TMJ or something else?

I'm not the best person to ask but the nerve they numb up for dental procedures is a branch of the trigeminal nerve. I had trigeminal neuralgia in addition to PMR. My trigeminal neuralgia symptom at the worst was unimaginable facial pain. A dentist couldn't even touch my face without causing severe facial pain when trigeminal neuralgia was active,
https://www.mayoclinic.org/diseases-conditions/trigeminal-neuralgia/symptoms-causes/syc-20353344
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While trigeminal neuralgia isn't treated with Prednisone, my facial pain decreased when I took Prednisone. It was hard for me to accept that it wasn't somehow linked to PMR. I referred to trigeminal neuralgia as my "inflammation alarm." Trigeminal neuralgia was more active when PMR was active,

I had brain surgery for trigeminal neuralgia. The neurosurgeon said it was a vascular problem but not anything like GCA. The neurosurgeon said he did the best he could to fix the problem but now the entire left side of my face and scalp including my left eye and the left side of my mouth are all numb. The neurosurgeon also said that Prednisone was probably helping the inflammation in the area near my brain stem where the problem was.

My “TMJ” started with sharp pain too, when I was eating a cookie! The pain became excruciating, like a terrible earache. After several courses of antibiotics for what was thought to be an ear infection, it was determined to be a TMJ issue. I truly believe it is still part of this whole PMR problem. My rheumatologist believes that also.

How are you doing now? Are you able to open your mouth without discomfort?

Oh my goodness, I’m so sorry you went through all of this! It certainly makes you wonder if the two conditions were related?!

Dentist here:
Inferior Aveolar nerve block, given for dental/surgical procedures on the lower jaw, can on occasion damage the inferior alveolar nerve ( resulting in numbness in the lower jaw on injection side) or the lingual nerve ( resulting in numbness in the tongue on the injection side ) . Post op paresthesia or dysesthesia in many cases is temporary lasting up to six months.
Post operatively the nerve stops transmitting effectively , in order to heal what may be damage to the myelin sheath surrounding the nerve, the most common injury.
Good injection technique can inadvertently result in injury to the aforementioned and rarely in severing of the nerves, with resultant possible permanent damage. (very rare, never had such in 33 years of practice)

A patient calling later in the day or the next day complaining of persistent numbness would be advised to limit function, take over the counter pain medication or prescribed pain medication , and return to the office if the feeling did not return within 48 hours.
Follow up treatment of persistent numbness may involve a number of treatment modalities.
often in consultation with an oral surgeon.

On occasion a person may experience a sharp electrical "shock" upon injection , which is a "direct" hit on the a nerve , also associated with good technique in that the operator' s technique has located the nerve directly.

On a personal note I have PMR with GCA , have had many dental procedures since being diagnosed.
Jaw stiffness I experienced post op I attribute to holding my jaw open for an extended periods of time.
One would be well advised to ask your dentist to give breaks often during dental procedures in order to close up the mouth and relax the jaw muscles.
My take is the paranesthesia the original contributor describes is not related to PMR but more with the dental procedures per se.
Cheers

In retrospect ... I think the common denominator was inflammation. It doesn't really matter what diagnosis you have because inflammatory pain isn't good wherever it happens.

Trigeminal neuralgia is associated with multiple sclerosis (MS) which is also an autoimmune condition involving nerves. I didn't have MS but I certainly had trigeminal neuralgia.

My rheumatologist hardly ever referred to any specific diagnosis although she said PMR was my primary diagnosis. More often than not she referred to my condition as "systemic inflammation" as if the inflammation had no boundaries.

I think we would all be better off if the focus of treatment was to treat the inflammation and not a diagnosis. There are many mechanisms that can cause pain from inflammation. They are referred to as "inflammation pathways" that are regulated by a complex network of cytokines. For PMR/GCA the IL-6 cytokine is implicated the most.

In my case the medication that blocked the effects of the IL-6 cytokine also has stopped my PMR symptoms. It was more complicated than that but I'm much better than I was. At least my symptoms have stopped which was something prednisone never accomplished in more than 12 years.

I had a similar experience in just one side of jaw- stiff and clicking
but it resolved itself after a couple of weeks. All my seasonal allergies increase PMR- I think the idea of systemic inflammation may be a reasonable approach to weathering this condition.