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New to TMD

I went to ER tonight for terrible pain in the right side of my face, jaw and neck. The pain started five days ago and on Tuesday I went to my regular Dr. because I thought maybe I had a sinus infection. The Dr. thought the same and gave me Augmentin (a powerful antibiotic) I started taking it Tuesday night and things only seemed to get worse from there! By today I figured if I truly had an infection there would be some improvement so when my husband got home from work I had him go with me to the ER. The ER Dr. looked in my ears, nose and throat and said he didn't see any signs if infection and gave me a diagnosis of TMD. He prescribed me Ultram for pain and recommened I see the dentist soon. I hope the dentist can do something because basically if I don't take any type of pain killer I'm in horrible pain. I have anxiety and I have bad issues with clenching my jaw and grinding my teeth in my sleep and sometimes I clench my jaw in the day. I'm sure that's not helping the TMD but I can't seem to relax my jaw
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875426_tn?1325532016
Hi!  

Yes, clenching and grinding the teeth put a lot of pressure on the jaw joints.  Relaxing the muscles in your face and getting a TMJ guard (I have a flat-planed splint) can help take a lot of pressure off, along with altering your diet to a soft one and avoiding talking, singing, and chewing a lot.  Have you seen a dentist specializing in TMJ yet?  You might also ask your doctor about a muscle relaxant for night time use.
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1305767_tn?1361196276
I have an appt. on the 27th for the dentist.
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875426_tn?1325532016
Let me know how it goes?
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1305767_tn?1361196276
I will! I'm glad my appt is tomorrow because the jaw pain has flared up again. I have to take ibuprofen every four hours otherwise I'm in extreme pain
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875426_tn?1325532016
Yikes about the extreme pain!  How did your appointment go?
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1305767_tn?1361196276
It went okay I guess. The dentist said my bite is off because I have several bad teeth and when I clench my jaw it's "misaligned" I got to thinking though when I my jaw gets tight from clenching my teeth don't actually touch so I don't see how my bite has anything to do with it. Unless it's when I sleep because then I clench tight and grind my teeth,
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875426_tn?1325532016
I wouldn't think 'bad teeth' would affect your bite unless you are unevenly putting pressure due to being in pain with the bad teeth or they are uneven in the tooth surfaces, etc..  Did he explain why he believes your bite is off from bad teeth?  What exactly is wrong with the 'bad teeth'?  Are there cavities you could see in x-rays?   What did he propose?  Does he do night guards?  Did he suggest cyclic ibuprofen for awhile to try to knock down inflammation?

The misalignment of the jaw when you clench... do you have an overbite or a crossbite?  I've heard those with underbites almost never have TMJ problems.  

Since you are talking about your teeth not actually touching, if it's only one side, I'd recommend you pursue finding an oral and maxillofacial surgeon specializing in TMJ dysfunction.  If you are talking about your teeth not actually touching on both sides and have an overbite, those with overbites are far more prone to having TMJ dysfunction.  Since you are in extreme pain, if it is in the joint itself and not just the muscles, again, I'd recommend the oral and maxillofacial surgeon.  

Did the dentist do TMJ panorex x-rays?  If not, you might want to get that done and if an oral and maxillofacial surgeon suspects displacement of your TMJ discs, he/she might want to order a TMJ MRI to view those.
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1305767_tn?1361196276
I do have an overbite and the dentist did take x-rays. The pain alternates between sides. I'm missing several molars on the bottom (removed because of decay) Most of my other teeth are decayed and some are broken from decay and heavy night time jaw clenching ( I cracked a crown once clenching my jaw so hard in my sleep), The dentist said a full top and bottom denture should solve my jaw pain. I'm considering a second opinion though because as I said when I clench my jaw in the day time my teeth don't even touch. I have bad posture and I'm on my lap top a lot with my head tilted downward looking at the monitor. Plus there is all the clenching of my jaw.
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875426_tn?1325532016
How is your kidney function?  What's your GFR number (glomerular filtration rate)?  Because those with kidney disease have a higher risk of tooth decay I believe, so if you haven't gotten that checked out, I hope you will.

