Posted on in General

Often when a patient with a complex dental problem gets into trouble, they do not know where to turn for help.  That is why we have started to advocate for patients who have no solution available for their dental problems.

Here’s a case study:

P.J. was a 17 year old teen who was playing field hockey when she fell and was kicked in the right side of her jaw.

For the last 18 months, she has had severe pain and swelling in the region of the right jaw joint or TMJ.

Here’s what happened:

P.J. had seen two oral dental surgeons who tried pain meds, anti-inflammatories and bite plates. Nothing helped.

Rupert Case Management Inc. (RCM) was engaged by the family.  She had a MRI of her right TMJ which showed that the disc or meniscus was torn and displaced.

RCM found two oral surgeons with the expertise required to fix the problem.  She saw them for opinions. One of the oral surgeons suggested that P.J. have another MRI of the right jaw with a neuro-radiologist expert in vascular malformations. The MRI showed that P.J. had developed a venous malformation. This had resulted from the trauma.

The Outcome:

One of the oral surgeons did arthroscopic surgery (minimally invasive surgery) to repair the right TMJ. The venous malformation did not require treatment.

P.J. could happily go out for pizza with her friends and not have pain.


If a person is having a dental problem that is complex and eludes her/his dentists, then we will be pleased to have our dental team lead by Dr Neena D’Souza review their case.