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Pea size lump on joint?
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Pea size lump on joint?

I have a small lump about the size if a BB or small pea that sometime gets a bit bigger right on top if the joint in front of my ear. It is slightly movable.  I and two other doctors thought this was preauricular node or partoid issue as I have had a series of issues involving systemic lymphatic swelling. I have been having ear pain, feeling of imflammation in temple and upper cheek area, dizziness and eye pain as well as visible swelling on the left side of my face. My ENT just told me it is my jaw and I TMJD and need to see my dentist who I saw a few months ago and said I did not have TMJD or signs of teeth grinding. What exactly is this lump? I feel I can't trust any doctors anymore I keep getting passed from one specialist to the other.
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875426_tn?1325532016
It is tough when your doctors don't agree.  Part of your symptoms, such as the ear pain, sounds like you might have a TMJ issue.  But not all your symptoms sound typical to me.  

Grinding is not a prerequisite for having TMJ dysfunction.  Did the dentist do a panorex x-ray to look at your joints?  Did the dentist ask about if you were stressed and if you might clench your teeth, even while you sleep at night?  

If you don't know if you clench your teeth while sleeping, do you often wake up with a headache?
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Avatar_f_tn
Thanks for posting. I have since been back to the dentist. I had just the normal check up X-rays done. Nothing specifically for the joint. His observations were that the was no evidence of grinding again. I do not wake with a headache. He fit me for a temporary mouth guard which is very awkward to sleep so I only tried it for 2 nights. Today I saw a new ENT. She said the lump was my jaw joint. She thought it sounded like a  muscle or joint issue I was experiencing and suggested a different type of mouth guard. I also had a salivary gland biopsy (most painful thing ever) to rule out Sjogren's. One parotid duct did not seem to be producing any saliva. So I guess I am at the wait and see point.
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875426_tn?1325532016
I have no evidence of grinding either, but I clench when I sleep.  Did the dentist do the plaster molds for your teeth in preparation for making a custom made mouth guard?  Did the ENT tell you what different type to try?  I use a hard flat-planed splint myself on the top teeth.  Let me know your biopsy results?
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Avatar_f_tn
How do you know you are clenching at night? The dentist fitted me with a "loaner" guard that fits over my front two teeth. I found this really difficult to sleep with. I couldn't really close my lips over it and was forced to mouth breath all night which made my mouth more dry than usual and it was hard to drink with the guard on. Additionally, I kept waking with an allergy type ticking dry cough. I gave up after 2 nights. My 3 small kids wake me enough at it is. Sleep is precious. It seemed too tight and my front tooth was really starting to hurt when I pulled it off. My new ENT told me to just buy a cheap $5 mouth guard like they use for football. The kind that you boil then fit. She said I would likely bite through it in a week or so if I had a problem. So that is what I am using now for the past 4 days just on the top teeth. So far it seems fine. It's not great but easier to sleep with than the other. No noticeable improvement though. I am anxious for the biopsy results. I am not sure what I am hoping for other than some DX.  I have the feeling it will be inconclusive just like everything else. My list of health issues has been extensive and well beyond the list posted above
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875426_tn?1325532016
I have awoken with my teeth clenched together.  I also have awoken with a headache from doing it.

A "loaner"?  What does he do, sterilize it after the patient returns it for the next patient he wants to loan it to?  This type of guard you were given by your dentist is not the kind any one in my family has.  I'm glad the thing you are using now is an improvement over that one.

When do they expect to have biopsy results back?
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Avatar_f_tn
Hi there! I'm still not sure if night time grinding or clenching is my issue. I am not sure what the dentist does with the "loaner" guard. It was filled with acrylic to fit my teeth. He said it was the only one FDA approved for TMJ, whatever, it sucked. The other was better. After several nights of using the guard, I have not found much relief. Most of my pain comes on in the afternoons. I went to the ENT today. The biopsy show the salivary gland was scar tissue. I am told this is unusual but indicative of Sjogren's. the lab was unable to confirm SjS. She wanted to take another biopsy. When she cut in she couldn't even find a gland to use and aborted the process to avoid further pain with a poor outcome for the time bring. I then went to the eye doctor for Schrimer's test which showed dry eyes. Eye doc says clinical diagnosis is Sjogren's. I need to figure if this is the cause of my ear, jaw & face pain and how to stop it. Thank you for you comments and concern.
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875426_tn?1325532016
Grinding would be evident because of wear to the teeth, so that's something the dentist can find evidence of if you were grinding.  But with clenching, not so.  I've been told my teeth have all the anatomy of textbook teeth.

Perhaps it would be worth a try to wear your guard in the afternoon, starting prior to the time the pain usually starts up?  I found out from my dentist that even swallowing can cause many, many pounds worth equivalent in pressure on the tiny jaw joint.  And the afternoon sounds like it may be as time goes on, and you have exercised the joint and muscles more, the issue has been exacerbated (aggravated) by usage.  Also, you may want to focus on relaxing the muscles in your face, and go slack-jawed and see if that helps with the muscle stress aspect of things as well as taking pressure off the joint.

Now, it is interesting they are thinking Sjogren's.  On this site is a list of a variety of tests, including the Schirmer test you had, but listing many more types:
http://www.mayoclinic.com/health/sjogrens-syndrome/DS00147/DSECTION=tests-and-diagnosis

And take a look at this list of Sjogren symptoms!!!
http://www.mayoclinic.com/health/sjogrens-syndrome/DS00147/DSECTION=symptoms
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Avatar_f_tn
Thank you for all of your useful comments. I looks like enough doctors feel that is Sjogren's but might have other autoimmune issue going too. There seems to be a lot of overlap. So today my Rhuemy told me she wants to treat me as Sjogren's and prescribed Plaquinil and Salagen. I have had some of the tests listed on Mayo site. The symptoms they list is really a short list of the most common but other site have extensive lists. I am just happy to be getting help.
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875426_tn?1325532016
I'm blessed if I've been of help!  And I do hope your rheumatologist's prescriptions work out well for your symptomology!
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Avatar_f_tn
I have sjorgrens and my rheumoltoligist figured it out without having to biopsy any glands....they found it when my rt knee started hurting with arthritis symptons. My mouth drys out when I talk. so much I cant get my words out.... and I'm a teacher. Plus my eyesxstay dry and burny most of the time. My rheumotologist prescribes lyrica, plaquenil, and Diclofenac as my arthritis is getting worse. I chew sugar free gum to keep my mouth wet.
Go see a good rheumotoligist! Hope you get answers soon!
I'm having severe pain in rt jaw don't think I can  eat tonite...I was told by ENT that I need mouth brace for nite asxhe found TMJ...JUST got it will sleep in it tonite! This is a first for me to hurt like this in jaw.
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