I'm sorry you are having major problems with your teeth at such a young age.  

A grandparent of mine had to have teeth removed I believe at a fairly young age owing to having had scarlet fever.

Poor posture can affect the TMJ situation.  If the x-rays the dentist did included a TMJ panorex, did that reveal any arthritis in the TM joints?  Did he palpate the joint itself to see if it was tender?  If it turns out you have a disc (or both discs) displaced in the joints themselves, I strongly suspect  dentures would not eliminate the pain... of course, only an MRI would reveal that information (about the discs).  
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1305767_tn?1361196276
Yeah he palpated the joint from inside my mouth, it hurt! lol My kidney function is fine as far as I know. I will mostly likely see another dentist for a second opinion
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875426_tn?1325532016
If you choose a dentist, I hope you will find one who is expert in TMJ as well.  

While alligned dentures may help with the chewing part of your TMJ issue, if you've also got pain with talking, singing, and/or yawning, as I do, it may not resolve your issue.  

Did the dentist say anything about cylic ibuprofen?  With my second major flare, an oral and maxillofacial surgeon had me taking 800 mg of ibuprofen every eight hours (round the clock) for weeks.  

Depending on how much you are taking, every four hours potentially can be too often.  If it's more than 400 mg at a time, that would be too much for every four hours.  Plus, I had a doctor tell me that the dosage needs to be at least 600 mg at a time to be good for inflammation,not just pain.  Did the dentist say he thought you had TMJ inflammation, perhaps capsulitis, given your sensitivity when he pushed?
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1305767_tn?1361196276
When the pain is severe I end up taking 2800-3200 (max dose) a day, basically 800 mg every four hours which my Dr said is okay. The dentist didn't say anything about inflammation but the ibuprofen helps so there probably is inflammation. I've also been having problems with pain in my neck, stiffness and aching at the base of my skull to the left of my spine.
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875426_tn?1325532016
Though I see on one website that 3200 maximum depending on tolerance, I still strongly believe that much is bad, given potential for dangerous side effects, such as huge increase in risk for stroke (see private message).

Have they done any pictures of your spine?  Have they ruled out autoimmune problems such as rheumatoid arthritis?
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1305767_tn?1361196276
No pictures of spine but I recently had a blood test done to check my sed rate for indications of inflammation because I have other issues such as weight loss and flu like symptoms that come and go. The test came back normal and in April I had other blood tests checking CBC, antibodies, metabolism etc. Basically a full work up and everything is normal. This week has been really bad for clenching my jaw for some reason. I don't even realize my jaw is tense until my face, head and neck starts to ache
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875426_tn?1325532016
Did the dentist not prescribe a muscle relaxant for you to use at night since he's not doing a splint given the conditions in your mouth?  Is it possible you can get one from your primary care doctor?  Are you having a lot of stress right now in your life?  Because stress can always make the clenching situation worse and stress management is important.  Also, focusing in on relaxing the muscles in your face, making sure your jaw is slack too.

Did they also run cancer markers?
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1305767_tn?1361196276
I'm not sure if they ran cancer markers or not. The clenching hasn't been so bad since Saturday
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875426_tn?1325532016
If it's what they consider significant weight loss in a short time, you might ask about them running the cancer marker tests to try to rule that out.

I'm glad your clenching situation has improved!  I hope that positive trend continues- a large amount of pressure of those tiny TMJ joints!  
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1305767_tn?1361196276
Well I had been diagnosed with IBS and my appetite was poor and I had gastro discomfort a lot of the time so I think I lost all the weight from not eating that much. Things with that have improved though and I've started to gain. I saw my GP the other day for neck tension and frequent tension headaches and he prescribed me some muscle relaxers for the jaw clenching
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875426_tn?1325532016
That's good news that things have improved and you're gaining!  I hope the muscle relaxers give you some relief!  
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