TMJ questions

Posted by Pammy @pammyl66, Jun 7, 2015

I clench my teeth at night which has resulted in severe TMJ. I have seen dentist, ortho and medical doctors. I am on Zoloft to help reduce stress and I have a custom mouth guard. My problem is none of this is working. I find if I wear my guard I seem to clench harder, if I don't my tongue has teeth imprints on the end from pressing against my bottom teeth. I don't know what to do. This is miserable pain in jaws, neck and ear pain and headaches. My jaw locks up from time to time and my throat even gets sore. Muscles and probably gets scratched because I can't chew my food properly. Please Help! This has been going on well over 2 years....

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Profile picture for lauriedr @lauriedr

I have had TMJ since I was pre-teen, but not treated until college when my jaw locked up. I have worn a mouthguard for 30 years. About 15 years ago, I began having episodic migraine, which I haven't had since I was a young teenager. The migraines became daily and chronic 10 years ago. I am now 50. I had to quit work at 40 and am still fighting for disability benefits. For daily migraine, some of which is caused by TMJ, I receive botox, trigger point injections, Rf nerve ablation, counseling, psychiatry, acupuncture, biofeedback, PT, CT Scans, MRIs. I see a specialized dentist and take many supplements, herbs, essential oils. My neuro suggested I see a particular PT, and it has given me 1-2 low-pain days per week! I do daily jaw exercises, and put heat on my jaw, near my ears. I have a ThermaZone machine that provides heat. Cold is not recommended on the jaw joint, but I use the cold setting of ThermaZone on my eyes and forehead for head pain. An MRI recently revealed arthritis in my jaw, as well as lower in my back, along with buldging discs. The jaw arthritis is one of several causes of my migraine, ear pain, jaw pain. My dentist used computer imagery to test my jaw, and half my jaw was doing all the work. Using the computer, he was able to precisely file down ever so slightly problem areas on the tooth surfaces; he evened out my bite and jaw so that both sides worked equally. My neuro prescribed baclofen and tizanidine. The cyclobenzaprine (flexaril) I had been taking apparently doesn't work above the neck. The PT, heat, and meds worked for a while, but I had to give up my long-term custom mouthguard because, coincidentally, my teeth started rapidly shufting. I now have invisalign braces (traditional braces would have stressed my jaw too much.) I have had to stop wearing my mouthguard, and my jaw hurts now a lot more. But my PT is adjusting treatment, and we are working to get back on track. In 2 years I will have my teeth and jaw re-calibrated by the computer, and I will get a new mouthguard for clenching. I no longer get a 1-2 days/week reprieve from migraine, but in the long-run I should do better. A good habit to develop is to always have your tongue itouching the roof of your mouth at all times, except while eating or talking. Also, try not to have your back teeth touch top-to-bottom, That will help you not clench during the day. Try baclofen and tizanidine to relax your facial muscles. Tizanidine is a strong muscle relaxant that kicks in immediately; instant sleep. It can also cause hallucinations in high doses, so start slow and if you are bothered by side effects, your neuro will help you taper down safely and carefully to a manageable dose. I worked my way up to 4 Tizanidine at bed, then cut back to only 2 pills. I take 2 baclofen pills 4x/day. TMJ does not "go away." I thought mine had disappeared thanks to the mouth guard, but it simply shifted from facial pain to severe, debilitating head/ear pain. The dentist also did a 360 degree xray, and he also could see the arthritis in the jaw, as well as a stuck, flattened disc. I get botox in my jaw joints now, and a practitioner uses dry needling and e-stim (electric stimulation) in the muscles of my jaw. The dry needling did not work well for me, but with e-stim, my jaw muscles twitch away. They have been frozen for so long, they need help learning to move again. TMD, the new way to refer to what used to be called TMJ, requires many specialists depending on symptoms. I go to a pain clinic, specialized dentist, neuro (who specializes in headache), PT, and practitioner of e-stim. I am on pills for anxiety, depression, muscle relaxants. I take narcotics twice per week, and migraine-specific abortive and preventative drugs. I was told by neuro NOT to see a chiropracter, as there is a risk of stroke when the neck/jaw is involved. The PT focuses on muscles and joints, and gently massages my jaw from the inside and outside of my mouth. She manipulates my head and neck gently with stretches. I wish you all the best. TMD is a serious, debilitating illness, that is not often covered by insurance. I use a combo of medical and dental insurance, plus out-of-pocket expenses. I hope my story helps you.

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Wow. I too was diagnosed with TMJ in my 20s because my jaw locked up a few times while just talking and eating. I did go to the dentist but nothing in particular worked except learning biofeedback and rubbing the jaw. I’m now 67 and my dentist fitted me with a mouth guard on my lower teeth I was told I should contemplate wearing it throughout the day. I haven’t tried this yet but after my last visit he informed me that my jaw has now become arthritic thus the nagging ear and neck pain. I was on all types of meds in my 30 and 40s but including gabapentin and 200 mg of celebrex which gave me GERD. So Tylenol is the one of the only meds I take now along with 100 mg of celebrex and intermittent flexaril to relieve the muscle spasms in my shoulders and ultimately jaw. I don’t know if any other methods to alleviate the pain so hope it doesn’t get any worse. I know I’m kidding myself. God bless and I pray we find something that will help the pain and osteo degenerative process.

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Wow. I was on Zoloft fir about 20 years and weaned myself off the drug over 5 years ago. I take Wellbutrin generic now. I’ll definitely talk with my physician about this when I see her next month. Thank you for your information.

