I developed TMJ, TMD, TMJD pain whatever you want to call it in the fall of 2007 and I’ve only rarely had a pain-free day since it started. I hear a lot of people complain about it but mine is very, very painful I think its a lot more severe than most people who have it. Stress, strenuous physical activity, and staying awake for long hours without sleep obviously exacerbate it so I try to minimize things that make it worse but sometimes there are things in life you just have to do that make those things unavoidable. I had bruxism in my sleep which made things really bad and I also had a severe malocclusion of my teeth.
I’ve had to endure braces, wisdom teeth removal, and two jaw surgeries but I believe the grinding of my teeth has been resolved which has made it better because now my teeth are aligned properly and my wife said I don’t grind my teeth in my sleep anymore. But I still have this pain and it travels down to my neck, upper back, and shoulders. I take something every day for pain, I took so much Ibuprofen I developed a stomach ulcer at one point but I treated it and it has gone away but I still face the tough choice of being in pain or taking anti-inflammatories daily that may have bad long-term consequences.
I have also taken Tramadol for the last couple years consistently and other narcotics infrequently and these are the only thing that truly relieve my pain but I don’t want to keep taking them as they have their own obvious pitfalls and haven’t in a few months, I’ve just been taking steaming hot showers and using NSAID’s daily but they only help so much and I’m scared of getting another ulcer or some other negative side-effect.
The thing is I’m still in braces for some minor tweaking till at least the end of the year but they are adjusted every 3 weeks and I also have to have the rubber bands on them and these forces pulling on my teeth are extremely aggravating and make the pain worse.
Has anyone else gone through this with the braces, do you think once they finally come off maybe the pain will resolve since I won’t have the constant pressure put on my teeth and the occlusion of my teeth will be proper? I know some people have perfectly straight even teeth and still have tmj so its no guarantee but I’m hoping it will improve. Is there anything else I should try or ask the doctor? I’m frankly sick of taking medication of any sort for the pain but eventually it gets to a point where I can’t take it anymore and I have to take something. I won’t be able to use any kind of mouthguard because it will mess up everything the braces have fixed and the grinding aspect I believe is no longer an issue.
Did your dentist actually say you won’t be able to wear a mouth guard? I would think you must. How could it possibly mess anything up? If nothing else, it’s molded to your teeth and would keep them from shifting. I would think part of your problem right now is that you’re unable to wear one due to the braces, no? Just because grinding can’t be heard doesn’t mean it’s not happening. Also, clenching and the pressure just from that will aggravate the TMJ and cause enamel damage.
My dentist worked on me for a couple years to convince me the mouth guard would make a difference. Bruxism here, not TMJ, but damn once I agreed to it, what a difference. Lost the enamel on two molars before I was convinced, though. I clench. Hard. Less during the day now that I’m aware, and stopped chewing gum as that seemed to encourage the clenching (besides, gum chewing makes whoever’s doing it look stupid). But if I take even a nap without the guard these days, I wake up with sore teeth. I’ve never made a grinding sound.
I would think muscle relaxers would help while you sleep, too. If you want to try something that’s not narcotic. Hopefully someone with more pain management knowledge can chime in on that one.
I’m sorry you’re going through this. Chronic pain is no joke.
I have had two courses of braces over the last 18 years and 3 mouth guards inbetween. No idea why your doc doesn’t think you can have one after braces. They most certainly do not mess up alignment!
My night guard doesn’t focus on clenching but it has a large lump coming down under the front teeth that keeps my jaw from sliding backwards when I sleep. Even if my mouth is open. Actually I think they call it a ramp.
Come to think of it, I had a ramp permanently installed at one point. As in, a piece of plastic fused behind my front teeth that my bottom teeth fit in to. I guess it helped me keep my lower jaw forward for a while.
IMHO you shouldn’t be in so much pain still after work but you do need to see where you stand once this adjustment is finished. Then keep on your doctor to get you adjusted more, get a night guard or do whatever it takes to get you out of pain.
By the way have you ever tried a TENS machine for pain? It is a device that sends electric pulses through muscles. Usually used in large muscles like shoulders and legs but they can be used on the jaw. There is info online about using it in the treatment of TMJ to relax the muscles to get a specific type of cast of the teeth. There is also some stuff about using it just to relax the muscles when the patient has pain. I recently had the idea that I would like to use one when I had dental work done (cleaning, filling) because lying with my mouth open in the dental chair wrecks me physically for a day. My dentist approved and prescribed me a machine ($30) and I had a physical therapist show me how to use it properly, and I used it during a filling last week and it was a great success! I felt fine all day, no lasting aches and pains.
The only deal with a TENS is that you’re not supposed to put the pads “transncrainial” - around the head. But the PT told me that meant not on either side of the brain. But if you put one pad in front of your ear on the cheek and the other on the back of your neck (4 pads, 2 on each side) then you avoid the brain. That is what i did and that is what works for me.
ANYWAY…see if your dentist can get you a TENS machine as a therapy device. Something to relax your muscles when you can’t do it yourself, or when the dental work is giving you a problem.
