Tmj???? I Think

Hi Jodester,
Yes, you can have TMJ without a CT Scan showing anything wrong. The disc (meniscus) of the TM Joint is made up of cartilage and it changes position when opening and closing your mouth. Frequently what happens is that the disc gets "trapped" forward when the jaw (mandible/condyle) opens and closes. That is the clicking or popping sound that you are hearing - the rubbing of the bone (condyle) against the disc (which isn't supposed to happen). Even when you have TMJ, sometimes the disc does not get trapped. (And the clicking/popping can happen without any other symptoms or pain of TMJ.) What a finicky joint it is.

So, when you had the CT Scan done, it depends on whether your mouth was open or closed and if the disc got trapped or not. The pain usually comes from when the disc got trapped and the surrounding muscles started to spasm. These spasms may continue even after the disc has returned to its proper place.

I highly recommend that you do not "play" around with your jaw. By that I mean, don't push your bottom jaw forward. It is very important to take special care of your jaw for the next several weeks, maybe, the rest of your life. Following is some important basic self-help information:

Get enough sleep and good sleep. Keep relaxed from the head down to your toes. Go to nismat.Org tmj physical therapy page so you can see a picture of how not to hold your head and body. I'll come back to this again.

Use lots of moist heat and/or ice.

Use ibuprofen, if you can, for pain and to reduce any swelling. Use up to 800 mg if you feel the need. Do not take motrin/ibuprofen on an empty stomach and even though I don't know the exact amount, I wouldn't take more than 1600 mg a day.

Certain supplements are also very beneficial. Chelated magnesium (or just the regular stuff) can be very helpful if you are clenching and/or grinding your teeth at night. Up to 1200 mg a day. Super vitamin b complex is another great one. You might even try glucosamine, fish oil, calcium and vitamin d.

Anti-depressants can be very helpful for TMJ pain. It sounds crazy, but it does. If you don't want to find an anti-d that works for you (not all will), you might try St. John's wort. It's supposed to be a "natural" anti-d.

Always check with your doctor about any vitamins and supplements that you plan on trying before you start taking them.

Relaxation. Stress. Posture. These are TMJ's biggest enemies. Please believe me. I've gone through this for 27 years and rejected the stress and posture theories when I first heard about them. What a transformation when I finally made the changes. Even with all the damage done to my joints, the pain is now very manageable. Seriously!! Use any method to de-stress or relax that you can - hot tub, exercises, Yoga, massage therapy, etc.

I'm trying to keep this short, but it's just not working. There are a few more important points I feel you need to know. Sorry.

*** Be very selective with what you eat. When you are going through a bad phase - only liquid or softer foods for a few weeks (or months). A good idea for the next several months or years - no gum chewing, hard, crunchy, chewy or gooey foods. Treat your mouth like it has been sprained (like a knee). Baby it. Rest it and that does mean to talk as little as possible. Believe me, I understand the enormous inconvenience of tmj.

More - be careful about opening your mouth wide for a long period of time and please, please try not to pop your jaw. I know the feeling, the compulsion, the need to pop the jaw when it feels like it is "out-of-joint," but you must try and resist this as it will cause damage to the joints. Big time damage. The crackling you hear may be the start of arthritis, so please be very careful.

I have to go back to posture as this is so very important with the computer age now. Evaluate how you are sitting in front of a computer or desk. Your back should be reasonably straight, shoulders back and down, neck and head over body with the chin down (not too far down). Be very careful to not thrust your neck/head/chin up or out towards the computer to see the screen better (or any other reason). No slouching. Go back to the nismat.Org (tmj pt) website again for more directions on proper posture and good basic info on tmj.

I'll stop here as this will get you going in the right direction I think. TMJ can be "fixed" or managed. I wish I had known and/or followed through with this information when I was younger, it might have made all the difference in the world. The damage is now done, but thank God, the pain is now very manageable.

If you have any questions, please feel free to post them here. Support sites can be wonderful resources (just always be discerning). I thank God for them myself.

God bless...
Carol

Hi Carol

Thanks so much for your comments. It is so reassuring to know that I can manage this......and I WILL. I have to it has become such a nuisance in my life and I am going to get on top of it.

I will put into practice everything you have said, and hopefully I will start seeing some changes.

I have only a few days ago started on some Anti depressants so hopefully that too will help.

The information you have given me is priceless, and I thank you so much for listening.

THANK YOU, THANK YOU, THANK YOU.

You're Welcome!

I wanted to add a couple more suggestions, if you don't mind. Here goes -

1. Depending on what kind of anti-d you are taking, SSRIs can cause clenching issues. Prozac (an SSRI) was a God-send for years until a few years ago when my TMJ just flared up big time. I read some reports on the Internet (and they were reliable sites) that if you are taking an SSRI, you might want to consider adding a small dose of Buspar (I take 7.5 mg) if you notice clenching or pain. Supposedly the other anti-d types, MAOI, SNRI, Tricyclics, etc., don't but the SNRI are a newer drug.

