Jaw problems. Dentist or Doctor? Who do you trust?

Factual Questions
1

I have suffered from a chronic condition for most of my adult life.

It was finally diagnosed as being sinus related, causing excrutiating headaches.

(Been to all kinds of doctors, had all kinds of tests, been given all manner of meds) The most successful med turned out to be a head cold remedy, which is what brought everyone to conclude it was a sinus issue.

I’ve even had sugery, (nose job), but to little advantage. I can breathe better but still have these wicked headaches.

Well, as this has all transpired over 25+ years, I’ve pretty much adjusted to it, as best I can.

Truth is I count myself lucky that I stumbled upon a med that actually alleviated the pain, I knew there were plenty of other people who suffered and never discovered what exactly was the cause.

So here’s the thing, I went to a new dentist last week. (I checked this guy out, he’s the best in the city by all accounts, including the Dental School at the University.) He took one look in my mouth and his first words were about the misalignment of my jaw, and the fact that I must be quite a clencher.

Well, I was stunned. He stepped behind me, I was reclined, put a finger to each side of my jaw, and said does it hurt here? Yeah, every day, all the time, I thought it was just connected to my sinuses. He was speaking very casually but said the wear on my teeth really told the tale. I asked how it was that my SO hadn’t notice in 16 yrs that I grind my teeth. He said, you don’t grind, you probably only clench.

He gave me some information to read and I have been surfing the web reading everything I can find.

He wants me to get a thing to wear at night to correct the alignment, cost about $250. That’s a lot of money for me, though it would be worth ten times that if it works.

I’ve been on this search long enough to know that disappointment is always a possibility. People with chronic conditions are always waiting for the one piece of information that will bring it all into focus.

Since leaving his office I have made a conscious effort to be aware of clenching my teeth, and sure enough it’s like a really bad habit.

Since I have been trying to break this habit (a couple of days now) I have noticed a real difference in how my sinuses feel to me, something I am also conscious of on a daily basis.

My question is if you had a problem with your jaw would you consult your doctor or your dentist? Would you confirm the diagnosis with the other?

Is this a medical issue or a dental issue?

2

Elbows, I don’t want to freak you out, but I know a lady whose jaw basically dissolved. It was a very, very serious degenerative condition that required extensive surgery.

If you have jaw problems, I have no idea why no doctor ever figured that out before - I don’t believe it’s a terribly rare condition. But jaw problems can be a very serious and can get worse over time. I think you should be grateful for your dentist for pointing you in the right direction – and then get your face to a doctor. Do some research to find one who has experience with degenerative jaw disorders, and get it checked out. (Your dentist, if he’s as good as you say, should be able to talk to you about all of this and maybe give you a referral.)

Hopefully it’s just an issue with clenching, like your dentist said. But if it’s causing you a lot of pain, I’d make sure it’s not something worse.

Best of luck, elbows!

3

Sounds like you’ve got a “TMJ disorder” (Temporomandibular Joint). These disorders can be affected my many factors, and are not well understood by many doctors and dentists. I’ve suffered from this condition for many years, and I was lucky enough to find one of the world’s best dentists right at my local university, who took me on as a test case. In my case, the problem was due to uneven occlusion, which is a condition where your teeth don’t meet evenly and it puts stress on your jaw and facial musculature due to uneven bite. My dentist ground down the fine little tips of my teeth that were sticking up too far, he had me bite on carbon paper to see where my teeth hit together, and then ground them down. But you have to be careful not to go too far, you can’t really undo overgrinding. And your teeth shift around after treatment, so you have to go in for tiny adjustments, it took me months. I had a total cure for about 20 years until another dentist came in and messed up my occlusion again. Now I’m having my occlusion adjusted again.
Anyway, the “night guards” are pretty effective, from what I hear. Stress reduction is also very effective, stress seems to be the major aggravating factor in clenching and grinding.
If you need to consult a professional, I’d suggest finding an orthodontist, particularly one with recent training. The whole issue of TMJ treatment is relatively new, and still developing.

4

If you don’t trust your dentist, try an “orthodontist” or a “maxillofacial surgeon”. One of them may refer you to the other. Make sure the dentist and the specialist share information.

5

<Personal anecdote disclaimer>

I’m a lacrosse player, and I just took a shot off the jaw (damn C2 helmets), that really rattled me. It felt as though my lower jaw was knocked out of lateral alignment. So I gave my folks a ring, because they’re both MDs. They told me to have a DMD take a look at it if it continued to trouble me, as DMDs tend to have more knowledge of jaw joint problems.

