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Old 04-12-2008, 09:10 AM   #1
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Voice and Speech Symptoms... what does everyone experience?

When this TMJ nightmare began for me, one of my first symptoms was not being able to say my "S" sounds perfectly and almost whistling when I did so. Then I had some slight slurring of speech going on. NOW I have voice fluctuations, I believe, where I feel like my voice feels tired, strained, sometimes my pronunciation of certain words reflect the tired, strained voice with words not sounding totally "on key" as well. I notice that it says "voice fluctuations" for a symptom on the master list, what does this entail exactly? What I'm talking about? What does everyone else experience? Something close to what I do with a tired, strained voice that sometimes sounds "off key" and if so, why on earth would TMJ cause this? Thanks.

 
Old 04-13-2008, 08:52 PM   #2
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Re: Voice and Speech Symptoms... what does everyone experience?

There can be many reasons to explain some of the symptoms you are experiencing - muscular strain and inflamation are fairly common with tmj as is shifting teeth and bite. The tongue plays an important role in that its a muscle and is used for speech and for swallowing. Its position and mobility is often affected by jaw and teeth positioning - so a shift in the latter can affect the tongues function which probably resulted in your difficulty in enunciating the letter "S" and the slurring. As for your voice fluctuation, - although this is just a guess on my part, it could be due to inflamation of the vocal chords due to tongue muscle strain or even neck alignment problems. It could also be releated to tonsils - if you have them - and/or the uvula. The uvula and hyoid bone (under the tongue) are often affected by tmj as well.

But of course, to be on the safe side, if you have not yet done so, you should consult with an ENT and an OS to be examined and make sure there are no other possible medical causes for these symptoms such as polyps or oral/throat cancer, etc.

 
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Old 04-14-2008, 03:14 PM   #3
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Re: Voice and Speech Symptoms... what does everyone experience?

Quote:
Originally Posted by Thelma-Louise View Post
There can be many reasons to explain some of the symptoms you are experiencing - muscular strain and inflamation are fairly common with tmj as is shifting teeth and bite. The tongue plays an important role in that its a muscle and is used for speech and for swallowing. Its position and mobility is often affected by jaw and teeth positioning - so a shift in the latter can affect the tongues function which probably resulted in your difficulty in enunciating the letter "S" and the slurring. As for your voice fluctuation, - although this is just a guess on my part, it could be due to inflamation of the vocal chords due to tongue muscle strain or even neck alignment problems. It could also be releated to tonsils - if you have them - and/or the uvula. The uvula and hyoid bone (under the tongue) are often affected by tmj as well.

But of course, to be on the safe side, if you have not yet done so, you should consult with an ENT and an OS to be examined and make sure there are no other possible medical causes for these symptoms such as polyps or oral/throat cancer, etc.
Thank you for the excellent response.

I went ahead and scheduled an appointment with an ENT who diagnosed me 5 years ago with vocal cord nodules and I trust and like him, so I'll see him for this issue now as well. I know or at least I don't think it's nodules again because my symptoms are totally different than what I experienced 5 years ago. Anyway, my appointment is Friday morning so that's not too long of a wait.

In the meantime, thanks for the great explanation of what's causing my S whistling and slurring stuff. That makes so much sense.

Questions:

I noticed in the mirror today that my jaw when I open it widely shifts to the left, I mean my entire face seems to lean to the left more and coincidentally my tongue even is crooked and leans to the left as well, I assume because everything else is shifting that way too? Is this common for TMJ sufferers? When I went to my neurodentist I don't think he commented on this much, I should have asked more about it though I remember showing him my crooked tongue and he seemed unimpressed though he did say "Huh yeah" or something like that but that was the end of his response.

Also, when "voice fluctuations" are listed as a symptom of TMJ, does this fall in line with the strained voice I'm talking about, the slight hoarseness? Is this a common complaint by TMJ sufferers or is this probably unrelated to TMJ and something all together different?

I just find it so odd that my speech went from the S whistling, to the slurring a bit, then to this mild hoarseness. I feel like it all has to be connected so that's why I'm interested in figuring out if this all goes back to TMJ. Of course ruling out other causes like you nicely pointed out is a no brainer, thus the Friday appointment, but until then I would love to figure out if this could all possibly be tied to TMJ and I guess the main way of finding out is seeing if anyone else experiences this too who has TMJ.

Thanks.

Last edited by Mich5; 04-14-2008 at 03:20 PM.

 
Old 04-14-2008, 04:51 PM   #4
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Re: Voice and Speech Symptoms... what does everyone experience?

