New to Boards - Pain in tooth from TMJD? - TMJ Disorder -TemporoMandibular Joint Message Board

blahblah · 07-26-2007, 07:44 AM

Hi, I am new to the boards, glad I found you.

Is it possible to have pain in ONE tooth that is directly associated
with TMJD???

My TMJD began in 1/2006, at same time I had intense pain in tooth
#18 which is my lower left molar just infront of my wisdom tooth. There was a very small filling in the tooth but no present
decay. My dentist removed filling and found a small hairline fracture
that began at one side of the tooth but did not go all the way across
and did not go down as deep as gumline. She tried to bond it but that
made pain worse. (Upon biting down and releasing, sharp pain
resulted.)

It was then determined I needed root canal. The root canal was not
easy - I felt some of treatment due to inflammation from crack and
afterwards I had pain for a few days both in the tooth and jaw. My
jaw pain is on left side only - same side as tooth. My crown was
placed on tooth with temporary cement and left like that for months -
but the off and on discomfort remained. It was finally cemented in
permanently 6 months later. It is NOT same pain I experienced when it
was cracked - - it is on the sides only and almost feels like it is
loose - yet dentists have examined it and say it is not loose. Also -
most of the time when the tooth hurts, my jaw (on left only) hurts -
the pain goes back to from of ear area. Sometimes is a spasm, or a
tightening of muscles, other times a dull ache, and it will also
include my lower jaw.

Been to many many TMJD "specialists". (I live in the NY/NJ metro
area.) I finally found a specialist back in March who has begun to
help me. I have had two MRIs one year apart and he maintains I have
displaced discs on both sides. He started me on an $800 upper
appliance to reposition my jaw. Three months later I moved on to a
lower ($1200) appliance that is to stabilize my jaw. I am to wear
this for the next 6 months and once I am painfree - I am to get
braces. My bite has shifted significantly in the last year and is
very bad now. However new, lower appliance hurts my tooth! By the way
when I bite down I make NO contact with tooth in question! My TMJ
dentist has tried to make the appliance looser around that one tooth
but it did not work. He cut the crown off and tried to shave down the
tooth for a better fit, it did not work. He told me I must get the
tooth re-treated and to return to the Endo.

I saw Endo on Monday night and she will not retreat my root canal at
this time. After being in off and on discomfort in this one tooth I
had treated a year and a half ago she sees NO evidence of it needing
to be retreated. She xrayed it and sees NO shadows, only perfectly
filled roots. She also says for me to stay open that long will only
cause me to go into more spasm in my jaw. She said if I was not
dealing with TMJD issues she would try to retreat it - but she feels
CERTAIN the pain is associated with the jaw and is all referred
pain. If it were an infection I would have swelling and it would get
increasingly worse which it does not. My pain from the tooth
radiates back to my jaw and the masseter muscle and trijeminal nerve.

The Endo wants me to try to get the jaw issues under control first
before retreating the tooth. She does not feel it is fractured
further either - she tested the gumline etc. Now that said, there is
no way she can determine if the initial hairline fracture has gone
deeper because often hairline fractures go undetected but again she
does not believe that is the issue. She has asked that the jaw
dentist cut back my appliance so it does not cover that tooth but he
refused. She wants me back in one month to reassess the tooth.

So I continue with this discomfort in this one tooth. Very
frustrating. She said if it is pulled - I could STILL have the pain.
I will also add that upon waking my jaw feels good – and my tooth does not feel as bad. I typically take one half a Klonopin (muscle relaxant) at night. But within an hour or two of sitting at my desk at work my pain begins. I believe it is all connected to my posture and neck as well.

Has anyone ever heard of anything like this with the tooth pain? PLEASE help!

Mlouisa · 07-26-2007, 11:26 AM

Hello..
your story sounds a bit confusing... acttually all our stories are confusing.. but what I find strange is that you have 2 people trating you and they dont agree.. If I were you I would get a second / and or third opinion..
My personnal opinion is that when you say:My pain from the tooth radiates back to my jaw and the masseter muscle and trijeminal nerve...its probably the other way around.. because I also had more pain concentrated in one spot (thooth) and even after 3 years of treatment its still sensitive. but manageble.. and like you there was nothing wrong with the thooth but I think that at night I applied a lot of preasure in that spot when I was grinding my theeth
I am sorry I am not great help..
all the best to you

blahblah · 07-26-2007, 11:33 AM

Hi and thanks for the response. I guess what I failed to mention is that I have had a few opinions on my TMJD since this all began. I have been to two oral surgeons who did nothing but give me mouth guards to prevent me from breaking teeth when clenching at night.

I have no choice but to be under the care of two different dentists. An Endodontist is a specialist - who only does root canals. The root canal IS a separate issue from TMJD. The general dentist is a man who also works a lot with patients who have TMJD. He is addressing my jaw issues and because the tooth is bothering me he recommended I return to the original dentist (Endodontist) who performed the initial root canal and see if she would re-treat it. She does not agree that it needs to be retreated. Really no way of avoiding involving both - since both specialize in entirely different areas - the Endo does not treat TMJD and the TMJD though he could do a root canal does not specialize in them.

Thanks for your feedback though!

Lynda11011 · 07-27-2007, 05:19 PM

I have similar situation as you. I have lower molar that is sensitive, but TMJ dentist thinks its from clenching.Does it hurt when u push on it? He thinks the massiter muscle has affected everything like you said, and is causing pain. I too take Clozonapam to sleep as this is to repair the muscle in REM. Do you wake up after 5 hrs? I do. Anyway my face lower jaw starts hurting about an hour into the day as you. I apply heat, and take motrin to no avail. I am going to see a prostedontist who can possible fix my bite, and maybe crown the teeth in the back. NOt too soon though cause I hurt too much. Do your teet hurt also in the back? I sometimes wear my nightguard during the day to prevent the banging, which causes more pain. My endo also said the rootcanal is perfect, and would redo it, but the TMJ dentist said the nerves are in too bad a shape at this point after 3 mths, and any work done would be a mistake at this point. I get achy below my cheek and into my lower jaw area like in the glands.....Do you have this too? Its awful to go through life like this....i want it to be cured. Sorry you hurt too.

Thelma-Louise · 07-28-2007, 02:33 PM

What's on the tooth now or is it just being left prepped and exposed w/o a crown for a while ?

Does the tooth hurt all the time or just when you chew on it, just in the morning or night, only when you are at rest or when you move your jaw?

Have you tried not wearing the appliances to see if the tooth calms down?

Does the tooth above it meet the tooth that is bothering you - although teeth meeting too forcefully can cause pain, teeth that do not meet at all can cause the same thing - teeth will begin to erupt or grow so they do eventually meet so in essence you can experience eruption pain similar to when new teeth are cut.

Do any pain relievers affect the pain or do you then get break through pain. Generally if the tooth needed retreating for a r/c meds don't help, but if the nerve is just being irritated by the tmj issues causing a chronic ache or neuralgia, continuous use of meds should help ease it a bit after a few days.

This is just my opinion, but you may want to try taking 6 Aleve a day for 3-4 days to see if it eases up - if this is nerve pain I doubt a muscle relaxant is going to help - if the naproxen (Aleve) doesn't help then go back to the endo and have the tooth re-treated - however it it turns out to be a hairline fracture that has gone down towards the roots, there's not much they can do except remove it.

Its a tough one because tmj can affect the nerves of teeth as well as cause radiating pain so I tend to agree with the endo that if there was an infection there would be some evidence of it - not so sure about hairline cracks though, they can be difficult to determine their extent. I also tend to agree with her about keeping the splint off the tooth - at least until this can be figured out.