Health Chats
Temporomandibular Joint Dysfunction (TMJ)
Tuesday May 26, 2009, 03:00PM - 04:00PM (EST)
Ramin Mehregan, DMDBlank
Top 3 Dentists
Temporomandibular joint dysfunction (TMJ) afflicts some 25 million Americans. Symptoms range from headaches, neck aches, head pain, facial pain, jaw locking and popping and clicking, difficulty chewing, dizziness, ringing in the ears, ear pain, lower back pain, depression and more. Most of these cases are traumatically induced such as whiplash injury, jaw malposition, or a blow to the head to name a few. But the number one cause is a mal-occlusion (bad bite). The symptoms of these injuries are complicated and multifactorial. Patients wander from one doctor to another, undergo multiple diagnostic tests, yet the underlying cause of the symptoms will go undetected and unresolved. Our patients are victims of chronic pain distress with all the emotional and physical ramifications therein. There is help! Join Dr. Ramin Mehregan in an hour long chat to discuss the diagnosis, symptoms, and treatments of TMJ.
MedHelp:
Welcome to today's chat on TMJ. This chat will begin in 15 minutes. Please feel free to begin submitting your questions.
Dr. Mehregan:
Good afternoon, glad to be here and thank you Med Help for organizing this chat
MedHelp:
Welcome Dr. Mehregan. Thank you for joining us today to discuss TMJ.
Pam:
I was diagnosed with TMJ and my ENT suggested I see my dentist.  My dentist told me I needed to wear a mouth guard when I sleep and proceeded to make one for me.  Since I began wearing the mouth guard at night, my TMJ pain has gotten much worse and I find that I cannot open my mouth any wider than to get a straw between my teeth!  Is it common for a mouth guard to create more pain?  Should I give this mouth guard more than 2 weeks to see if something changes?
Dr. Mehregan:
Pam, a mouth guard is not a solution to treat TMJ, a TMJ orthopedic splint is a total different appliance. A mouth guard is a arbitrary made device. You need to find a TMJ expert
liza646:
Hi Dr. Mehregan, I have this left jaw pain for 9 years now. I feel like something is blocking my left ear drum. I have a burning pain in left jaw and face. My ears are always itchy too. Any advice?
Dr. Mehregan:
Hi liza, yes. What you are describing "could" be related to TMJ/TMD (temporomandibular dysfunction), it also could be a wisdom tooth problem. I have written 4 articles on TMJ issues on my blog you can read about them. It will give you more information. Please try to find a TMJ expert
kl42:
How can this disorder cause ringing in the ear? What steps can be taken to reduce this?
Dr. Mehregan:
Dear kl42, this will take more room and time for me to explain. The simple answer your joint cavity is also the front wall of your inner ear. Many anatomic structures pass through there that are affected if your jaw bone (condyle) is displaced
ajay_sf:
How can you tell the difference between TMJ and a migraine?
Dr. Mehregan:
ajay, how do you know for sure you have migraine? I have treated many patients who were diagnosed with migraine, but come to find out it was severe tension headaches. Even the MD's are not sure if headaches are true migraines. TMJ does not cause headaches it is your bite if it is malpositioned it can lead to muscle pain and fatigue (temporalis muscle, large muscle going from your jaw and fans out on both sides of your head)
Michael:
My wife was recently diagnosed with TMJ so I am doing a little research. Her Dr was not able to give her much information on what causes it. Since she is in her late 20's She does have a tendency to grind and clentch her teeth at night.  I also grind my teeth at night and I find myself clenching my jaw most of the day. Should I also see my dentist to get tested for TMJ? Also, my wife complains about popping and cracking when her jaw opens and closes. Is this normal with TMJ?. Thank you for your time!
Dr. Mehregan:
Michael, grinding is not the sole cause of TMJ problems, it can lead to it. But the fact that your wife's joint are cracking there is a TMJ problem. Did your wife had braces or does she need braces(are her teeth crooked). This is another reason for TMJ symptoms
AKJK406:
My husband has the weirdest situation.  Sometimes when he is eating, his jaw will lock and he has to physically move his jaw to one side with his hand, in order to get it back into place. After this happens he often experiences headaches.  Could this be TMJ?