[QUOTE=Mich5;3530938]
Questions:

I noticed in the mirror today that my jaw when I open it widely shifts to the left, I mean my entire face seems to lean to the left more and coincidentally my tongue even is crooked and leans to the left as well, I assume because everything else is shifting that way too? Is this common for TMJ sufferers? When I went to my neurodentist I don't think he commented on this much, I should have asked more about it though I remember showing him my crooked tongue and he seemed unimpressed though he did say "Huh yeah" or something like that but that was the end of his response.[QUOTE}

Yes - this is fairly common - I have the same thing going on the same side as you. My tongue was the first clue something was not right. I noticed it was aching on the lower left side kind of underneath and on the side of it. B/c I had several crowns on that side I attributed it to them being too bulky and not allowing my tongue the mobility it needed. I also had problems with certain words and letter combinations such as "sc" and "L's".

[QUOTE]Also, when "voice fluctuations" are listed as a symptom of TMJ, does this fall in line with the strained voice I'm talking about, the slight hoarseness? Is this a common complaint by TMJ sufferers or is this probably unrelated to TMJ and something all together different? [QUOTE]

The hoarseness could be that you are unconsciously keeping your mouth open more often now - it tends to be a natural response when there is a problem with the mouth in general. Have you noticed any sinus problems, dryness,stuffiness or congestion (another thing fairly common with tmj) - if so then more than likely you are also sleeping with your mouth open and breathing through it as well which can account for the hoarseness. With regards to the voice fluctuations it occurred to me that one dr noticed that I could not raise my voice above a certain level - why? b/c my tongue was not positioned correctly and basically obstructed my air passage way - so I couldn't get enough air to expand my diaphram which allows the voice to be raised - perhaps what is happening with you is that you are not able to breathe while speaking (has your swallowing reflex been affected as well?) so your voice level fluctuates as you replenishh your air supply or swallow? If you are feeling that your voice is strained it could be you are not able to freely breathe while speaking w/o making a conscious effort to do so - if your swallowing reflex has been affected - this may be why you are not able to adequately and frequently replenish your air supply.

I hope you find the answers you are looking for - are you being treated for the tmj?

Last edited by Thelma-Louise; 04-14-2008 at 04:53 PM.

 
Old 04-16-2008, 04:41 PM   #5
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Re: Voice and Speech Symptoms... what does everyone experience?

First off, thanks so much for responding, you're so sweet.

Secondly, I ended up getting in early to an ENT today instead of Friday. He scoped me. All normal results, no vocal cord nodules like I had years ago, no polyps, masses, ulcers, no inflammation, nothing, vocal cords he said moved well. Totally normal. I mentioned to him I had TMJ and of course he seemed rather unimpressed which slightly annoyed me but I guess I wasn't going to him for any TMJ help, just to rule out anything in the throat and he was good at doing that.

The thing that I'm wondering though is.. because I read... they said neurological problems like vocal cord weakness could take place with those types of diseases... could an ENT tell that I didn't have that based on the scope he did? I mean, if I had vocal cord muscle weakness would he have seen that and ruled it out based on him telling me to say, "Eeee and Aaaaa" and watching the cords move like he did today? I hope so, anyway, because of course my mind wanders and I think about stuff like this, I wish I didn't. So if anyone knows anything about this, that would be great.

Quote:
Yes - this is fairly common - I have the same thing going on the same side as you. My tongue was the first clue something was not right. I noticed it was aching on the lower left side kind of underneath and on the side of it. B/c I had several crowns on that side I attributed it to them being too bulky and not allowing my tongue the mobility it needed. I also had problems with certain words and letter combinations such as "sc" and "L's".
Gotcha. Yep my letter combos were and still are "S" and "Sh" though there's other ones as well, including a general mumbling sometimes, especially when my jaw is achy and tired like it is right now because I basically could barely get through eating my dinner, both sides got so tired and felt like they just wanted to stop working. Of course now I have a neckache and headache. Love how one area affects the other.

So the tongue taking on this crooked postion... is it because the jaw is off, the muscles are tight so things are essentially pulling to that side and the tongues going with the tension then?

Quote:
The hoarseness could be that you are unconsciously keeping your mouth open more often now - it tends to be a natural response when there is a problem with the mouth in general. Have you noticed any sinus problems, dryness,stuffiness or congestion (another thing fairly common with tmj) - if so then more than likely you are also sleeping with your mouth open and breathing through it as well which can account for the hoarseness.
Oh yeah, definitely. Funny you mentioned sinus because I have had sinus trouble for years now. Chronic sinusitis though I haven't had any infection recently, but constantly postnasal drip for sure. Though I don't remember it ever affecting my voice.