2. Holding my mouth. Important, I can't believe I forgot this. You should try holding your mouth with the teeth apart at all times, lips together relaxed (or slightly apart) and the tongue resting on the roof of your mouth. It took me years to get this part habitual. I do notice when I tense up, my teeth start coming together. I have to fight that urge and sometimes win and sometimes lose.

Okay, that's all. You will be able to do this. Don't get frustrated and don't give up seeking help. Too many doctors just do not understand TMJ.

Take care and God bless...
Carol

hang in there---there is hope. even if you opened the joint most of the time it would look normal. ct,s mris and xrays arent all that accurate. i was told this week that an mri is only 20% accurate. get to a good tmj doc and tell him everytning make sure that he listens. if he wont listen there isnt much point in goint to him. if you nee d help finding a good doc let me know and illhelp you.

The Anti D I am taking is called Zoloft I'm not quite sure if it is one that you suggest. Is Buspar available over the counter?

I was also considering seeing a dentist about getting a splint for night time. What do you think?

Also I had a pain in my temple which started on Monday and has lasted about 3 days now turned into a full blown headache. Woke today with it gone. Is this a symptom of TMJ, does anyone else get these types of headaches from TMJ. At the same time I started getting the headache I also started my menstrual cycle??? What about hormonal changes????

Oh and I have been really trying hard to keep my mouth open at all times like you said, its hard to get into practice but I will persist.

Thanks so much for your advice, I truly appreciate it.

THANKS AND GOD BLESS you Carol.

Yeah that would be great. What do I look for to find a good Doctor. I am in Australia. Any hints I should now when trying to find a good TMJ Doctor, I wouldn't know where to start.

Thanks for listening.

Jodester

Hi Jodester,
Zoloft is a SSRI like Prozac. If you think you are clenching or grinding your teeth at night, ask your doctor about including a small dose of Buspar (Buspirone). It is not available over the counter here but it is a cheap drug. You would not take the normal dose of Buspar, which is an anti-anxiety drug usually not used with Zoloft or Prozac. But just a small dose of 7.5 mg at night will usually work well together to stop any bruxism issues.

Your headaches sound exactly what I used to have when I had periods. Every month I'd get a one-sided temple headache that almost killed me. My TMJ usually went crazier than usual too. After years, we did discover that the migraine medication Zomig worked miracles on those types of headaches. This is a drug that has to be prescribed.

Regarding dentists or doctors to look for - a dentist, orthodontist or oral surgeon would be your primary TMJ doctor who would make bite splints, etc. He/she should be someone who spends a lot of their practice helping TMJ patients.

I need to put a warning here. An orthodontists wants to straighten teeth and an oral surgeon wants to cut people. That's a crude way of saying it, but be careful here. Orthodontics and surgery can be useful, but they are irreversible and that is scary in my eyes. One of the best bite splints I ever had, though, was made by an orthodontist. He was a wonderful man.

You may have to do a lot of calling before finding one. Consider the first appointment like an interview - you are interviewing them. They should be a very positive person who emphasizes conservative methods, I believe (conservative methods are primarily what I gave you in the long posting plus bite splints, physical therapy, etc.)

You may also need to find a doctor who will prescribe pain medications to you. Some dentists will and some won't. My family doctor now prescribes the Vicoprofen and Zanaflex that I need sometimes for pain. A neurologist initially prescribed the Zomig and Lyrica, but now she handles everything.

And the last person on your team might be a physical therapist or a massage therapist. Both should be trained to work specifically for TMJ sufferers.

I hope this answers your questions. Remember to watch your posture and relax. Teeth apart, shoulders relaxed, no stress. (I'm asking for a lot, aren't I?)

Take care and God bless...
Carol

Thanks Carol you are a god send, I have been trying to maintain everything you have told me, and guess what I am feeling a lot better, still not 100% but a massive improvement on how I was feeling.

I spoke to my oral surgeon the other day, and he to said that I need to fix the stress in my life first, then see how I go, then perhaps I may need a night splint.

Thanks so much for your wealth of knowledge on TMJ, I am not going to let it take over my life.

You are a god send, thank you thank you thankyou.

God bless you Carol

Jody

Hi Jody,
I partially disagree with your oral surgeon. Yes, reducing the stress should be a major priority, but if you are grinding or clenching your teeth at night, you need a bite splint ***NOW***. You will always have stress and yes, we can reduce our stress, but we should also get all the help we can and the splint can be a great help. Since your OS has this attitude, I would talk to your dentist to see if he makes splints or has an associate who does. Bruxism is not only hard on the jaw joints, but the teeth as well. I know some grinders who have broken their teeth. Please look into this.

