Help For Tmj - Where To Go?

[bkkangel]

Hello,

it seems like i got some tmj problem

as diagnosis from bdic (bangkok dental international clinic),

but the suggestion of 2 weeks ibuprofen to fix the problem

didnt work (and it didnt seem too sure, the "doctor" didnt seem

like a real doctor, no namesign etc.)

does somebody know what i can do, or a better place to go (specialist or good dr.) ?

need help

bkkangel

Edited April 21, 2006 by bkkangel

[cenctm]

Hello,

it seems like i got some tmj problem

as diagnosis from bdic (bangkok dental international clinic),

but the suggestion of 2 weeks ibuprofen to fix the problem

didnt work (and it didnt seem too sure, the "doctor" didnt seem

like a real doctor, no namesign etc.)

does somebody know what i can do, or a better place to go (specialist or good dr.) ?

need help

bkkangel

Can't help with a location in BKK but your first step should be with a good Orthodontist to see if tooth mis-alignment might be the cause. Are you grinding your teeth at night? A mouthguard might help(from Boot's??). If it's due to stress you might try exercises for the jaw(plus a reduction in stressors) that you should be able to find on the internet. A lot of Dentists claim to be experts with this but very few are. Good luck.

[lopburi3]

All hospitals have well staffed dental departments so that would be my first choice. Much better chance of getting specialized attention in a hospital than any but the largest clinics.

[bjsanook]

Hi,

I'm a dentist with over 11 years experience including surgery.

Please describe:

Your pain, where is it, burning, sharp, aching, dull, throbbing?

Scale of 1 to 10 for following:

Where is it today? Worse case? At Night? In the morning?

Do you always have the pain?

Overall body pain?

Stress?

Anxiety?

Anger?

How long in time do you think your teeth are touching in 24 hours?

What feeling do you have when they are touching?

Do you grind your teeth? Has someone told you?

Habits: Bite nails, chew gum, hold a phone between your shoulder and head?

Have you a history of trauma to the face or body?

Allergies?

Medications taking?

How much alcohol, cigarettes, caffiene in a day?

Do you eat balanced meals, skip meals, weight gain or loss?

Exercise level?

Headaches: Do you get them, where, how long, how often, when, what triggers them?

Neck Pain? Same

Mouth: Teeth hurt, gums hurt,

Jaw: Are there sounds when you open or close?

Does your jaw open straight or altered?

Is your jaw stiff? In the AM or PM?

Ear problems?

Sleep: How much, bad dreams, how, pillows etc:

There is more, but this is just part of it and what your "specialist" should be asking you.

Most of this is personal and it is hard to diagnose on-line, BUT,

if you would like feel free to PM me and I'll try to help you out.

BJ

Edited April 21, 2006 by bjsanook

[bkkangel]

Your pain, where is it, burning, sharp, aching, dull, throbbing?

it begun with strange feeling in left ear, then dull pain in lower teeth on left side.

clicking in left ear since few days, even when stabilising the lower jaw with hand, so maybe different cause?.

Where is it today? Worse case? At Night? In the morning?

in morning when wake up is quite ok, but after stand up pain comes, the later the day mostly the more pain. stiff muscles on left cheak, stiff neck after few days and backpain from today.

Do you always have the pain?

almost

Overall body pain?

neckpain, back.

Stress? Anxiety? Anger?

yes. relationship trouble.

How long in time do you think your teeth are touching in 24 hours?

What feeling do you have when they are touching?

i dont know, not so many times i think.

Do you grind your teeth? Has someone told you?

mouthguard since 3 years, plastic, at night from dentist, cause of unusual tear of teeth.

Habits: Bite nails, chew gum, hold a phone between your shoulder and head?

no.

Have you a history of trauma to the face or body?

no.

Allergies?

no.

Medications taking?

ibuprofen now, but sideeffects (stomach)

How much alcohol, cigarettes, caffiene in a day?

no alc, maybe 10 cigarettes, 2 coffee

Do you eat balanced meals, skip meals, weight gain or loss?

quite normal, no difference.

Exercise level?

not so much in last time.

Headaches: Do you get them, where, how long, how often, when, what triggers them?

normally not, but few times in last days.

Neck Pain? Same

since tmj: yes. before sometimes back/shoulderpain.

Mouth: Teeth hurt, gums hurt,

on xray seems ok, so maybe just tmj? rootcanal 1 year ago on one teeth on left side, but looks ok.

Jaw: Are there sounds when you open or close?

i think no. just clicking in ear, but even if just breath.

Does your jaw open straight or altered?

i think straight, not sure.

Is your jaw stiff? In the AM or PM?

left side muscle feel stiff during day and night.

Ear problems?

clicking sound and strange feeling (inside), but chula and bhn diagnosted that its ok.

Sleep: How much, bad dreams, how, pillows etc:

about 7 h, quite normal. normal pillow.

There is more, but this is just part of it and what your "specialist" should be asking you.

Most of this is personal and it is hard to diagnose on-line, BUT,

if you would like feel free to PM me and I'll try to help you out.

BJ

thank you

[bjsanook]

Well,

The ear thing can cause problems which trigger pain throughout the jaw. Please have the ear looked at to ensure no infections.

Relationship and stress, biggest problem. Also, mouth guard can be trouble.