Quote:
With regards to the voice fluctuations it occurred to me that one dr noticed that I could not raise my voice above a certain level - why? b/c my tongue was not positioned correctly and basically obstructed my air passage way - so I couldn't get enough air to expand my diaphram which allows the voice to be raised - perhaps what is happening with you is that you are not able to breathe while speaking (has your swallowing reflex been affected as well?) so your voice level fluctuates as you replenishh your air supply or swallow? If you are feeling that your voice is strained it could be you are not able to freely breathe while speaking w/o making a conscious effort to do so - if your swallowing reflex has been affected - this may be why you are not able to adequately and frequently replenish your air supply.
Swallowing has been slightly affected but then I also have another medical disorder I'm battling, GERD very severely, my esophagus has been streched due to a stricture I had whenever I was 22 years old, and I have dysmotility aka muscles at the lower end of my esophagus that are lazy and barely move the food through in a timely manner all due to chronic GERD. So swallowing issues can be from this condition as well.

Quote:
are you being treated for the tmj?
Yeah, I went to a neurodentist 2 weeks ago and he told me basically that my bite was fairly decent, some teeth shifting but not too bad, my teeth showed severe signs of grinding, my face, he could tell that my muscles on my left side were the ones being overworked because they were puffy and certainly more prominent while my right side he said, the muscles were not "weak" but they just appeared droopy because my left side has such overworked muscles so thus, the uneven appearance to my face. He said my joints are fine, and I can open my mouth just fine, it's all muscular in origin, all of it, so he fitted me for a mouthguard, wants me to start physical therapy, and take it from there. I also had a neck and head mri which showed I have bone spurs and a herniated disk in my neck that physical therapy should help as well.

He also said speech is definitely affected by TMJ, the slurring and S problems I mentioned all go with TMJ. Back then I didn't have the hoarseness to tell him about which sucks because I wish I could have run that by him, I certainly will mention it when I go in and get my mouthguard.

But until then, is there ANYONE here with TMJ who has voice changes at all besides the normal slurring, articulation problems? Has anyone noticed anything like this? I know my mouth and tongue and everything is totally out of whack so I still can't shake that these voice fluctuations are also connected to my TMJ.

Last edited by Mich5; 04-16-2008 at 04:49 PM.

 
Old 04-16-2008, 09:59 PM   #6
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Re: Voice and Speech Symptoms... what does everyone experience?

The crooked tongue is basically from the deviation in the jaw which could be due to overworked muscles or a cervical problem. I am seeing a cranial chiro currently and each time he adjusts the base of my neck around the atlas or C1 my tongues moves more center - unfortunately it doesn't stay there for long but it no longer feels like it is being pulled toward the left (at least recently) although when I try to extend it, it still deviates and my upper teeth are still sitting on my tongue instead of on the side of it which is very annoying.

Have you been to a neurologist - they can check for muscle weakness by doing an needle EMG although I am not sure how they would check around vocal chords. I found the procedure quite uncomfortable and painful - but some have said it wasn't so bad for them so I am assuming my neuro was just too agressive with it, I guess.

Funny - I had acid reflux and a hiatal hernia for years before my tmj started - but since then with a change in my diet to softer and therefore blander food all of that has since resolved itself.

So the ENT didn't see any reason for your hoarseness? No irritation, redness?
I'm assuming you have also been to your primary dr as well? Have you tried gargling to address it - maybe something like Biotine or Tom's mouth rinse which supposedly soothes sore throats? Or Chloraseptic?

 
Old 04-17-2008, 09:49 AM   #7
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Re: Voice and Speech Symptoms... what does everyone experience?

Quote:
Originally Posted by Thelma-Louise View Post
The crooked tongue is basically from the deviation in the jaw which could be due to overworked muscles or a cervical problem. I am seeing a cranial chiro currently and each time he adjusts the base of my neck around the atlas or C1 my tongues moves more center - unfortunately it doesn't stay there for long but it no longer feels like it is being pulled toward the left (at least recently) although when I try to extend it, it still deviates and my upper teeth are still sitting on my tongue instead of on the side of it which is very annoying.
Gotcha. I should really look into seeing a cranial chiro. And thanks for the explanation about the tongue and why it's crooked.

Quote:
Have you been to a neurologist - they can check for muscle weakness by doing an needle EMG although I am not sure how they would check around vocal chords. I found the procedure quite uncomfortable and painful - but some have said it wasn't so bad for them so I am assuming my neuro was just too agressive with it, I guess.
Yeah I have been to a neuro. I told him about the slurred speech and the numbness and tingling, jaw problems, and he ended up being the one who did the neck and brain mris to r/o MS. Oh he did EMGs on my one arm and leg then did the other arm to check for neuropathy and as it turns out I also have carpal tunnel in both of my wrists, too. I didn't have the deeper voice and strain I feel when I talk when I saw him, though.

Quote:
Funny - I had acid reflux and a hiatal hernia for years before my tmj started - but since then with a change in my diet to softer and therefore blander food all of that has since resolved itself.
That's good. It seems like there's many people with both TMJ and acid reflux issues.