And again keep working! Don’t let the dentist tell you he/she is done if you are still in pain! Get a custom made night guard.
Good luck. TMJ pain is whole body pain and is awful. So are ulcers.
I’ve had TMJD for the last four years. I too rarely have a pain-free day, even with medication.
Acupuncture has been a godsend for me. I won’t get into the debate of whether it is woo or not. I don’t really care. I went because I felt like my head was being crushed in a vise 24/7, and I couldn’t handle being in chronic pain like that anymore. I was desperately trying anything. Every “normal” doctor I went to did nothing about it. After my first acupuncture appointment, most of my pain went away. I can often go for months now without having to go for treatments.
The other thing that helps is physical exercise and time away from computers.
There is a physical therapy method developed by an engineer who took a biomechanical approach to how the muscles and skeleton interact and move. I don’t remember what it’s called (though if anyone wants to shout out guesses I will probably recognize it if I see it).
In any case, I have a friend who has some training in this, and last time I had a major (MAJOR) TMJ flare-up he offered to help me out. Basically, the idea is to get the muscles moving in the fashion that they are supposed to – so instead of clenching/grinding, or trying to force yourself to relax the clenching/grinding, you do some simple movement exercises.
For the jaw, just move it open, closed, over and over. Don’t force anything, pay attention to the movement but don’t try to “correct” how it moves. After a few repetitions, open your mouth, then move your lower jaw forward, then reverse the motion and shut your mouth. Try to keep the motion fluid. After another few repetitions, open your mouth, move your lower jaw forward, then move it right, back to center, left, back to center, then move it back and close your mouth.
You wouldn’t think this would make a difference but oh my god it was amazing. The muscles loosened up not just noticeably but by several orders of magnitude. I had to do the exercises multiple times daily for a while, but these days I only do it as needed. Useful trick to pull out whenever the tension is getting to you, and you can do it anywhere (as long as you don’t mind the occasional weird look on public transit. )
Try visiting a pain management specialist. S/he might identify problems with the trigeminal nerve brought on by the TMJ/TMD problem. They also will work with you to find non-dental treatments.
I also have TMJD, but no braces. I would think the pain will at least improve once you don’t have them putting pressure on your teeth. Part of my problem is clenching my teeth at night and I haven’t found a solution to that other than trying relaxation exercises so I’m not as tense at night.
Braces or no, you may want to speak with a TMJD specialist about mouth guards. I’ve been told by more than one that mouth guards are specifically not recommended for people with TMJD, but regular dentists don’t seem to know much about it. Some mouth guards come with instructions that also recommend not using them if you have it. They supposedly make the pain worse for us, but I’m not clear on why exactly.
As best I can tell from talking to dentists and trying to do research, there’s not much to be done other than surgery and avoiding everything that exacerbates the condition, but most insurance companies won’t cover surgery and the ones that do (or dentists that will do it) will insist on various treatment hoops before even considering it. Unfortunately, most of those treatments (like mouth guards) tend to just make the problem worse.
My teeth are relatively straight, but I developed TMJD almost 10 years ago. It’s a frustrating condition, exacerbated easily. All I’ve been able to do for mine is be mindful of pressure on my jaw or how I hold it, and anything that could make it tired, so I don’t eat chewy food and I sleep kind of strangely, sort of on my side with most of the head support above my jaw. It helps. If I don’t do that I’ll wake up with my jaw stuck closed and a migraine the rest of the day.
I had TMJ when I was younger (had to manually move my jaw to open my mouth sometimes) and a physiotherapist figured out that it was caused by a tight muscle in my neck. It took a number of different chiropractors, physiotherapists and massage therapists but I finally found a chiropractor who fixed it. Haven’t had an issue in years. Maybe try some different chiropractors?
The reason I’m pretty sure I can’t wear any type of mouth guard is because I had two surgeries to correct an apertognathia or “open bite” google images of open bite and you’ll see what I mean, my teeth all touch now but at the time it was only my molars. I had to spend thousands of dollars and endure a lot of pain to correct my bite but it was worth it to me. Even if you have surgery to correct your bite your teeth and muscles will try to revert back to your old bite that’s why you need a removable or permanent retainer after the braces come off. I really don’t want for the last two years to be all for nothing and have my bite relapse and a mouth guard keeps your teeth apart and supposedly there have been cases where they created an open bite in someone who didn’t have one before using them.
I guess it wouldn’t hurt to ask my orthodontist anyway as he should be able to answer that question for me but I think the mouth guard option is off the table. I may look into some kind of biofeedback device but I’m not even sure what type of practice you would go to for that.
My first night guard after braces just sat up inside my upper palate and there were wires that stuck out around my teeth to hold it in place. My teeth touched 100% on the side. In the front I had a “ramp” like I talked about in my last post, just to keep my lower jaw forward. And like I said I also had a permanent ramp at one point, to keep my jaw forward. Nothing kept my other teeth from touching, but keeping my lower jaw forward was key.
My new dentist just has me in a tray-type mouthguard (with a ramp), and it keeps my teeth from touching. But I think because she doesn’t have the same skill my old dentist had.
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