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Old 08-15-2009, 07:52 PM   #1
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Should I consider being checked for TMJ?

Hi all,
I'm new on this board. I was researching my symptoms and came across this board and TMJ as a possibility. Some of my symptoms are on the sticky list at the top of the board. I'm trying to decide if I should persue being assessed for TMJ. I know my insurances (medical and dental) won't cover it if it is. All of you have experience

I've had a "stuffy" ear for about 5 months.
My ENT and most recently my PCP said my ear looked fine. That it was probably just allergies. I do have allergies, but years of immunotherapy have helped and I haven't had many other allergy symptoms all year. The ENT offered to do more testing if further allergy treatment didn't work. That was about 3 months ago. I haven't been back again yet because I figured a stuffy ear wasn't such a big deal and I could just live with it.
I've had an "itchy" ear for about 3 years.
I've been told it is eczema and there isn't anything that will help.
I have sinus pressure.
Lately the pressure has been in my cheeks with sometimes pain in my upper teeth.
I've had ringing in my ears.
For about 6 months, I've had periodic on-going ringing in my right ear, the stuffy one. It gets pretty annoying at night especially. My ENT puts it down to a hearing loss I have in my right ear. I've had the hearing loss my entire life. Why would the ringing begin when I'm 38?
I've had shoulder pain and neck tightness.
I've had some pain in my right shoulder and most recently around my right shoulder blade. I know I have rotator cuff problems, but surgery 1 1/2 years ago helped with that. The most recent pain is in an entire different place. The tightness from the shoulder extends up into my neck area. I've been going to a chiropractor to help with that and some hip pain.
I have bruxism.
I found out about 7 years ago that I have bruxism pretty bad. The grinding/clenching is only when I sleep. My back right teeth were grinded almost flat when I finally had a dentist tell me what was happening. I've worn an acrylic occlusal guard for about the last 6 years. I'm on my second guard because I cracked my first one. My dentist said I shouldn't have been able to do that. I also had some really large unilateral bony tori develop on the left side of my outer jaw. They got so big that I had to have them shaved down. I've read that they are typically caused by the bruxism as well. I can tell the bruxism has been worse lately because I've developed new ridges on the inside of my cheeks, especially on the right side.
I do not have any jaw pain. Should I be considering TMJ as an option?

I have an appointment with a new Audiologist in a couple weeks in a couple weeks. After that, I need to figure out what route to take for following-up. Do I go back to my ENT? Should I be scheduling an appointment with my dentist? (I'm not quite due for my 6 mos. check-up). Should I self-refer to a TMJ specialist? I'd appreciate any advice you might be able to impart.

Thanks,
MountainReader

Last edited by MountainReader; 08-15-2009 at 09:50 PM.

 
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Old 08-15-2009, 09:49 PM   #2
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Re: Should I consider being checked for TMJ?

I am pretty sure you have a tmj issue b/c of the bite problems. All your symptoms fit this very well. Bruxism is usually a sign that your jaw is trying to grind down what is "on the way" in attempt to correct the bite.
I'd suggest to see a good TMJ and/or bite specialist.
I have not heard of many good stories about splints especially on the long run. From wearing them for too long one might actually get more dental/tmj problems.

 
Old 08-16-2009, 06:54 AM   #3
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Re: Should I consider being checked for TMJ?

Quote:
Originally Posted by StillHope View Post
I am pretty sure you have a tmj issue b/c of the bite problems. All your symptoms fit this very well. Bruxism is usually a sign that your jaw is trying to grind down what is "on the way" in attempt to correct the bite.
I'd suggest to see a good TMJ and/or bite specialist.
I have not heard of many good stories about splints especially on the long run. From wearing them for too long one might actually get more dental/tmj problems.
Hi--The thing that is most obvious is your teeth grinding. This is a sign that your body is trying to find the perfect bite for you, but it can't, so your jaws are in a constant state of grinding at night when you sleep. Also, the fact that you have neck and upper back/shoulder pain. Please find a tmj specialist and get a consult. Whatever you do, do not let them permanently change anything at first, that's usually way down the line after they have done testing, splints, etc.. Try to find one that belongs to these 3 associations--
1. American Academy of Orofacial pain
2. American Acaedemy of Craniofacial pain
3. American Academy assoc. of Functional Orthodontics
Please be careful and do lots of research of your dentist. There are so many people out there that claim they can cure tmj, but will take tons of $$ from you and you might be no better or worse than you started. Ask dentists in your area who they refer their tmj cases to, and see whose name comes up the most. Also, you can call orthodontists office and do the same. Their practice in my opinion should consist of at least 40% tmj or I would run. Good Luck!!!---Jill.

