Temporo Mandibular Joint

Greystoner

I am pretty convinced that I have TMJ, but who do I go to for help; dentist or doctor?

Thanks.

Mary28

A dentist will refer you to a specialist. A doctor might too but my dentist referred me.

highway81

Your doctor or dentist should be able to refer you to a specialist. Just be sure that you do not get invasive or irreversible procedures done until you have tried natural and home remedies for tmj. Mouth splints will often lead to "phase 2" treatment of reshaping teeth, grinding teeth down, crowns or orthodontics. There are plenty of exercises, and natural and medical remedies you can try before setting down that irreversible road. mod edit for one place for loads of info on tmj

Oral Surgeon

highway81 wrote: »

Your doctor or dentist should be able to refer you to a specialist. Just be sure that you do not get invasive or irreversible procedures done until you have tried natural and home remedies for tmj. Mouth splints will often lead to "phase 2" treatment of reshaping teeth, grinding teeth down, crowns or orthodontics. There are plenty of exercises, and natural and medical remedies you can try before setting down that irreversible road. mod edit for one place for loads of info on tmj

This phase 2 you speak of is pretty outdated, occlusal equilibration and full mouth reconstruction and orthodontics for TMD is unproven and seriously expensive. By all means get ortho or crowns if you need them but don't expect them to cure your TMD.

Basic treatment these days;

1st, soft non chew diet, no gum, meat etc, a course of anti-inflammatories and analgesics regularly for 2 weeks or so, nurofen is good (if your medical history is ok with that.....!!)

2nd, a hard or soft night bite splint, hard works best but is more expensive, this helps a lot of patients by breaking the cycle of night time grinding and can give some relief to the jaw muscles

3rd, mild night time muscle relaxants if grinding or clenching is part of your problem. These make you sleepy so not for everyone, botox can also be injected into an enlarged jaw muscle for the same results

4th, a joint wash out called an arthrocenthesis, usually done under GA or sedation, needles are placed into the affected jaw joint and it is washed out with saline and/or a steroid, this reduces the inflammatory mediators in the joint and calms things down

5th, if the joint disc is displaced and preventing proper opening and this is the cause of the problem- open joint surgery may be indicated, called an emminectomy, this is where the jaw joint is opened in front of the ear and a piece of bone is removed to allow the disc and joint to move freely. This surgery is for a functional problem not solely for pain.

OP, seek a referral to maxfax through your GP or dentist,
Good luck,

OS

Greystoner

Thanks for the answers.

I think I will phone my dentist and see what she can do. Can they see it on an xray clearly enough? I don't think my problem is a toothy one as such; my little boy headbutted me hard upwards and since then everytime I chew, especially bread and chewy things,there is a click and I can feel the jawbone moving when I touch near my ear.I also get the click when lying down. Also I don't know if it is relevant, but there is no pain, my hearing in my right ear seems affected, and I also have an 'overbite' which someone mentioned can be linked to it.

Thanks for any advice.

Oral Surgeon

Greystoner wrote: »

Thanks for the answers.

I think I will phone my dentist and see what she can do. Can they see it on an xray clearly enough? I don't think my problem is a toothy one as such; my little boy headbutted me hard upwards and since then everytime I chew, especially bread and chewy things,there is a click and I can feel the jawbone moving when I touch near my ear.I also get the click when lying down. Also I don't know if it is relevant, but there is no pain, my hearing in my right ear seems affected, and I also have an 'overbite' which someone mentioned can be linked to it.

Thanks for any advice.

New info; when did you get the blow to the jaw? not likely but did you consider a jaw fracture? Characterized by pain on chewing, limited mouth opening, altered bite, swelling bruising etc....

Clicks are really common in the general population so don't get too hung up on it...

Feeling your jaw bone moving in front of your ear is normal- this is the head of the condyle sliding forward- it should feel the same on both sides...

You may have bruised the jaw joint from this blow causing a haemoarthrosis....
If your hearing is affected, you may have fractured the part of the temporal bone above the jaw joint, this connects with the middle ear...
Have you always had the overbite??
OS

Greystoner

My little boy headbutted me about 4 weeks ago and I had to wiggle/click my jaw back into place, intially a little bit sore, but then fine. It has clicked when eating ever since then.

There is no pain. It feels a bit weird at night,(like it is out of place) when I lie down, but maybe that is because I am now 'over aware' of my jaw and tend to focus on it.

I read on the internet that if you place your fingers in your ears and open and close mouth, you can feel the jaw moving; I can definately feel a difference in the right side (The left feels normal)

I have always had the overbite. Maybe the dodgy hearing is just 'me' (getting older!).

Would this problem ever rectify itself do you think, or should I still visit my dentist?(Havent had a chance yet to phone her).

Oral Surgeon

Greystoner wrote: »

My little boy headbutted me about 4 weeks ago and I had to wiggle/click my jaw back into place, intially a little bit sore, but then fine. It has clicked when eating ever since then.

There is no pain. It feels a bit weird at night,(like it is out of place) when I lie down, but maybe that is because I am now 'over aware' of my jaw and tend to focus on it.

I read on the internet that if you place your fingers in your ears and open and close mouth, you can feel the jaw moving; I can definately feel a difference in the right side (The left feels normal)

I have always had the overbite. Maybe the dodgy hearing is just 'me' (getting older!).

Would this problem ever rectify itself do you think, or should I still visit my dentist?(Havent had a chance yet to phone her).

You're probably fine and it'll probably settle but really you should get it checked for your piece of mind, get a scale and polish while you're there:D