TMJ Pain – Atypical Series with Dr. Agatha Bis

Temporomandibular Joint (known as TMJ) is the joint that holds your lower jaw against the base of your skull.  Many people experience TMJ discomfort at times, or popping or clicking, but never think much about it.  But when John came in to our office, unable to chew, close his mouth all the way, and in severe pain for days, it was time to address this issue, and quickly.

John came in to our office in severe TMJ pain, unable to chew or even close his mouth all the way for days.  John had some of the following in the past but dismissed it:

• TMJ occasional clicking
• occasional discomfort when chewing, especially large pieces of food, or hard chewy meats
• history of grinding – past nightguard
• occasional clenching when stressed

But 3 days ago, John woke up, brushed his teeth, yawned, and was unable to close his mouth back again.  He took pain medication, but it didn’t help.  Hoping muscle relaxants would help, he took some before bedtime that night, but he woke up the same and in more pain.

Many people experience TMJ pain occasionally, especially when they put a lot of pressure when chewing hard foods.  Sometimes, clicking and popping can occur, causing discomfort.  Very often, a nightguard is used when sleeping to help reduce the severity of discomfort, and allow the person to grind on it rather than their own teeth.  But severe TMJ pain, especially when you have a history of other TMJ issues, needs to be addressed right away.

Most common treatment for TMJ pain is:

• reduce the source of irritation (especially if aggravated by hard foods)
• anti-inflammatory meds
• a nightguard (custom fit for you; NOT the kind you buy in a drugstore)

But in John’s case, after a thorough exam and discussion of past history, we decided to use a nightguard (for long-term reduction of symptoms and prevention of new ones) and Botox injections to help relax the muscles responsible for clenching and grinding, that led to his pain in the first place.

The decision to use Botox not for everyone.  There are many TMJ pain situations that do not require the use of botox.

Call us for consultation if you have TMJ pain or other related dental issues.