 
Old 08-16-2009, 06:35 PM   #4
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Re: Should I consider being checked for TMJ?

Buying a splint is kinda like buying a car...it's all in what works for you best, how good the quality is and who makes it. Generally, splints are temporary; you should not wear one for longer than a year. They should fit comfortably and their purpose is to bring your bite back to where it should be so that your muscles and joints quit overworking and causing you pain. Also, a lot of splints prevent bruxism. My night guard is a blessing.

 
Old 08-16-2009, 07:09 PM   #5
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Re: Should I consider being checked for TMJ?

Is there a difference between a splint and a guard?

I've had my acrylic guard for years. It was never intended as a short-term thing. Just to keep me from damaging my teeth further. It was custom fit for my mouth and bite.

I've never had a dentist make a connection between Bruxism and TMJ for me. Even the specialist I went to for my tori removal didn't say anything, even though it was the grinding that lead to the tori developing over the years.

The more I read, the more I'm inclined to believe this may be my problem. I'm concerned about scheduling a follow-up with a specialist right now though because it isn't really covered by my dental or medical insurance. I'm already paying off two surgeries from the last year. No end in sight on those right now.

 
Old 08-16-2009, 07:24 PM   #6
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Re: Should I consider being checked for TMJ?

Quote:
Originally Posted by MountainReader View Post
Is there a difference between a splint and a guard?

I've had my acrylic guard for years. It was never intended as a short-term thing. Just to keep me from damaging my teeth further. It was custom fit for my mouth and bite.

I've never had a dentist make a connection between Bruxism and TMJ for me. Even the specialist I went to for my tori removal didn't say anything, even though it was the grinding that lead to the tori developing over the years.

The more I read, the more I'm inclined to believe this may be my problem. I'm concerned about scheduling a follow-up with a specialist right now though because it isn't really covered by my dental or medical insurance. I'm already paying off two surgeries from the last year. No end in sight on those right now.
A guard simply prevents bruxism while a splint creates an artificial bite for the teeth to fall into assisting the muscles back into proper positioning to prevent spasms and pain.

The thing about grinding your teeth is what kind of damage is it causing? The biggest one being stressed out muscles giving you headaches and cramps during the daytime. Generally taking a mild sedative or muscle relaxer before bed can assist with the grinding issue and lessen it.

Generally a consult with a specialist is free so there's really no harm in getting one. They can see if your teeth grinding is causing other problems which it might later down the road. Either way, prevention is better than treatment. I'd say schedule it just in case.

P.S. Valerian root is a natural sedative you can get at a health food store. You can drink it in tea form but it tastes like dirt.

 
Old 08-17-2009, 06:53 AM   #7
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Re: Should I consider being checked for TMJ?

Quote:
Originally Posted by velvetrance View Post
A guard simply prevents bruxism while a splint creates an artificial bite for the teeth to fall into assisting the muscles back into proper positioning to prevent spasms and pain.

The thing about grinding your teeth is what kind of damage is it causing? The biggest one being stressed out muscles giving you headaches and cramps during the daytime. Generally taking a mild sedative or muscle relaxer before bed can assist with the grinding issue and lessen it.

Generally a consult with a specialist is free so there's really no harm in getting one. They can see if your teeth grinding is causing other problems which it might later down the road. Either way, prevention is better than treatment. I'd say schedule it just in case.

P.S. Valerian root is a natural sedative you can get at a health food store. You can drink it in tea form but it tastes like dirt.
Valerian root is a great product. Yes, it tastes nasty, I affectionately call it the armpit tea, but it does work. If you have to , add honey to it, or stevia, natural sweetener. Good for anxiety.

 
Old 08-17-2009, 06:38 PM   #8
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Re: Should I consider being checked for TMJ?

I like valerian root as well (not the taste!). I kind of cheat and buy the alcohol tincture of the root so it tastes better to my opinion. It does help and is harmless.

Development of tori is also associated with the improper loading of the teeth - wrong contacts on them so the body tries to withstand the damage by building more bones. I have them too all over and they are incredibly sensitive to touch. Finding out whether your bite is off is not an easy thing.
At some point I learned that I had "two bites", i.e. I'd bite where the jaw wanted and then the jaw shifted each time b/c of the wrong contacts. but even when I pointed this out to dentists (why didn't they notice it from my obviously wrongfully made crowns?) some of them would make big eyes and not be able to see that shift.

That's smth you can check on your own and especially if you'll ask for a piece of marking paper from your dentist. Open and close your jaw few times w/o touching the teeth. Then watch in the mirror (better an magnifying one) how they will touch. If they make even a tiny slide after they touch this means that the contacts are not stable so your jaw might be grinding that at night.
The more you learn about your bite and the jaw movements yourself , the better.

 
Old 08-17-2009, 08:12 PM   #9
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Re: Should I consider being checked for TMJ?

Thanks all for educating me on what to learn more about and giving me some direction.

StillHope, have you ever had any of your tori removed? I had two removed about two years ago. They got so large that I was catching crumbs of food between them and my cheek causing sores in my mouth. I had an Exodontist sculpt them down. He said that my tori was one of the largest he had ever seen. I had two dentists and 3 hygenists watching him perform the procedure. Found out after that the dentists had moved around other appointments to clear time to watch. It isn't even a teaching center, but I understand my specialist was a local expert and was visiting my dental office.

I can understand the "two bite" thing. For many years, I've felt something was "off". The dentists have never seemed concerned though.

 
Old 08-18-2009, 07:34 PM   #10
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Re: Should I consider being checked for TMJ?

I am glad you had an expert doing the surgery.
No, I haven't done that. Only when I had one last molar extracted and the surgeon didn't take out all of the pieces of the bone he had to remove it later and I think he polished some of that tori bone that was connected to this.
They don't bother me too much unless I go to a dentist. Hope that if my bite will be fixed (when?? -LOL!) then the tori will stop growing more.

These shifts or "two bites" are very essential for the proper occlusion (I mean their absence). Dentists call it "the interference to the bite" (or to Centric Relation). So make sure they see what you have when you bite!!
They won't likely see it on their own tho it's about the basics!

 
Old 08-18-2009, 08:32 PM   #11
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Re: Should I consider being checked for TMJ?

Good to know exactly what to ask about when I go in. I'm trying to figure out how to do as much as I can that is covered by insurance. I was hoping to get a referral from my dentist. It will be a couple months before I am eligible for my next dental appointment. I've thought about asking for a referral from my ENT. (I really do trust him.) He had offered to do further testing because of my ear symptoms. I haven't wanted to spend the specialist co-pay though if it doesn't lead me anywhere productive. At this point, I do have an audiology appointment next week. (I have one already deaf ear and just found out I have declining hearing in the other.) I figure that I can talk to her to get some advice on a local expert for TMJ. Internet searches to find a local expert have been a bit confusing. I'm looking for someone in Utah. There aren't any UT docs on the thread at the top.

It is making me feel a bit hopeful though that I might have found out what is going on though.

Thanks again,
MountainReader

 
Old 08-18-2009, 09:26 PM   #12
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Re: Should I consider being checked for TMJ?

It's totally your jaw.
Even though you have insurance I assure you it's a waste of time.
Sorry, I would be a little more verbose but I just took my night night meds.
You need tomographic x-rays and an overview of your head and neck. Also as far as your other symptoms, a TMJ doctor will go over that will you.