Now, I’m assuming that the DMD was recommended merely for basic diagnosis, and that there do exist specialists in jaw surgery who would be the people doing the actual work were any needed. However, unless you can find one of these right next door for an optimal second opinion, it sounds as though you might want to talk to another DMD for a second opinion as oppposed to going to an MD.

</Personal anecdote disclaimer>

-ellis

6

My name is Myron, and I’m a clencher.

I used to wake up most mornings with an ache in my jaws and the back of my head. It got worse and worse and then one morning I woke up with my jaw out of line on one side. I couldn’t open or close my mouth.

I went to the walk-in clinic first, and they said it was an infection of a salivary gland (after a bunch of insinuating questions designed to see if my condition was due to someone having SLUGGED me or not) and gave me antibiotics. I was like yeah, but how can an infection MOVE MY JAW OUT OF LINE?

Fortunately two mornings later it was back in place. My dental checkup came up a week later, and sure enough, when I asked him to check, my dentist found evidence on my tooth surfaces that indicated clenching and grinding. So I did get the night thingy, and it does work.

If you do get the night thingy, elbows, make sure you dedicate yourself to wearing it for the rest of your life. It snaps tightly over your teeth, and if you don’t wear it regularly, it won’t fit any more, and you’ll have a $300 piece of useless plastic.

So anyway, regarding your OP: My doctor knew squat, my dentist fixed the problem.

7

I have TMJ (which I agree it sounds like you have) and the plastic guard (my dentist called it a splint) didn’t do much for me over the two years I wore it; it basically kept things from degrading until I could get surgery. Luckily they no longer have to open up your face to fix the problem, they just use arthroscopy.

[anecdote]
The night I was admitted for surgery someone (the anesthesiologist?) came around to do an ECG and a few other tests. He was surprised when I told him I was having arthroscopy on my jaw. It was practically unheard of in Toronto at that time. Now it’s everywhere. Supposedly I talked throughout the surgery, even with my jaw immobilised.
[/anecdote]

Ten years later I have only a little, infrequent pain, although I have to be careful with chewy or hard foods (“Sorry, I can’t eat that bread, the crust’s too tough.”) I’m also very careful playing my flute, and I never put billiard balls in my mouth anymore.

8

…for all you input.

I have made an appointment to see my physician on Thurs, she’s been treating my headache for many years, and has been helpful with my search for answers.

I return to the dentist early in February.

Since he alerted me to this I have become very aware of how often I am actually clenching.

I now catch myself, whenever I am concentrating on anything, clenching my teeth. I had no idea!

Since I’ve begun to conciously break this cycle my mouth/teeth/jaw/sinuses feel entirely odd.

When I do, unconsciously clench, my teeth feel kind of like when you stand up again after being off your sore feet for a little while. Does that make any sense?

Suo Na: how did you know you required surgery? Doctor? Dentist?

9

You could cut to the chase & see a maxcilliofacial (sp) surgeon. They should give an estimate for free, but call first.

If your jaw is too small for your mouth, they can cut it apart & refit it. Cool. You get your jaw wired shut for a couple weeks & drink some liquid food.

10

My husband had TMJ and was sent to an orthodontist and ended up with braces. He should have had them as a kid, but his mom couldn’t afford it. He was told at the time that straightening his bite could relieve the pressure on his jaw enough so that the deterioration would slow down or stop. They didn’t recommend surgery–the orthodontist told him that it was often not very successful. He still wears a retainer.

11

I do both especially in stressful situations. I also have been diagnosed with TMJ, but cannot afford the surgery involved. TMJ, according to my dentist, has been declared a medical condition, not a dental one. However, my insurance feels differently and will not cover the maxio-facial surgery to correct the problem.

I’ve noticed a distinct difference in the onset and amount of pain involved when the weather changes and my sinuses act up. The best thing I’ve found in those situations is to take a liberal amount of Excedrine Migrane. It dulls the pain.

Further, you may be clenching or grinding your teeth as you sleep. I have done this for years and wake up with pounding headaches and aching jaws. Sometimes I have to force myself to fall asleep with my mouth open just to offset my urge to do this.

Get to a surgeon and quickly. Before your jaw starts to creak and pop. You get a lot of really odd looks when you make those noises when you yawn.