I think it's great that some of my suggestions have helped. My shoulders are so tight right now that I need to take my own advice and see a massage therapist for a few weeks. I had stopped going and my TMJ has been doing well (still is), but my left shoulder is a killer.

I hope you are continuing to do well. You need to be your own medical advocate, so fight for that splint if you are having problems with bruxism.

God bless...
Carol

You do need a splint to save your teeth if you grind them down to a pulp you wont have them any more. Im getting on to findind you a doc in australia. ill be back in a few. if you want to you can email me


Ok here are 2 docs. call them and make sure that they are neuromuscular dentists as they are the best. They are the only ones that were able to help me. let me know how you get on.

Hart Dental
Chris Hart
141 Queen Street
Brisbane, 4064
Australia
Phone: 61-7-3221-727

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Lake Dental Pty Ltd
Paul Holliday
Suite F7 Professional Level 235 Forest Lake BLVD
Forest Lake, QLD 4078
Australia
Phone: 0738798999
smil e@lakedental.com.au
www.lakedental.com.au

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If these dont work for you give me your postal code and ill get right on it for you.

email me or pm me anytime that you want. And im sure that after Carol gives me a swift kick in the pants she will say the same thing.lol

Hi Dyan

Thanks so much, its so good to hear from others who care.....I so appreciate all your comments.

Unfortunately though those doctors are in QLD and I am in Mornington Victoria 3931. If you know of anyone in Melbourne Victoria that would be fantastic.

I am feeling a lot better since taking the anti D but still not right, still have jaw pain, little tender to touch, some ear ache........oh I forgot you know what else.

Anyway thanks so much for your help and comments, its so good to talk to people who know exactly where I am coming from.

Take care and thank you.

Jody

try this http://www.me dlanddental.com/dental-associates.php

and ill keep up on this too.

here is another one
http:/ /www.brisbanelaserdentist.com/dental-assoc iates.php

Jodi - are you able to take ibuprofen (motrin) for pain? If you can, I would take 600 to 800 mg every 4 to 6 hours (not on an empty stomach). Also, when your jaw aches, that is when to use the moist heat directly on the jaw. You'll be surprised (well, hopefully).

Take care and God bless...
Carol

Thanks for all your advice.

My doctor has just increased my dosage of Zoloft from 25mg to 50mg.

I want to make an appointment with my dentist to look at having a night splint made for me. I woke last night with my teeth clenched together.

What is your experience with splints? Have you benefited with one? I'm thinking of going to see a chiropractor too.

Take care and thanks again for all your support.

Jody

Thanks for all your advice.

My doctor has just increased my dosage of Zoloft from 25mg to 50mg.

I want to make an appointment with my dentist to look at having a night splint made for me. I woke last night with my teeth clenched together.

What is your experience with splints? Have you benefited with one? I'm thinking of going to see a chiropractor too.

Take care and thanks again for all your support.

Jody

I personally have benefited from bite splints. The one I have now is the best one I've had. It's thinner. That really makes a big difference to my small mouth. It's also a bottom one, which I didn't think I would like after years with a top one, but it's great! Try and stay away from bulky ones.

There are different kinds of splints. Top and/or bottom, sleeping or all day. I don't know them all to list here but the most common are flat plane (most used I think) and repositioning which usually means there is going to be more done to your teeth later. I have a modified repositioning bottom sleeping only one. About a year after starting with it, my teeth were filed to balance the bite, but just a very little bit. I don't usually recommend teeth filing or shaving until you are pain free and absolutely sure your teeth aren't going to shift anymore and only a little bit needs to be done.

But, I have to warn you. Not all bite splints are made equally as well as they should. Some splint makers are just not as good as others. You might be able to find out if your dentist is good if he has a lot of TMJ patients. Usually that means he is well liked and has had lots of practice.

Once you get a bite splint, it is important to have it adjusted. Usually frequently at first and then it tampers down. In my opinion, the dentist should not charge you extra for adjustments, but I guess some do. Mine never have.

***.A good bite splint maker and adjuster is worth his/her weight in gold.***

Jody - I hope the increase in Zoloft helps but don't forget about the SSRI clenching problem and possibly adding 7.5 or less mg of Buspar.

Take care and God bless...
Carol

im pming you the name of a good doctore the closest to melbourne victoria that me and my team could find.

im pming you the name of a good doctore the closest to melbourne victoria that me and my team could find.

Hi Dyan

Thanks so much for your help with the Doctor, unfortunately though it is about an 11 hour drive from where we live....doh

I am seeing my doctor today so I will ask him if he knows of anyone in Melbourne Victoria, who specialises in TMJ. I did do a search on the internet and found a woman doctor who has a special interest in TMJ disorders, so I will see the chiro tomorrow then maybe make an appointment to see her, depending on what my doctor has to say.

Thanks again

Jody