TMD can bite me... if it could get its jaw open to do it!

Miscellaneous and Personal Stuff I Must Share
21

This part isn’t agreeing with what I’m reading and have been told. Yes, some people have a bite problem that leads to a jaw problem. That’s definitely true. But it looks as though other people (like me) have a jaw tension problem that leads to a jaw problem that leads to a funky ass jaw problem.

At least, that’s how I’m understanding what I’m reading and heard from my dentist–that I don’t have an underlying bite issue (he said it would show up on my teeth and doesn’t) but that I have, in essence, a behavioral issue that is causing me to do something that is overstressing my jaw.

Do I have the wrong end of the stick?

22

I had TMJ, starting with just an odd clicking that seemed to surface right before I got a cold. It was probably due to a buildup of fluid. Then I could make my jaw click on command and it could ruin a perfectly good yawn. My dentist did the fingers-in-the-ears test and it made him jump! I had no related pain, and for that reason he suggested no invasive treatment. He prescribed the hard plastic night guard, which seemed to help. I stopped wearing it after having a crown put in – the idea of popping the night guard in over my “new” porcelain tooth just squicked me out.

I haven’t had the popping in years, and never had any pain beyond the occasional ruined yawn. But now my husband complains about my snoring, so I’ve got a snore guard.

What’s a snore guard, you ask? Why, it’s two TMJ night guards, upper & lower, joined by a strong rubber band. The idea is to pull my lower jaw forward. Hubby says it’s useless.:frowning:

23

This really doesn’t seem like the case for me. My bite was fine for many, many years until one morning, amidst a period of great stress and whilst taking a medication known to cause bruxism, I woke up unable to close my bite. My teeth didn’t move overnight. My TM joint did. And my bite changes throughout the day as my muscles contract and my joint moves. So it seems to me that an orthodontist can’t make my teeth move multiple times per day to adjust to that.

Now, I do have a muscular issue, that’s true. I’m looking into ways of dealing with that. I saw a physical therapist who specializes in this, though, and didn’t respond as well to the therapy on the muscles as most of his patients.

So I’m looking at next steps. And I’m wondering if surgery can pop my jaw back into place, because it’s clearly slid forward. Maybe that’s not the right way of conceptualizing it, but after a couple of months of agony, that’s my fantasy.

On the reality side of things, I’m looking at all options.

It threatens my ability to earn a living, as I’ve developed debilitating migraine headaches since this all started.

And a dentist is in the business of selling TMJD appliances, and crowns, and braces, etc. They’re all out to make money. I’m wary of all the folks trying to sell me an alleged cure.

All I know is, my dentist has already proposed the following:

–Physical therapy: cost me $600. They told me it rarely cures the bite problem.

–TMJD appliance: $1500 estimate. Dentist said it rarely cures the bite problem.

–Crowning all my teeth in back so bite can close or building them up with composite: many thousands of dollars, and damage to very healthy teeth. Dentist admitted that since my bite changes daily as the jaw moves, this is isn’t a great solution…yet he’s willing to do it anyway.

–Braces: thousands of dollars. Again, same problem as above. Yet they’re willing to take my money and do it.

I’m wondering if surgery can take my money AND cure me for about the same amount my dentist proposes to take without offering up much hope of a solution.

I’m just very deeply frustrated.

24

I posted my TMD experience at another board back when I was going through it. The consensus there, as well, was to avoid surgery until every other avenue had been completely exhausted.

The consensus was also to seek out a specialist, versus just your dentist.

25

I have had TMJ and bruxism as long as I can remember, I solved the problem when I was broke and had no insurance by training myself to sleep with my mouth ajar. I still click, and at times it sounds like I am eating chips but it only hurts occasionally.

26

I think the problem with going after the joint when it’s a muscular issue is that the joint, the actual point of movement, isn’t where your jaw is fucking you over. It’s the muscles around your joint which are tugging your jaw out of whack.

If it’s the same feeling I had yesterday and (much less) today, it’s absolutely horrible and I completely understand how desperate you must feel. Seriously, that’s one of the worst feelings I can ever remember. As I told Asimovian last night, it was a feeling of intense WRONGNESS that just made my brain rebel. I could bite down one day, then the next day my jaw didn’t align and it was absolutely horrifying.

Okay, so if what’s going on in there is imbalance and spasming and distortion to the joint caused by the muscles because they are so stressed that they are just completely out of sync, that doesn’t seem like a likely candidate for a surgical fix. Even if you could do something surgically to the joint itself, if the muscles are the cause, they will just hurt the new joint. At least, that’s how it seems to my very amateur eyes.

