TMJ

Parent Cafe
1

Does anyone know how TMJ is normally treated? what kind of dentist can treat TMJ? What educational background and experience should I look for?

Yes, I have googled and talked to dentists, but I am interested in knowing other people’s experience.
DD’s teeth was not too bad. A few years ago, the orthodontist recommended Invisalign, but DD seldom wore it and she began to complain jaw pain. The orthodontist ignored her complaints, eventually she was given a night guard. During a visit to her dentist, she complained to the pediatric dentist who told her she has TMJ, and recommended her to another dentist. I didn’t like the dentist as I was his patient hence I have to find another dentist.

2

Despite having people with all kinds of expertise on this forum, when I had a family member with TMJ there were maybe two others on the forum who had some experience with this problem.

We spent over a year and visited over a dozen doctors of different kinds (dentists, oral surgeons, “TMJ” specialist dentist,s chiropractors, and physical therapists - never made it to the neurologist, therapist, or physiologist that were recommended at various times). Paid thousands in treatments including expensive day and night appliances, muscle relaxants, NSAIDS, rounds of blood work, various x-rays (although never got an MRI or SCAN), props (foam roller, exercise ball, heel lifts, and back support pillows), stress reduction classes, and blenders to make liquid foods. I also lived on the internet googling and desperately searching for answers (advice - never believe medial information on Reddit - that is the worst).

The good news is that my family member is fine and can eat everything and lives without pain (there was about 9 months where they couldn’t open their mouth more than a finger’s width.)

What I know now is that for many TMJ (and it is really TMD - TMJ is the name of the joint) is a symptom of something else not the originating problem. In my family member’s case it was caused by an undiagnosed case of whiplash from a fall (with a slight concussion which was diagnosed). The jaw pain, limited mouth opening, and aura headaches came months after the fall, so the link was not obvious. The treatment was PT which strengthened and fixed neck and shoulder muscles. A very good PT (there had been several before her) figured it out by doing a complete evaluation of her body. The family member will continue to do exercises to keep these muscles in shape forever.

TMD is typically not covered by medical insurance companies because they don’t identify it as a medical condition (some dental plans do the same).

Given all this, my recommendation to you is to go to a TMJ Dentist as a start, because it sounds like the bite is causing the issue. We had better luck with general dentists who treat TMJ patients, instead of those affiliated with medical/dental schools and TMJ research. Call a dentist or orthodontist who you do respect and ask them who they recommend for their patients with jaw issues. In my cause, I had a dentist who said your issue is so bad he sent me not to the TMJ guy he usually recommends but instead the guy that that TMJ specialist sends his toughest cases to.

I will tell you that a pediatric dentist told me that he sees lots of TMD in his practice and stress is definitely a part of it.

GOOD LUCK to your DD - I hope you have a shorter journey than we did. Feel free to PM if you want.

3

See www.tmj.org mayoclinic and many other TMJ sites. The healthboards med forum is full of people with TMJ.
Some home remedies can give some relief. The exercises and jaw stretches help a bit. During an acute episode soft foods only. Avoid stress.Hot or cold pack for on site pain relief, wrap the pack always in a soft cloth never direct skin contact. Do not sleep sideways on the TMJ jaw if both jaws are affected avoid any side contact. Hope you find help soon. Perhaps your local hospital can recommend someone. The all around the skull Xray to see both jaws and the joints connecting jaws to skull here in EU the oral surgeon/jaw surgeon does that. Our regular dentist do not have that Xray machine because of expensive cost. That Xray is important they look at it in bigger view see what is happening.
Sometimes TMJ is combined with some form of arthritis. In older persons like women in menopause you have TMJ with osteoarthritis. Some people have flare-ups some people have constant TMJ. The mouth guard many people of all ages do not wear them because it feels like gagging and is disturbing in mouth and disturbs sleep. I try to write this I am sure I forgot some useful tips…if I remember anything else I will add more in another post.

4

@dwhite @1214mom anything else to share from you TMD experiences? These were the two who replied when I asked about it back in 2015

5

I’ve seen a dentist and a chiropractor. I’ve had it on and off since I was in college. For sure stress and clenching make it worse. During one bad flare I was on heavy duty muscle relaxers and pain meds, the pain can be excruciating. I do think ice and a hot wet rag help. The chiropractor also helped me, but he had special training in tmj, not just a run of the mill person. I’m guessing a shoulder/neck massage would help as well. I would sometimes have hubby use his fingers and just press into my jaws around my ears.