Dr. Mehregan:
Yes, hes has a displaced disc which causes the lock jaw. Recommend he sees a TMJ expert
eaglesJW:
My dentist is a TMJ specialist and I've been suffering with TMJ for 3 years.  We've tried all the standard treatments (bite plate, etc).  He is now suggesting that our next step might be cortisone shots.  What is the success rate of cortisone shots and what are the side effects of these shots, if any?
Dr. Mehregan:
dear patient, I don't recommend it and I never had to resort to it. I recommend you find a Neuromuscular Dentist
liza646:
I have seen lots of TMJ doctors. I have about 10 pairs of splint. They remove one of my wisdom tooth in the left side. But I still have this blocking in my left ear drum. I can feel that the air is not circulating properly. If this is TMJ problem with all the doctors and splint I have plus all the exercise I did it could be resolve is it? Have you had a patient that has a tumor between the jaw and the ear drum(bones area)?
Dr. Mehregan:
liza, have these "TMJ" experts taken any x-rays to rule out tumors????? It is a possibility but as an TMJ expert you would see a tumor if you take x-rays. Read my blogs here on MedHelp it will give you an idea how Neuromuscular treatment works.
ChitChatNine:
Can TMJ go away?  I used to wear a clear plastic custom-made nightguard to sleep ... for grinding teeth I think I was told ... that was many yrs ago.  I am on synthroid and 50 yrs old and find I grind my teeth when more anxiety from the med dose needing adjustment (more hyperactive) than when the dose is right for me.  Can TMJ come from medicine side effects?
Dr. Mehregan:
No it can't< In your case your TMJ disorder is due to bite issue and as long as you are biting into your habitual bite this will continue. (teeth dictate what happens to the joints and muscles)
Michael:
Thanks for your questions.  My wife's teeth are pretty close to perfect.  She has one wisdom tooth that is a little crooked, but otherwise her teeth are very straight and she never wore braces.
Dr. Mehregan:
Michael, again it is hard to give you a perfect answer why her joints are clicking without seeing her. A straight looking bite does not always mean it is a proper bite.
liza646:
What is your worst patient in TMJ? Is there any cure of this disease? Beside the splint what's the best advice you can give to all of us who have this TMJ problem?
Dr. Mehregan:
liza, my worst patients are those who had bilateral joint surgery and had titanium implants place and are debelitated for life because they listened to some TMJ expert that surgery is their only hope. I am a Neuromuscular dentist and have treated many patients in this way with success. Unfortunately there is no fast fix answer to you. As long as your habitual bite dictates it will keep causing these problems. I know it is not a solution, but I have seen many who had been treated with many splints by many TMJ experts
sk123:
Can MS cause or contribute to TMJ?
Dr. Mehregan:
sk, the simple answer it can contribute to it
Carol 1:
Hi Dr. Mehregan,  thanks for taking my question!  I have been having a problem with chronic headaches that are centered around my temples.  My doctor is stumped after running an MRI.  He suggested that I might have TMJ.  Are headaches a common symptom of this?  If so, what treatment options might work for me?
Dr. Mehregan:
Carol, yes it is one of the most common symptoms, please refer to www.top3dentist.com and find a neuromuscular dentist
OwenG47:
What tests do you do to determine if a person has TMJ, or some other problem? For example, is there a medical test that will differentiate TMJ from Trigeminal Neuralgia or some other problems?
Dr. Mehregan:
Yes, but lets differentiate between Trigeminal Neuralgia and TMJ. These are two different entities, common symptoms, but totally different. To diagnose TMJ I take 3 different kind of x-rays and Sonogram (listen to your joints), jaw tracking and EMG's (electromygraphy)
nyydad:
What's the connection between TMJ and the sinuses? I suffer from sinusitis which can sometimes cause great discomfort and pain.