For those of you not in the know, TMJ is a problem that affects the temporomandibular (sp?) (joint of the jawbone). It can cause a popping sound when opening and closing the jaw, jaw joint pain, neck/ear/shoulder pain, and even dizziness or vision problems.
I was told I have TMJ by my orthodontist when I first had braces put on, 6 years ago or so. At first, I only had the occasional annoying popping sound when I opened and closed my jaw. Over the past few months, however, the pain and overall discomfort have become almost unbearable.
I am going to see my dentist next week for a regular cleaning and will bring up the subject with him. But from the research I’ve done so far, it doesn’t seem that any definitive treatment is known. Some dentists and doctors either don’t acknowledge the disease as having a true physical origin or don’t even know about it.
Many people spend thousands of dollars of their own money seeking treatment (many health and dental insurance companies don’t cover the treatment). I am hoping to avoid that fate by asking you, dear fellow Dopers for some help, advice, info., etc. Anything would be most appreciated.
Hmmmm. The reason my husband got braces (at 35) was that he was developing pain due to TMJ. I would get a referral to someone who specializes in that sort of problem. Your regular dentist just may not know much about it. I gather that treatment is important, due to the fact that the disorder lead to a progressive breakdown of the joint.
Getting braces would seem to be a cure for TMJ. They would eventually help properly allign the jaw itself and help lessen the pain. But I have read on several websites (not so reliable, I know) that dental work such as braces or the removal of wisdom teeth could actually make the pain worse.
Braces certainly seem to have made the pain worse for me. Before them, I only had some popping noise. Now I’ve got a whole slew of problems.
FYI, “TMJ” is “temporomandibular joint” and what you’ve got is commonly known as TMJ syndrome. But let’s not quibble over semantics.
I am probably the first cured case of TMJ syndrome, way back in about 1972. I was lucky enough to live next door to the dean of my local dental college, who was looking for a test case. He literally wrote the book on my case. My own problems were severe, you could hear my jaw pop when I chewed, even 10 feet away. Once my jaw dislocated while I was talking and it took me half an hour to get it to shut. Fortunately I never had headaches. The cause was an uneven bite, the treatment (which is now fairly widely accepted) is “equilibriation.” This is a procedure to correct malocclusion, which just means your teeth don’t meet evenly when you bite together, one of your teeth is higher than the other. The treatment consists of biting on carbon paper while you have thin plastic spacers between your front teeth. This way, only the highest points on the teeth are marked. Then the dentist grinds down those high points. Now your teeth meet a little more evenly. Alas, your teeth aren’t anchored firmly, and they move around slowly as you chew and bite down. So it takes a few treatments a week or two apart to get things into “equilbrium” (thus equilibriation). Once you get into this condition, wear on the teeth tends to stay in the same pattern and your bite doesn’t change much. I was cured for about 25 years… until an overly agressive dentist ground too hard while cleaning my teeth and screwed up my bite. I found a good periodontist (!!) who was expert in this TMJ problems and has done some more treatments on me, and he’s really inexpensive too. He says my bite is really sensitive and a malocclusion of just a few microns can cause me agony. This round of treatment, I started having severe migraines, and a very small dose of a common generic drug (amytriptylene) helped quite a bit. But it was just a stopgap until the equilibriation was finalized.
Anyway, this treatment won’t cure everyone’s problems. If you have more severe malocclusion, like totally misaligned or crooked teeth, you might need braces to straighten things out first. Some people’s problems are so severe it requires major surgery but I recommend you try everything before trying an irreversible alteration of your body.
One device I’ve not tried is the “night guard” which is a plastic device to stop your teeth from grinding at night. Most of the stress on the jaw muscles and TM joint is caused by grinding during sleep (everyone does this, you can’t prevent it from happenning). Many people say this device has cured them, but I think it just prevents the grinding without dealing with the underlying cause. I wouldn’t know, I’m just guessing since I’ve never tried it.
Anyway, if you have severe TMJ problems, you really should consult an orthodontist or other TMJ specialist. Many of these are real shysters and charge too much. I hope you find a nice guy like my periodontist who actually charges me $35 per treatment (total of about 6 treatments so far). Also, try to find someone who is a relatively recent dental school graduate, or is committed to ongoing education. This subject wasn’t taught in dental schools until very recently, and the TM Joint is such a complex structure, their knowledge of its function is still being researched.
It seems like everyone with TM joint problems has to become their own doctor to some extent, I’ve researched it quite a bit, so if you have any further questions, let me know.
As a CDA (Certified Dental Assistant)I have to state you are correct to ask your dentist. that said. The mouth guard will not corret the TMJ problem, just keep you from grinding or gritting your teeth. This does hepl prevent quite a bit of pain. There are other appliances out there that will help shift your jaw into the correct position, if this is the problem you have. However a lot of things that dentists use to help people who have TMJ problems can not be used while you have braces. The braces may be causing some of your problems because they are causing your teeth to shift. Because your teeth are shifting constantly, your bite is also constantly changing and your poor jaw doesn’t know where your next occlusion is going to be. As suggested, find a dentist who really is up on the latest treatments for TMJ problems. Don’t be afraid to go to as many as you have to to find one that is right for you. It is not unusual for X-rays to be taken, and impressins of your teeth. The dentist may want to see the impressions of your teeth before you had the braces put on. Your orthodontist may still have them. Keep in mind that there may be no real cure for your problem, just a way to help most the pain. I hope in your case that something will be done for you.
I’ve been dealing with this for a while. I suggest Advil and plenty of it. Ralofin is good too. I use that when my jaw locks up so bad I can’t eat. Yay. I thought I was cured on one side, but my Ortho told me that I was just permanently out of joint. I get awful headaches.
Cure? I dunno. I’m going the braces route. Dealing with the pain? Anti-inflammatories, avoiding the food and activities that bring it on. Sucks, don’t it?
I broke my jaw when I was 18, found out when I was 31, and have had TMJ issues throughout (crushed the bursa, misaligned the right upper mandible leg). The serious pain has a warning stage for me, when the joint feels “gritty”. I take very much care when that feeling appears, avoiding chewing or opening my jaw much. I’ve been unable to chew for days at a time when I have ignored those signs, so the learning curve is very sharp. I feel it every day, but it doesn’t hurt every day. Surgery isn’t worth it for me right now, but is an option if it get too bad.
I’d suggest investigating other drugs. As far as OTC drugs, I found Naproxen to be the most effective, and I tried them ALL. Also, amytriptylene is an anti-inflammatory, it’s also prescribed in higher doses as an antidepressant, but my doctor said he took it when he tore a ligament and had chronic pain for a while. It takes a while to build up in your body, it might take a week or 2 to take effect.
Oh… One other thing, absolutely make sure to sleep flat on your back. The only time I have problems lately is when I roll over and sleep on my side or face down, and I push my jaw out of alignment all night.
I second that. I spoke to several dentists who didn’t seem to know anything about TMJ. Finally I looked in the phone book and found one that specifically advertised treatment of TMJ disorder.
I never had any jaw problems until last year, when I started to get very frequent popping and clicking in my jaw (while eating), which was usually not painful but was very very annoying. My dentist fitted me for a mouth guard which I wore at night for a few months. The problem gradually went away, and now I rarely have the clicking and I don’t even wear the mouth guard anymore. This does not mean that this is the right treatment for you, of course, but it is a possibility.