Profile #7: Rafida Deo
Currently studying towards a BE (Materials) and BSc,
Intern at Amaero Engineering Pty Ltd
Our seventh profilee is Rafida Deo, an undergraduate in the Materials Science and Engineering department at Monash. Rafida and I have been friends for a few years now, having taken classes together and worked together on the Materials Engineering Society committee. She's been one of the stalwarts of our department for a while now, and you'll generally see her helping out wherever help is needed, particularly with her beloved 3D printers! In the last few years, she's been involved in volunteering, multiple research projects, and has picked up many awards along the way; she's an expert in PCR (polymerase chain reactions), FDM (fused deposition modelling), designing and building high-tech metallic components, and has been honoured with the Faculty of Science Dean's Top Twenty Undergraduate Award, the Monash Scholarship for Excellence and Equity, a place in the Vice Chancellor's Scholarship Program, and a persistent presence in the Dean's Honours List for the Faculty of Engineering.
Her effort and enthusiasm have always impressed me, so when Rafida came to me recently to talk about increasing awareness for TMJD, I assumed it was just another one of her projects to help the people around her. Unfortunately, this issue hits a bit closer to home - Rafida, while putting the rest of us to shame with her energy and achievements, has been suffering with TMJD herself.
Temporomandibular Joint Disorder (TMJD) affects the joints that connect the lower jaw to the skull, and allow the jawbone to rotate and slide. This joint can become inflamed, and affect normal jaw function - this means pain when eating, pain when talking, and even pain when sitting still. TMJD can occur due to wear and tear of the cartilage covering the ends of the connecting bones, structural problems in the joint, or other degenerative processes. However, TMJD can also arise when normal dental procedures go awry.
This kind of pain is pervasive and affects all aspects of life - not being able to talk or eat properly takes an immense mental and physical toll. On top of that, diagnosis of this condition is not easy - there is no standard test for TMJD and so diagnosis relies on a medical and dental history, as well as clinician experience.
Once a diagnosis has been made, the treatment of this condition is also difficult, as the safety and efficacy of most jaw joint treatments are as yet poorly understood. Experts recommend the use of conservative, reversible treatments when at all possible, with surgery as the last possible option - this leaves patients with ongoing mild pain and little hope for a permanent solution. Conservative estimates indicate that TMJD affects between 5 to 12% of the population of developed countries such as England, Sweden and Hong Kong, and is more prevalent in younger patients.
Image courtesy of Cosmetic and Esthetic Dentistry, MA, U.S.A.
Read on for more about Rafida's story.
What is your involvement in engineering?
I am currently studying at Monash (Bachelor of Materials Engineering and Bachelor of Science) and am currently working as an intern at AMAERO engineering.
What inspired you to choose materials engineering?
During my general first year of engineering, I decided to pick the materials engineering elective to see what it was about. Before that point in time I hadn’t heard of materials engineering and thought I wanted to become a chemical engineer. However, after listening to John Forsyth and Don Rodrigo, I knew that materials engineering was for me. What appealed to me the most was the fact that materials engineering overlaps with other types of engineering. Furthermore, the course offered insight into different materials (polymers, metals, ceramics) which provides an excellent foundation for future development of new materials.
Onto TMJD - tell us about your journey...
Up until recently, I had no jaw issues. When I got my wisdom tooth extracted, things changed for the worse. Initially I had a little bit of pain which my dentist said was normal. However, after 3 weeks I knew something was seriously wrong, because tasks such as laughing, eating food and even just talking caused pain. It was then that I decided to get a second opinion and found out I had TMJD (temporomandibular joint disorder) on the right side of my jaw.
TMJD has caused me a lot of grief to say the least. Imagine a toothache, but amplified, and ear pain and jaw pain, and imagine having that for 3 months. Because of the pain, I was unable to talk normally and became very reserved. Even going to work was difficult because I knew talking would result in pain. Eating solid foods became near impossible and I went on a soft food diet. What made it worse was that this all occurred before my final year project presentation.
It wasn't until I went to the TMJ specialist centre Melbourne that I started to get better. Even then I was unable to eat solid foods for 3 months and lost 5-6 kg (more than 10% of my body mass). As a result, I was perpetually tired and trying to fight off muscle spasms because of the treatment.
I think people don’t understand how painful TMJD can be; both emotionally and physically. Not being able to eat or talk was very difficult for me, especially when work culture is centred around going out for dinner and drinks. Not knowing when the pain would end made me feel helpless; if it wasn’t for the continuous support from my mum, dad, and partner I would not have been as positive as I am now. The specialist and chiropractor also helped me quite a lot in my times of need, even when I called up at 10 pm, freaked out about a different jaw muscle spasming.
What are your thoughts on TMJD research, perception and awareness?
My experience with TMJD has made me realise that this problem could have been avoided if my original dentist had taken the appropriate precautions prior to my extraction. I believe that it should be mandatory for everyone to have an MRI scan (magnetic resonance imaging) done to ensure their jaws are in the right position and their jaw joints are healthy, prior to dental work. If I had done so, it would have shown I had a pre-existing small jaw condition (making matters more complex).
The current preventative measures (during extractions) include using mouth blocks and other such mouth apparatuses to hold the mouth open. However, after some research, I have found that these are not very helpful as the asymmetric distribution of load on the joints can still lead to TMJD. Therefore, I am currently working on a mouth block design that will hopefully be used in the future.
In my case, I was fortunate enough not to need additional surgery. However, if I had waited for a few more weeks before seeing my specialist, I would have gone under the knife and would have to have taken pain killers for the rest of my life.
Currently, surgery is not the preferred method to solve this issue because there are many uncertainties involved in the procedure. Therefore, I think it is necessary for everyone, TMJD sufferers or not, to know what are the signs and what CAN cause TMJD. These problems are treatable and everyone must enjoy their lives to the fullest!
What can you do to help raise awareness for TMJD or support those in your community with this illness? Consider donating to patient support organisations like the TMJ Association Ltd. (N.B. based in the U.S.A.), and reaching out a hand to anybody you may know who is affected.
Rafida also recommends the following prior to getting any invasive surgery done;
If you feel like you need to get your temporomandibular joint checked, you can request the following scans to be done: an MRI, a CBCT scan, and/or an MRI-CBCT scan. "MRI-CBCT registered images significantly improved intra- and interexaminer consistency among experienced readers in evaluating internal derangement of TMJ compared to MRI alone" . Once these scans are done, a detailed report (with images) is sent back to either your GP or dentist and will outline the condition of your joint, and the soft/hard tissue surrounding it.  Mohammed A.Q. Al-Saleh, Noura A. Alsufyani, Manuel Lagravere, Brian Nebbe, Hollis Lai, Jacob L. Jaremko, Paul W. Major, MRI alone versus MRI-CBCT registered images to evaluate temporomandibular joint internal derangement, In Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 122, Issue 5, 2016, Pages 638-645, ISSN 2212-4403, https://doi.org/10.1016/j.oooo.2016.07.024. Available from: