I discovered that I also grind my teeth at night. I’ve been reading around and they recommend a mouth guard for that.

So my question: is it too late to go the “appliance” route to ease the increased pain of my TMJ, and if not, would it also work for teeth-grinding, in effect killing two birds with one appliance?

Is my TMJ beyond help of such an appliance, and getting a mouth guard for my grinding would just make my TMJ worse?

I’ll gladly scrape up the money to see a specialist again, but I don’t want to go in there and be told I need emergency surgery on my jaw, ’cause I will go bankrupt.

Thanks.

Response
FWIW I grind and clench, but not to TMJ stage yet and I got this thing called an NTI device that takes those powerful side jaw muscles out of the way and prevents grinding, and isn’t all bulky like a mouth guard. Got it at the dentist, but insurance didn’t cover it, I think it was $100 or $200. Totally worth it

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