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what would you do? I need advice!
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what would you do? I need advice!

my dentist told me i made my mouth guard wrong and told me how to make it since i can't afford the custom ones. so i made a new one, it fit snuggly on my top teeth and felt good when i bit down. i wore it the other night and woke up in MORE pain than ever with TMJ. i have always had ear congestion for months but never jaw pain or stiffness to where i can't open my mouth far. now i am afraid to go to sleep! my question is, should i not wear anything or just continue the one i just made until i see my doc? i took a muscle relaxer last night and i am not sure if it helped, because this morning i still had pain and my ear felt like it was going to pop and my left jaw area felt swollen. my right side is fine though. i am going to call my dentist AGAIN on monday and have him actually check my bite as he didn't even check me a few days ago. he just told me to get a new mouth guard. i have a scratchy dry tongue and throat too that gets worse in the evening. every time i swallow there is a crackling sound in my ear. i am postitive this is all TMJ related and do not want to make it worse so I don't know what to do for the next few nights except take a muscle relaxer and not wear a night guard and hope and PRAY i don't clench my teeth.
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Avatar_m_tn
Mouth guard or occlusal appliance therapy is highly effective for
TMDs, however, it requires delicate skill and knowledge.seeing a competent tmj specialist is advised.
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875426_tn?1325532016
It sounds like your home-made one is doing more harm than good.  I think you should stop wearing it.

The scratchy dryness you are having is possibly due to the muscle relaxant you are taking.  Do you have G.E.R.D.?

I have to wonder about a dentist who would have you make your own appliance.  I recommend you find either a TMJ dentist or oral and maxillofacial specialist who offers TMJ splint service and who will work with you on financial payments to get it done right.  Or...

Since you only mention you previously had ear congestion and it sounds like clenching, you might get a much cheaper night guard from your TMJ dentist than a flat-planed splint for the clinching and see your Ear, Nose, and Throat Specialist about your ear and throat symptoms.

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5025679_tn?1363545101
Hi, thanks. Unfortunately I can't afford to see everyone. I am limited 4 visits a year with my co pay and I already have 3 visits used up. I have ONE left till next January! It stinks!
I did use the OTC mouth guard last night because it's better than having nothing. I have heard that the "sleep right" ones work well. I may order one on amazon. My chiropractor treats TMJ so he did use his hammer tool on my jaw yesterday- and it doesn't feel as bad today.

But I do have a question regarding GERD. I have a small hernia by my belly button. Do you think that causes GERD? I don't get heart burn though. I have heard of silent reflux- maybe that is it? I take prilosec twice a day and have for a while now. But I wonder if I need it. I don't want to take it if I don't need it. I was having pain in my stomach off and on, it would come in waves a few years back and my doc put me on prilosec. Since I have been on the prilosec I haven't had that pain.
My tongue was dry and felt this way before I was taking the muscle relaxers-- there was a week I didn't take them at all and my tongue felt awful. So I don't know...
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p.s. i did make a new mouth guard- same brand but just made it more snug around my teeth. i think the main problem is, i have my wisdom teeth and i don't make it to fit that far back because it makes me gag. so it only covers the back molars.
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875426_tn?1325532016
No, you're hernia near your belly button would not cause acid reflux.  The acid reflux comes  up higher than that.  I may not get this perfectly, but here's the general idea: the esophagus gets a weakened sphincter muscle which closes off the stomach and the esophagus from each other.  That weakened sphincter muscle then allows stomach acid, which the stomach is better built to withstand, to flux upward into the esophagus, which would be like pouring acid on your skin- ouch!

But L.P.R.D. is where the acid goes clear up to your throat- (laryngopharyngeal reflux disease) from the esophagus and that can cause a sore throat.  

There are potential unwanted side effects from protein pump inhibitors- I think less calcium absorption is one of them.  If you could get an E.G.D. with a BRAVO capsule from a GI doctor with your last specialist for the year, that might be a plus.  I guess you really have to pick and choose though what doctor you want to see- that makes it tough.    