6

I agree with @eyemamom about seeing a chiropractor specifically trained in tmj. Son was diagnosed with mild tmj after he got his braces off. Jaw clicking, pain and some locking. He started seeing the special chiropractor once a week, then every two weeks, then gradually less often. Now only once every 3 months unless it’s acting up.

The major trigger for him is gum chewing. If he stays off the gum, he has very few issues at all.

7

Hi there. You have gotten great responses thus far. Similar to @kiddie - my son’s experience was quite the journey lasting several years and including many specialists, scans, PT, acupuncture, etc.etc. He presented with severe headaches (in back of head) and it took months to finally figure out the actual cause. He does have bad bruxism, which is (we believe) the cause of his issues and stress definitely plays a role.

Good news is, he is doing much, much better. He wears his mouth guard religiously and will go to the TMD specialist to have it “tweaked” if he starts to have an issue. He also has exercises he learned in PT and will periodically take a low dose muscle relaxer at night if he feels a flare coming on.

Feel free to PM me if you would like more info.

Best of luck!

8

I have a type of TMD but I don’t remember the exact label. It’s partially connected to my connective tissue diseases and partially from grinding my teeth in my sleep since I was a kid.

What has generally helped me:
-night guard. Not the thick plastic (?) ones that the dentist makes for you but the soft, moldable ones you can pick up at a local CVS. The hard ones made my jaw sore. I usually go through the soft night guards once a month or so but it’s so much better. I am in excruciating pain if I somehow forget it.

-motrin or alieve. Just general NSAIDs are usually enough.

-If not, I take flexeril. It’s a muscle relaxer that helps dull the pain.

Good luck!

9

I actually had good results, not bad, from going to a dental school specialist. The local treatment specialist, an orthodontist, wanted to do surgery but I wanted a 2nd opinion. Next time that I visited family, I took myself to a specialist at a state flagship dental school.

He gave me a list of things that might help and assured me that it was OK to try alternatives and if warranted, have surgery later. He pointed out that he probably saw more TMJ cases in a week than the guy at home saw in a year.

I don’t remember all the things on the list but the “cure” was physical therapy with someone with special training, which I didn’t expect to find in my rural area, but was pleasantly surprised. The Rx was for 6 weeks and I felt that really encouraged the PT to zero in on the most effective approach. I ended up with exercises that I did religiously for over 10 years before slacking off. It was about posture, habits, relaxation, etc.

I also got some massages and maybe did some yoga. The TMJ has stayed at bay. Occasionally if it seems to be creeping back, I will start exercising again and consciously relaxing my jaw especially while going to sleep. Night guards are useless for me. If soft, I chew right through them. If hard, they protect my teeth from chipping but do not relieve the torque on my jaw.

10

Tagging on to what was just said - TMD treatment should start with those easy fixes, chiro, PT, mouth guards, mild drugs, etc. Very, very few people end up needing the extreme treatments such as surgery.

11

I was treated back on the 1980s, and I remember it being called TMJ syndrome or something like that. I couldn’t open my mouth very wide, and I don’t remember other symptoms, other than chewing gum exacerbated the symptoms. I wore braces and bands for quite some time, but all has been fine for decades now. I was treated by an orthodontist.

12

I had a root canal in my 30’s that I did not need by the small town dentist because of jaw pain.

I found out through a colleague’s teaching me self hypnosis that I clench. I have been to a number of specialist since but none of their appliances fit in the end. My best dentist is a general one and somehow gets it right. The one that truly fit has recently literally deteriorated! as it was 15 years old and used for even a nap. (I bite my lower lip as I fall asleep and clench my back teeth in general). During that tIme I had a specialist make two that did not fit,

My last appliance was a super difficult adjustment as I had a reaction to the material. My wonderful dentist was upset with me and had no idea why. A close friend who is a dentist simply asked me what I ate or drank before bed–ginger tea–and I stopped and the reaction stopped.

I takes a lot of perseverance to get a guard right but they do last for years. No one can tell you that
an appliance is comfortable or not. And even when you get a good one there can be periods where you grind or clench anyway. I get headaches and a jaw ache when things are off. I agree stress is an enemy.

Good luck!

13

One of our dentists recommended a Prosthodontist. He does not specialize in TMJ, and we will be meeting him this week.

14

With all my TMJ research I have never heard of a Prosthodontist before, but it looks like most of them include TMJ related issues on their specialties list. Let us know how this works out.

15

I am nervous as I had experience with a few bad dentists.

16

TMJ problems can range from just noise to severe pain et al. I talked with oral surgeons when I was an anesthesiologist for their TMJ surgery cases. Reading posts here I see myriads of causes and experts to see. OP- getting a recommendation for an expert from one of the dentists you trust is the way to go. Teen compliance- sigh…