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Pammy (@pammyl66)

TMJ questions

Ear, Nose & Throat (ENT) | Last Active: Mar 6 12:23pm | Replies (39)

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I have been a Dental Hygienist for 44 years. Sadly, I see many patients with TMJ of varying degrees. I have suffered with TMJ for 30+years. I have 2 night guards. One for night time & another more flexible guard for daytime.This daytime guard is flexible but still snug enough so as not to interfere with talking. And we dental hygienist like to talk !!
When My pain is not resolved by wearing a guard I take ibuprofen. I have tried “Mobic” but it does not work as well for me. I have taken Zanax but for me it is just a temporary fix. I also apply a topical ointment for pain & swelling “Pennsaid”. I do feel that my anxiety leads to “clenching”.
So often I do not realize that I am feeling anxious untill my TMJ begins to ache. Clenching sounds like such a harsh word. Our teeth can only tolerate the pressure we use while eating. So…any extra pressure on the teeth & surronding muscles,tendons & fibers is irritating.Thus leading to irritation of the Temporal Mandibular Joint (TMJ). Various things can lead to clenching….Chronic Pain and even Weight Lifting ! I did consult with an orthodontist but was given no guarantee that Braces would alleviate my TMJ.
At the beginning of my career we did not wear a mask or gloves !!! So,while cleaning teeth I tried to keep my mouth closed for esthetic reasons.Unknowingly,my upper & lower teeth where in contact. Just an example of unintentional clenching.
Many anti-depressants can cause “Bruxism” (grinding,clenching of the teeth). This is a term that is unfamiliar to many physicians.
Wow,that was “a mouth full” !!! I will keep you updated on any new findings. AND I will keep you in my prayers.

The best tips I have received in my 35 years of having TMD is to keep my tongue on the roof of my mouth, when I am not talking or eating. I also do not allow my back teeth to touch while I am awake. It takes practice, but over time it helps a lot. I see a physical therapist who focuses on my jaw, and I do morning “exercises.” Heat helps. If you are in the market for a custom mouth guard, search for a dentist who uses computers to analyze the strength of your entire bite; chances are you may be favoring one side or the other. If your dentist utilizes only the colored wax strips to customize your mouth guard, go elsewhere. There are new technologies that not every dentist has in their office. It is worth the extra expense to analyze your bite and get the most perfect mouth guard available to you. Additionally, some teeth surfaces may need to be shaved lightly, or a lot, but it makes all the difference in the world to the pressure on each joint. Orbital xrays and cervical MRIs can identify if you have developed arthritis in the TMJ, or determine if a disc in the joint is flat, stuck, or bulging. It can get expensive, because typically these expenses are covered under dental, not medical, insurance. My TMD causes me immense migraine pain. My neuro, PT, and dentist are all in touch with each other and they coordinate my treatment. If you do not need a neuro, your primary physician can order the MRIs, which should therefore be covered under medical insurance. Only certain muscle relaxants work above the neck, such as baclofen and tizanidine. For years I took cyclobenzaprine (flexeril), which is useless because it does not work above the neck, according to my neuro. You may need to research then educate your caregivers. Keep searching for the right PTs and dentists. My TMD is still not well-controlled, but we are working on it. Botox in the TMJ muscles and e-stim are also very helpful. The muscles become tight or frozen after years of TMD. These last two procedures get the muscles moving and relaxed. Good luck everyone!

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