Okay, so if muscles are inflamed, spasming, stiff, or otherwise recalcitrant, what makes sense? Probably the same things that make sense if you have other muscles that do the same thing. Rest, hot or cold therapy, massage, anti-inflammatories, muscle relaxants, diet, careful use/stretches. The night appliance is supposed to help with rest. Hot or cold packs for the therapy. Massage is something you’ve already seen. I don’t know if you’re on any anti-inflammatories (I’m on 3 Advil every 6 hours as per dentist recommendation now) or muscle relaxants. Diet might matter in two ways: My dentist recommended soft foods so I could avoid too much chewing and if it’s anything like charlie horses or the like there are nutrients that make muscle spasms less likely. F’rinstance, I drink a daily Powerade usually to avoid charlie horses, but I didn’t drink my daily allotment this week because I didn’t have the flavor I like and I just realized this and if Asimovian is reading this he’s going to scold me. Eek!

Anyway, I’m just trying to throw out some ideas for you. I definitely am not trying to claim I know all about this, but I hope there’s relief out there soon.

27

To address both jsgoddess and QN Jones at once - as far as I know, the only surgery there is is to get your cartilage replaced, shaved or fixed. So when QN says “I just want surgery!” and then “there is nothing wrong with my cartilage!” then I say “er well you probably don’t want surgery.”

I do realize that it can feel life-threatening…like I said I’ve been suffering from TMJD for 14 years. I’ve been there where I couldn’t open my mouth for days on end. I’ve been there where I couldn’t open for just a day. It does keep me from talking a lot and it does make me feel absolutely awful a lot. As I said just 2 days ago I felt like I fell out of a tree.

But I’m not going to wake up dead from TMJD, ever. It’s not life threatening.

I was told right from the start that there’s no “cure” for TMJD. I read several things that agreed with what I was told. It’s something you manage, like diabetes or hypertension or sciatica.

I woke up one day with TMJD too. My ear hurt, my teeth hurt, my jaw hurt. It got really bad over a few weeks. Not like I got punched in the face and was out of alignment. Not like my cartilage got a chip in it and all I needed was a new piece.

It came up the last month of summer when I was working 14 hours a day and about to leave home for the first time to go to college. And it got worse as I went through the first few weeks of college. Think it can be brought on by stress?

I got the thousands of dollars in braces and orthodontics. It helped. I know it helped because I went to passed out on the floor to having a life. Then I had to do it again, as I was warned. And then I had to do more, as expected.

If you really think that since it came on quickly that you’ll just get it fixed quickly, then good luck. I hope you find the cure you’re looking for.

28

It feels like it’s both the joint and the muscles that have issues, but I can’t know that for sure. The physical therapist says my masseters are some of the worst he’s ever felt. But I’ve also suddenly got a lot of popping in the joint that was never there before either.

Desperate is the right word. I started getting migraine headaches after this started, so the whole thing is really debilitating.

And I keep smashing my teeth together. Like you, my dentist always told me I had pretty teeth. Now I literally have nightmares that I’m going to accidentally crack and chip them all until I’m toothless. Before this, my bite was fine.

I’m trying some of those things. One of the complications is that my GP is kind of terrible about accommodating patients with emergent issues and I haven’t been able to get in to see her. Finally will on August 1, so we’ll see what she says. I’m doing some of the stuff you’ve recommended now. The Powerade thing is interesting. Maybe it could help with the muscle problem. I’m not really allowed to take OTC anti-inflammatories without consulting my doctor first, so I haven’t been taking any. I’m pretty sure the answer will be that I’m not permitted.

I’m definitely going to explore getting the appliance. It’s just that possibly making the malocclusion problem worse freaks me out.

All I want is a little relief. :frowning: I’m just wanting information about every option out there, and am so frustrated that, for the first time, there isn’t straightforward information about a medical problem that I’m having.

29

I got my appliance this morning. I never had braces or the like so when he was taking it off I thought it felt like he was taking my teeth off, too, but after a couple of times I got more used to the sensation.

I’m mostly better in any case. Still some morning pain, but my teeth mostly mesh and I can chew again. Whee!

QN, any relief at all?

30

Mine is slowly returning to baseline popping/cracking after wisdom teeth extractions but not quite there yet. The horrible persistent muscle ache is gone but if I want to take a bite of anything large I have to stop and think about the necessary movements first or else it’ll stick halfway. And a hot dog was pushing its limits over the weekend.

jsgoddess, did he make you bite on pieces of blue paper to see if the fit was right? I think I had to go back every day for a week as it adjusted to bite on some more damned pieces of paper. Such a fuss!