Back to TMJ- a hammer tool- that sounds painful!  I've never heard of such a thing!  I'm glad you are feeling better though.  TMJ night guards typically are not covered by insurance anyway, so it would be a payment plan thing you would need to see if you could work out if you want to have a custom fit one that is most likely to work the way it's supposed to.  If your main problem is clenching and not pain with the TMJ, I think a night guard might be the way you want to go- much cheaper than a flat planed splint like I have.



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5025679_tn?1363545101
My chiro said the "sleep right" mouth guards are the ones he orders for his patients with TMJ issues. I may try one of those. Right now I am using an OTC one- that I boiled and fitted. I made a new one. It's tighter on my teeth but the problem is I have all my wisdom teeth so it doesn't cover them. I gag with it that far back. It covers my back molars, that is as far as it goes. Sometimes there is some slight clicking in my left side by my ear when I chew. Every time I swallow there is some crackling in that ear. Or thumping occasionally which has happened in both ears. My doctor prescribed me Xanax to take before bed. Not just for the bruxism but also because I get really bad leg cramps at night. So I am going to start that tonight. We'll see if it helps any! Thanks again!
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875426_tn?1325532016
So, you have more than a feeling of ear fulness then, with that clicking and crackling.  Have you gotten a TMJ panorex?

I know getting the molds for a custom flat planed splint, which is what I have, it's an experience where a person feels like gagging.  Thankfully, I don't have my wisdom teeth!

Regarding the bad leg cramps at night- have you had your circulation checked in your legs with a doppler study?  Have you had a fasting lipid panel lab test done and if so, with what results?  Have you had your potassium level checked?  Do you know the reason behind the bad leg cramps at night?

I know Xanax can be very addictive.  I think the one I take, diazepam, can potentially be addictive also, but I try to reserve it for especially bad nights for my TMJ and/or my IC.

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5025679_tn?1363545101
I have only taken the Xanax ONCE and my leg cramps were WORSE! but the weird thing was, I didn't panic like I normally do and I normally sweat and my heart rate goes way up. Because they are scary! More like shin splints...in my shins, but mostly in my left shin/ankle area. So here is what I am thinking... I have always had cramps in this area, but never like this and every night. But I recently started wearing a heel lift on that foot because I found out my left hip is 8 mm higher than my right and I ended up slipping a disc in my low back in December due to exercising -- doing a workout I should NOT have done with this condition but I didn't know I had this! And I have scoliosis which I am being treated by a Chiropractor for. I am not sure if it's that but I wouldn't be surprised. So I got some homopathic Hylands leg cramp pills, hoping it works tonight! I can take it with Xanax. The Xanax helps with my clenching -- I did feel very relaxed last night, until the shin cramps woke me up. I have had lots of blood work done but none of it was fasting. The first round came back normal. Tomorrow I will go have blood drawn, testing CBC something or nothing and iron and some other things that I don't even KNOW! Lol. But thyroid for sure. I will keep you posted. Thanks for answering me!!
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875426_tn?1325532016
Sounds like the heel lift could make the leg cramps worse, but you say you've had cramps prior to this... have they ever tried to determine the cause of them?  Did he homeopathic remedy work for the pain?  I hope they do check on your circulation and do a lipid panel on you.

When the pain is really bad, it's helpful for me to have the diazepam, along with pain medication, to be able to get to sleep.  I'm glad you felt more relaxed and hope you wont find you need to take the Xanax too often... I think I may clench more when I've been stressed alot.

If you don't know something in a week, and you don't hear from me if you post something on this thread, please private message me?  
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5025679_tn?1363545101
Well, the leg cramps before the heel lift were about one maybe two times a month. So not often at all. AND it was normally because I did a workout that day and didn't stretch good or drink enough water. In the past I used to run a lot (before my low back injury) and there were some days I didn't eat enough or drink enough and I would have massive leg cramps at night... so then I made sure to eat a banana at least everyday if I could (I need a good yellow banana, I am picky!) And sometimes I eat two. And the vitamin supplements started helping when I started taking them so I never worried about it and they rarely came at night. But the teeth clenching has gone on for years. So the Xanax helps with that, I believe-- the reason I think it's helping is because I have been waking up with little to no ear congestion and I was waking up every single day feeling like I had an ear infection, and it got worse at night. I still wear a mouth guard- I wish I could afford the custom ones. But anyways... the blood work I just had done was to check my thyroid and iron and for anemia. That's it. Before that it was deficiencies  which all came back normal. But I think my leg needs to get used to this heel lift. And I wear different ones in different shoes- though they are all 8mm.
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875426_tn?1325532016
I know I have one leg longer than the other, but when a therapist tried putting lift material in my shoe, it bothered my neck, etc. so much from the change I took it out the same day.  