Stress: You can relive your worries and start clenching which begins to cause soreness of the muscles. Your body compensates by "guarding" against pain and it futher causes joint derangement. If you have a panograph x-ray, you can see the joint area and sometimes spot some potential problems.

Mouthguards: Hard or soft? I'm guessing hard, which can also cause troubles as they wear, and may do so un-evenly.

Motrins: Try Advil (Naprosyn) same anti-infammatory effect, 2 times a day and usually easy on the belly.

Without actually seeing you it is about as far as I can go. Try to reduce the stress, (I know, Ha!),

reduce the caffiene somewhat.

Cut your food into small portions, don't over open your mouth, no hard foods, take damp wash cloth and heat them in a microwave and massage the face in the TMJ and Masseter region.

If the mouthguard is over 6 months old it needs replacing and calibrated. Use a prosthodonist for this as GD won't get the occlusion right.

Hope it helps, I'll be in Bangkok mid-June if you need me to check anything the other doc's are doing, or just post it,

BJ

[bkkangel]

thank you for your information.

yesterday i went to chulalongkorn dental school, was lucky to get a appointment on same day.

the doctor wants to make a hard splint, >100 US dollar. anyway, i dont really know other way,

he said my bite is wrong, so i ordered it, it will be ready on monday.

one more thing, about 1 cm under and before my left ear there is a kind of small "ball", maybe radius 8 mm. i forgot to tell it to the doctor. when i touch it it hurts.

normally i saw things like this in people with infections of any kind.

is it a normal symptom of tmj or could it be some infection and should i go the antibiotics way (which?)?

the clicking sound in ear comes even while supporting the chin with hand. and now also sometimes in the right ear. i hope they know what they do...

thanks a lot

bkkangel

[taxexile]

if you get no joy from the splint ,then try the bangkok dental hospital on sukhumvit 49.

tmj problems are very common and very difficult to diagnose properly.

if your bite is "wrong" , it means that instead of when you put your teeth together , all the hills and valleys of your upper and lower teeth mesh together at exactly the same time for each tooth , there are some areas of a tooth or teeth that contact prematurely and the meshing or occluding is not complete , the mandible then has to slide into an incorrect position to occlude completely , this puts stresses on one or more of the many muscles that operate the jaw , and eventually an imbalance occurs causing any number of symptoms , from clicking of the jaw to neck , back and headaches.

wearing a splint prevents the teeth coming together and so prevents the lower jaw going into a "wrong "position , thereby resting the strained out muscles , ligaments etc.

the 8mm swelling in the ear region could be a lymph node swollen due to some infection , which in turn could give pain in the tmj.

or you may have a low grade chronic infection around one of your wisdom teeth , (you dont say how old you are.)

have that little swelling looked at too.

dont self medicate for an infection until you know exactly what is causing the infection.

please let us know what the eventual diagnosis is.

and if the splint doesnt work , i would recommend seeing one of the oral surgeons at the soi49 dental hospital for a second opinion.

good luck.

[bkkangel]

if you get no joy from the splint ,then try the bangkok dental hospital on sukhumvit 49.

the 8mm swelling in the ear region could be a lymph node swollen due to some infection , which in turn could give pain in the tmj.

or you may have a low grade chronic infection around one of your wisdom teeth , (you dont say how old you are.)

have that little swelling looked at too.

dont self medicate for an infection until you know exactly what is causing the infection.

please let us know what the eventual diagnosis is.

and if the splint doesnt work , i would recommend seeing one of the oral surgeons at the soi49 dental hospital for a second opinion.

good luck.

the clicking sound in my ear is really concerning me, i read on internet about sinusitis and chronical inner ear infection and hope the thai ear doctors examinating have been right that everything is ok.

cause i remember that cold 4 weeks ago that i treated with amox and i hope its nothing from that.

or should i get a ct of the tmj or head to be 100% sure (cost? where is the best place to go for that?)

i am 28, i still have all wisdom teeth, all not errupted yet, the lower one on left growing against the other. how to get sure that infection comes from there? the doctor at chula even didnt make xrays, he just took model for the splint.

in which price range is the soi49 dental hospital?

best regards&thanks

bkkangel

[taxexile]

the clicking sound , if it is coming from the tmj , which it probably is , is nothing to get unduly worried about , its very common.

the mandible articulates with the skull via the tmj.

this is a very complicated joint , between the head of the jawbone and the skull there is a disc that stops the two bones from rubbing during movement of the jaw. this disc is stabilised by various ligaments and muscles , as the jaw opens , as well as performing a straightforward hinge type of opening movement , the mandible moves forward , it kind of slides forward along the depression in the bone near the ear , the ligaments and muscles that hold the disc in place will operate to allow that forward movement.

sometimes the movement is not as smooth as it should be and the final part of the movement , instead of being smooth , it is like a spring being released and the jawbone springs forward the final few millimetres , along with the cushioning disc.

hence the click. over time this may result in some soreness.

a check up and opg (x ray of the jaw joints) at that hospital will cost about 2000b , and the dentist who examines the x-ray will refer you to the appropriate dentist in the hospital for a consultation.

the hospital is not cheap , but it does have a good reputation.

should you get x rayed there but decide not to take things further with the dentists there , you can take your x-rays with you when you leave and that will save you some expenses should you go elsewhere.

i would also mention to the dentists there about your history of ear infections and the lump near the ear.

tmj problems are hard to diagnose , so be patient.

Edited April 27, 2006 by taxexile