31

Yeah, I’m a lot more aware of what’s going to happen now if I open my mouth too wide and try to be wary of doing it too quickly, though I’ve been caught a few times without thinking about it.

And yes, there were MANY little pieces of blue paper. When he first put the splint in, essentially only my right lower canine could touch without my forcing it, so there was a lot of trimming and grinding, thankfully it was of the appliance, not my teeth!

32

I have suffered from TMJD for about 15 years. However, mine seems to present quite differently from what most of you are describing.

In middle school, I was sent to an orthodontist to check the alignment of my teeth. He declared my teeth straight, but one side of my jaw is shorter than the other. For some reason, this was a problem for him and he convinced my parents to pay to have an appliance made that would pull the short side forward. I am convinced that this was the genesis of my TMJD.

My symptoms are mostly nerve-related. The trigeminal nerve runs through the TMJ and clearly it is being impinged on the right side of my face. Usually it presents as ear and neck pain. As with others, I’ve gone to the doctor more than once absolutely certain I had an ear infection, only to be told otherwise. Physical, emotional or mental stress will make the symptoms worse. At its very worst, the right side of my face went numb. That was fun. I do click, but I’ve never had any kind of locking.

Over the years, I’ve found that ibuprofen therapy works for me. Basically, when the pain kicks up, I start taking 3-4 ibuprofen, 3 times a day and keep that up for a couple of weeks. That stops the pain and gives enough time to ease the inflammation. Heat or cold also helps, as does avoiding triggers (gum, whole fruit, stress, etc.). A nurse once suggested using a blowdryer on the pain, but I’ve never tried that.

My interpretation of the surgery option is that it should be a last resort because its chances of working are so slim. More than 50% of surgery patients have no change in pain or even more pain. :eek: Plus, you have the cost and risk of surgery. With those chances, it really is worth looking at all of the other options first.

33

Been there, done that and paid through the nose to one of the top prosthodontists in the country. Wore graduated appliances for a year while my muscles were retrained (the later appliances had bonding material in and on them to build up the appliance) and then had extensive crowning done to keep my jaw (and teeth) in place.

Prosthodontist was very up front with me. He said it would take two things to fix, time and money. It was worth every penny.

Don’t waste your time and money on a regular dentist, orthodontist, etc. Go to a prosthodontist. It’s like screwing around with a family doctor and an ob/gyn when what you need is a heart surgeon. All the good intentions in the world won’t make them into what you really need.

34

Thank you for asking. This has been such a crummy day, stress-wise, that just someone asking if I’m feeling any better just seems really nice. :slight_smile:

My masseters have actually un-bunched the last few days. Rarely do I have any tightness there. But my bite is still as messed up as ever. The lack of discomfort makes this easier to live with, for the time being.

Unfortunately, I have spent $2000 on this problem in the last 2 months, and can’t afford to spend any more on it for quite some time. So no appliance for me in the near future, whether it costs $500 or $1500. I’m sleeping with a drugstore bite guard every night.

Thank you for this advice. I will check it out.

Does anyone know anything at all about neuromuscular dentistry? I hear them mentioned in the literature on TMJD, but am wondering what peoples’ experiences are with them.

35

Yes, the best ones are also prosthodontists.

This is not the one who did my work, but he is a prosthodontist and neuromuscular dentist.

http://www.garygreendentist.com/tmd-treatment.html

36

Thanks! Good to know. :slight_smile:

37

I don’t know if you’ll consider this good news or bad, but I’ve done a couple of nights with my splint and it’s definitely no miracle cure. I was mostly better already, and I don’t think it is hurting anything, but I’m not seeing any magic.

I do bring the sexy now, though. You betcha. :smiley:

38

Someone on here, I think, suggested a supplement of calcium, magnesium and zinc before each meal and it’s done me some good. So has avoiding steak, nuts, roll sandwiches, protein bars, licorice, gum, sushi (in the way you’re supposed to eat it), and corn on the cob. Basically, if you have to open your mouth wide to eat it you’ll aggravate your TMJ.

39

You mean “oo bweccha!” drool :wink:

40

I had an episode of not being able to open my jaw properly when I woke up this morning - I blame you and this thread, jsgoddess. :slight_smile:

I do sleep with a splint every night for my clenching and grinding - I think I was having a really grindy night last night.