I'm glad you are getting potassium in your diet (banana) as it is so important not only to prevent leg cramps but to your heart as well.

I'm glad you are noticing significant help with the medication!  Maybe you could save up a little each month for a custom splint?

  I have had to go back to my first custom made hard, flat-planed split which is thicker due to the severity of my TMJ problems.  It was made I think in early 2005.  It was 800 dollars at that time for it and some f/up visits included.  Later, I got one that was thinner (which I still have) and that one cost me 900 dollars, including a certain amount of follow-ups for adjustments.  I don't know how much one would cost today with the way inflation is now.  

A soft night guard splint a parent of mine bought (that kind is significantly cheaper) in the last 3-4 years cost 400 dollars.
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My dentist wanted to make a custom mouth guard (so it would be one that fit my upper teeth and I would do a mold, so it's not a splint. That would cost me 390.00 bucks. That is WITH insurance. I can't afford that at all. I am already going to have to pay over that much for blood work and other medical bills that are soon to come. My insurance is horrible. I pay for myself because I am not covered under my husbands job. My kids, praise God, are on Healthy Families. I pretty much pay 40% of everything, and I still pay over 200 dollars a month just to have insurance. It's ridiculous. We are BROKE! Anyways... at Target I bought a night splint thingy called "Sleep Right" my Chiropractor told me he could order one for me for 50 bucks but at Target the same one was 37.00 - So I bought it. I came home, put it in my mouth the way it shows you- adjusted it to fit and the HIGHEST setting, or biggest (I have a big mouth and all my wisdom teeth and a missing molar on the bottom) still did not fit. It is TOO SMALL. Then I turned the box over and of course in small print it says "slim fit" -- then I read inside this fit small mouths. AHHHH!!! So now I have to mail it to the manufacturer for a full refund. So I am doing that. I'm not even gonna try to sleep with it- it covers my big ol gap on the bottom, and it needs to cover my back teeth, back molar and wisdom (imo) But the other one I wear is Dentek- it's blue and I boiled it and bit down firm when fitting it-- it doesn't come out of my mouth, fits well but I think it needs to go further back. But I am still wearing it because it's better than nothing. I'd rather not crack a tooth if I were to clench or grind. The sad thing is we never know if we are going to grind or clench that night! So I am taking the Xanax every night. Just .5 mg. It's such a small dose and I don't feel weird or hung over when I wake up. I feel fine. It's not addicting either... it doesn't knock me out. I wish it did! SO...there are other "Sleep Right" guards, you can look them up and tell me what you think. They are flat splints that go in the back and there is a rubber type band that comes and comfortably stays in front of the bottom teeth. It's SO much different than my dentek one which molds to my top teeth and is flat on the bottom. It doesn't mold to my bottom teeth. For the past several days I have not had any ear pain or jaw pain- but when I brush my teeth it is uncomfortable in my upper left jaw. It's tight up there... I can't open my mouth as wide as I used to. So my wisdom teeth are so hard to brush! But I do get them-- I have to hold my chin while I brush so I am not opening my mouth so wide when getting those back teeth. I have no head aches or jaw clicking when I eat either- that is the strange thing. But my left side feels like it may be a just a tad lower...So I think I will continue to have my chiro adjust that side with his hammer thing, which doesn't hurt at all. Since he did it last my ears have barely felt full!

But yeah, I wish I could afford a custom mouth guard! Or Splint! I may order a different "Sleep Right" one off Amazon. They are only 25 bucks, I think. There are some that got really good reviews.
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p.s. I am SO glad to know you are a christian!! It's nice to have a fellow believer to talk to about these things. :)
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875426_tn?1325532016
I don't know what I'd do without the Lord!

I'm sorry you got the disappointment of the slim fit and the inconvenience!