Quote:
So the ENT didn't see any reason for your hoarseness? No irritation, redness?
Nope, nothing. He said he saw absolutely nothing out of the ordinary and chalked it up to "voice strain" due to "something unknown" but also said even if he didn't see redness, my acid reflux could play a part in this anyway.

Quote:
I'm assuming you have also been to your primary dr as well? Have you tried gargling to address it - maybe something like Biotine or Tom's mouth rinse which supposedly soothes sore throats? Or Chloraseptic?
Yeah, I've been to my primary as well, not much help. I'll try the mouth rinse.

It's so weird because when I talk I DO feel my jaw muscles pulling and they're totally strained with tension, even my neck hurts, my throat stings, it feels sore but not like in a classic sore throat type of way, and my voice is deeper in nature and it almost feels like it's difficult to get the words out, like something is preventing me from doing so. It's so strange.

I read about muscle tension dysphonia and I have to wonder if I could have something like this? Anyone know what this is or have it? Of course I just pulled that out from nowhere but I do share a few of the same symptoms as this but then I wonder if my ENT would have seen this on exam with the scope?

I just know that in the TMJ symptoms list it does say "Voice Fluctuations" for a symptom... is what I'm describing classified as just that?

 
Old 04-17-2008, 06:16 PM   #8
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Re: Voice and Speech Symptoms... what does everyone experience?

If its any consolation to you I have what feels like a large lump in my throat all the time and the sensation of something wrapped around my throat - b/c of that I tend to leave my lower jaw hanging open often which is the cause of my dry mouth and throat and the soreness from that. Its pretty much impossible to even suck on a throat lozenge with tmj so I basically just live with it. As a result my voice sounds scratchy and old.

Initially I thought you were referring to dysphagia or painful swallowing but when I looked up dysphonia it is described as hoarseness and straining of the voice and curiously enough a common symptom of MS - but I do not mean to alarm you with that. I have MS in my family and my neuro sent me for the brain and cervical MRIs and they came back suspicious due to finding 10 significant brain lesions considered to be too many for my age bracket. They wanted to do a spinal tap but I just pushed it aside - maybe out of fear, not sure - kind of felt that maybe too much partying when younger left their marks - but also knew what my cousin went through and my symptoms were not like hers at all.

Have you noticed if you are snoring - I started to snore about 6 months before my tmj went full blown - even had a few episodes of sleep apnea. Maybe you should try using the breath right strips to see if that will help you breath through your nose more at night.

Did your primary swab test for oral bacteria - thrush, strep, etc?

To be honsest there are numerous neuromuscular and skeletal/muscular conditions that may result from tmj or be associated with it - you can get into quite a debate about what came first - the chicken or the egg - my current tmj feels its best to try and resolve the actual problem with the tmj and the other symptoms and other conditions will go by the wayside on their own - although treatment for some might be warranted if it eased the discomfort or provided some immediate relief or benefit in some way.

 
Old 04-20-2008, 11:28 AM   #9
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Re: Voice and Speech Symptoms... what does everyone experience?

I have noticed recently that I have had some speech problems. I don't know if it's because of tmj or maybe my nasal obstruction, or perhaps a bit of both. Sometimes now I want to say something in my mind but I know I can't say it, it's usually just the first letter of the first word that I find hard to say. So instead of attempting to say it, I change what I was going to say and say something else instead.lol

 
Old 01-02-2011, 07:16 PM   #10
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Re: Voice and Speech Symptoms... what does everyone experience?

hey guys
i didnt know that we can slur for the letter s with TMJ problems till i read this post i think i have many of those symptoms, i keep my mouth tight most of the time, sometimes i have pain in my right ear and i have shown to many ent doctors and none could diagnose anything, it could my tmj, also my right side neck muscles, the sterno cleido mastoid muscles are hypertrophied i think maybe because of this, it looks puffy that side and my neck ultrasound came back negative, i didnt know what else could be that reason, so all these may add up, i also have chronic PND and i cant raise my voice most of the time
thanks guys for letting me know, i more relieved now, i will start relaxing my mouth now

 
Old 01-02-2011, 08:34 PM   #11
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Re: Voice and Speech Symptoms... what does everyone experience?

I found out about my TMJ due to ear pain caused by the muscle spasms around the ear.

Interestingly enough, my TMJ dentist had me count through the 60's when fitting my splint. Evidently the S thing with speech is common with TMJ.
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Old 01-02-2011, 09:08 PM   #12
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Re: Voice and Speech Symptoms... what does everyone experience?

thanks for letting me know that, looks like that is exactly my problem, i think i have to do the muscle relaxations now

 
Old 01-02-2011, 09:27 PM   #13
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Re: Voice and Speech Symptoms... what does everyone experience?

thanks for letting me know that, that must be my problem too, i will start relaxing my mouth now

 
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