If the problem is so bad it's definitely an option to relocate. My doctor is awesome and I have been able to finance m

 
Old 08-18-2009, 09:52 PM   #13
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Re: Should I consider being checked for TMJ?

I wouldn't agree that all insurance is a waste of time - when I had United Health Insurance (medical ins) and Delta Dental ins thru my employer, Delta covered nothing and United covered all my testing (mris, ct scans, tomos), various splints one of which was $3K and all the therapies I tried - PT, chiro, cranial sacral, acupuncture, etc. The diagnosis code submitted on the claim paperwork seemed to be the issue however - they wouldn't cover tmj but did cover diagnosis codes for myofacial, cranio facial or orofacial pain disorders. Splints were covered under the procedure codes for medical supplies or equipment. What intitally helped me was that one dr I went to had a fantastic billing dept that seemed to know all the insurance "tricks of the trade" - they contacted my medical ins provider and found out what would or could be covered and I used that info with subsequent drs that did not accept insurance and submitted claims on my own which were paid as well. So its important you call your insurance provider if you have not yet done so and find out what they cover.

Also - you could look into purchasing insurance that does cover tmj - most have a waiting period before claims can be submitted however and some have clauses preventing payment on pre-exisitng conditions - but if you have never been treated for tmj nor been formally diagnosed this should not be an issue.

 
Old 10-08-2009, 09:45 PM   #14
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Re: Should I consider being checked for TMJ?

I finally have an appointment on the 19th to see a TMJ specialist. Have to pay in full on the first visit. It is so not in my budget, but I'm going to make it work. I want to address the TMJ before it gets even worse. (My dream of getting hearing aids to regain some hearing will just have to wait several months longer that I originally anticipated. Saving $4800 when you work in the social service field isn't easy.)

Until this week, my primary symptoms were chronic ear stuffiness and Bruxism. My ENT and Audiologists couldn't find anything physically wrong with my ear. I do thave hearing loss that has gotten worse though.

I had a crown (first one for me) fitted earlier in the week and my jaw and ear are in major pain right now. Today it was spasming of the muscles as well. The tooth itself seems fine, but I can tell the TMJ is inflammed. This pain is new for me. Even after a couple oral surgeries to shave down bone from my jaw a couple years ago, I didn't have this kind of pain in the joint. The dentists office said that I'm probably bruxing worse right now because of the temporary crown. At least I have a good fitting occlusal guard to help with that.

I'm alternating ice and heat and taking Tylenol or Motrin for the pain.

Anything else I should be doing in the short-term?

 
Old 10-09-2009, 06:59 AM   #15
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Re: Should I consider being checked for TMJ?

Quote:
Originally Posted by MountainReader View Post
I finally have an appointment on the 19th to see a TMJ specialist. Have to pay in full on the first visit. It is so not in my budget, but I'm going to make it work. I want to address the TMJ before it gets even worse. (My dream of getting hearing aids to regain some hearing will just have to wait several months longer that I originally anticipated. Saving $4800 when you work in the social service field isn't easy.)

Until this week, my primary symptoms were chronic ear stuffiness and Bruxism. My ENT and Audiologists couldn't find anything physically wrong with my ear. I do thave hearing loss that has gotten worse though.

I had a crown (first one for me) fitted earlier in the week and my jaw and ear are in major pain right now. Today it was spasming of the muscles as well. The tooth itself seems fine, but I can tell the TMJ is inflammed. This pain is new for me. Even after a couple oral surgeries to shave down bone from my jaw a couple years ago, I didn't have this kind of pain in the joint. The dentists office said that I'm probably bruxing worse right now because of the temporary crown. At least I have a good fitting occlusal guard to help with that.

I'm alternating ice and heat and taking Tylenol or Motrin for the pain.

Anything else I should be doing in the short-term?
HI---My gosh you are like the 5th person this week I've heard say a crown either started their tmjd, or worsened it. Do some dentists really know what the heck they are doing?? Anyways, if I were you, I would wear the guard 24/7 until they can fix your bite to exactly what it should be. IF you are not satisfied with the results, get another consult because if the crown isn't just right, your spasms will get worse quick. I wish you the best of luck! take care

 
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