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Profile picture for lustarr @lustarr

Wow. I too was diagnosed with TMJ in my 20s because my jaw locked up a few times while just talking and eating. I did go to the dentist but nothing in particular worked except learning biofeedback and rubbing the jaw. I’m now 67 and my dentist fitted me with a mouth guard on my lower teeth I was told I should contemplate wearing it throughout the day. I haven’t tried this yet but after my last visit he informed me that my jaw has now become arthritic thus the nagging ear and neck pain. I was on all types of meds in my 30 and 40s but including gabapentin and 200 mg of celebrex which gave me GERD. So Tylenol is the one of the only meds I take now along with 100 mg of celebrex and intermittent flexaril to relieve the muscle spasms in my shoulders and ultimately jaw. I don’t know if any other methods to alleviate the pain so hope it doesn’t get any worse. I know I’m kidding myself. God bless and I pray we find something that will help the pain and osteo degenerative process.

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@lustarr Welcome to Mayo Clinic Connect, a place to give and get support.

You've had this issue for a long time and I'm sure you have a lot of information and support to give.

It sounds like you have successfully explored many pain management options.

May I ask how you were able to navigate the system so well? Did your dentist send you to these treatments?

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After I was diagnosed with TMJ and was referred to a dentist to make a splint for my mouth, I got burning mouth syndrome. The oral surgeon thought I was just alergic to the acrylic splint. I could not wear a splint for several months. However, after many different doctor visits, that the burning mouth was triggered by anxiety. My doctor first prescribed Zoloft and I tried for only a few days and I was clenching my teeth harder. I quit that and my doctor tried me on Paxil....same thing. We settled on buspar but it doesn't really completely get rid of my anxiety. So I still get burning mouth but am able to sleep with the splint at night. My question is that my jar is still not right and would like to know if anyone has gotten TMJ surgery?

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Profile picture for trixie1 @trixie1

After I was diagnosed with TMJ and was referred to a dentist to make a splint for my mouth, I got burning mouth syndrome. The oral surgeon thought I was just alergic to the acrylic splint. I could not wear a splint for several months. However, after many different doctor visits, that the burning mouth was triggered by anxiety. My doctor first prescribed Zoloft and I tried for only a few days and I was clenching my teeth harder. I quit that and my doctor tried me on Paxil....same thing. We settled on buspar but it doesn't really completely get rid of my anxiety. So I still get burning mouth but am able to sleep with the splint at night. My question is that my jar is still not right and would like to know if anyone has gotten TMJ surgery?

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Sorry, I don’t have any suggestions/recommendations for your jaw/TMJ. However, I suffer from extreme burning tongue syndrome, have you found any solutions/remedies to help with the pain?

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Profile picture for 3315 @3315

Sorry, I don’t have any suggestions/recommendations for your jaw/TMJ. However, I suffer from extreme burning tongue syndrome, have you found any solutions/remedies to help with the pain?

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Do you wear an acrylic splint? The burning can be from an allergic reaction to the coloring in the acrylic process. I have tried taking alpha lipoic acid 600 mg daily but has not helped. I am in the process of finding a dentist that can make a hard splint with some other material. I am allergic to some metals like nickle too.

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Profile picture for 3315 @3315

Sorry, I don’t have any suggestions/recommendations for your jaw/TMJ. However, I suffer from extreme burning tongue syndrome, have you found any solutions/remedies to help with the pain?

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@3315, you mentioned burning tongue. You may wish to join these discussions:
- Burning Mouth Syndrome. I have it very severe. https://connect.mayoclinic.org/discussion/burning-mouth-syndrome-very-severe/
- Burning Mouth Syndrome (BMS): Anyone found any relief? https://connect.mayoclinic.org/discussion/burning-mouth-syndrome-2/

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Profile picture for lustarr @lustarr

Wow. I too was diagnosed with TMJ in my 20s because my jaw locked up a few times while just talking and eating. I did go to the dentist but nothing in particular worked except learning biofeedback and rubbing the jaw. I’m now 67 and my dentist fitted me with a mouth guard on my lower teeth I was told I should contemplate wearing it throughout the day. I haven’t tried this yet but after my last visit he informed me that my jaw has now become arthritic thus the nagging ear and neck pain. I was on all types of meds in my 30 and 40s but including gabapentin and 200 mg of celebrex which gave me GERD. So Tylenol is the one of the only meds I take now along with 100 mg of celebrex and intermittent flexaril to relieve the muscle spasms in my shoulders and ultimately jaw. I don’t know if any other methods to alleviate the pain so hope it doesn’t get any worse. I know I’m kidding myself. God bless and I pray we find something that will help the pain and osteo degenerative process.

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I was just diagnosed too with OA TMA in my right jaw! I am a 72 female. It does not hurt so much until I eat! Was told to chew on both sides, but how can you when it hurts? I was blown off by doctors and my dentist but found a "head, neck & TMJ" clinic near me. A CT scan showed it was OA. They also fitted me with a lower "splint". I hate it but am able fall asleep with it. I don't see how stretches will help since it is OA. Hurts to even open my mouth wide. Also hard to eat unless cut up very small.
I do ice it after meals and take 400mg of Advil at the end of the day. I also take 1500 mg of Glucosamine with 1200 mg of Chondroitin once a day. Not sure it does anything. Unhappy!

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I have tmj issues where my jaw is locking
I wear a mouth guard I got from a tmj clinic. I can’t eat much because of the locking.
I don’t know where to get help anymore

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I just posted but will add to it that I don’t have pain. I use heat and I did do tensing; which is not effective for me anymore.
I wear the mouthguard at night and I still feel the clicking
I just want relief!

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