I got my two custom-made splints I have while on disability, but I know there's been a lot of prices on so many other things going up lately with the current policies in Washington, including the cost of medical insurance and co-pays.  I've never bought the kind of TMJ splint that aren't custom-made.  

I have a sibling, however, who bought a couple over the counter varieties, but they didn't work out (a grinder versus me, who clenches during sleep).  One of them, my sibling was afraid they might swallow it!

I didn't used to have to hold my mouth while brushing my teeth at all that I can recall, but have had to do it a lot more since September of last year when another TMJ 'incident' happened to me.  

Have you (or your chiropractor) ever tried massaging the muscle from the inside?  I've read where it's described.  I've tried massaging some from the outside.

I'm glad you aren't feeling addicted thus far with the Xanax.  I remember in nursing school days how the word was out how it was highly addictive and there was problems with nurses stealing it from the medicine supply at work!  But the medication is made to help people, so kept in its proper place, hopefully it will be just fine for you!   Diazepam actually has muscle relaxant properties to it, which is why I choose that one for my TMJ when it's really bad, mostly trying to reserve it for night and sleep.  As long as you have something working well for you, that's a plus!    

Do you get your chiropractor care covered well by insurance?
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5025679_tn?1363545101
My mom is paying for my chiropractic care. Bless her heart!! She is paying A LOT too so I make myself go and I make myself do exactly what he tells me. Along with the heel lift I am also laying on this spine block on my left side... it is going to help straighten my spine. I know from doing that 10 minutes a day I have very tight sore muscles up by my neck and upper spine. I get adjusted today so today is like PAY day for me! lol.

My left ear feels like it has some air in it this morning. no pain, but just foggy in there so I must've clenched last night, even my right ear does a little which it never does. I keep yawning.
I don't have any clicking when I eat or open my mouth. And I have heard of those massage techniques for the inside of your mouth. I should try them.
The Xanax is such a small dose. It doesn't even make me sleepy. I haven't upped the dose either. But maybe I should since I feel like I did have a clenching episode last night. Maybe the clenching makes me move my leg and then it spasms and cramps up. Maybe it's all connected...

My insurance went up too and I still pay 40% of all the work I have done.

But yes, without Christ I'm sure I'd be sleeping all day and in a great depression over all this. So I am thankful to have HIM.
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875426_tn?1325532016
How does he explain lying on a spine block is going to straighten your spine?  Sounds like it's keeping you in some pain which would make you feel like you want to keep going back and patronizing his business- I've become something of a cynic over the years.  It is VERY nice of your mom to try to help you!

Do you try to keep from opening to wide when you yawn?  I was told a long time ago to use fingers to keep my mouth from going too wide when I do.  It might be stress is the common factor between the clenching and the leg cramping at night.

We can attribute our rising costs to Obamacare, I suspect.

He is my reason to live!
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P.S.- in case there was any confusion, I mean Christ Jesus is my reason to live.  I definitely didn't mean Obama!
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5025679_tn?1363545101
Haha! Oh I know what you meant. Lol.
I don't open my mouth wide anymore and when I yawn I keep slightly open. I have been doing these relaxing stretches on my jaw, pulling my fingers down while pressing firmly over the muscles on the outside of my jaw, starting by my ear and going down.
I took ibuprofen yesterday a few times.

He said the spine block will eventually shift my spine so that it's straight. Because right now it is leaning slightly to the left so I lay on my left to push it back. If I put two pillows under my head it's fine. The block is foam so it's not that bad. He showed me x rays of a patient who had a worse bend in their spin than me and after 6 months their spine was completely straight. So we'll see if this really works.
Yes, it is very nice of my mom to pay for this...which is why I feel I must continue treatment. I am paid for up until December 26. So after my treatment (which is almost over) I can drop in whenever I want, still. So that is nice. After the year is up I think it costs 50 bucks to go in for an adjustment. And here is the thing.. after seeing a Chiro, you pretty much want to keep going back... it's like your bones need it, they get used to it so they often get out of whack on purpose! lol. I dunno, but that is my theory. Keeps Chiros in business.
I will ask my sister in law about the spine block. She is a physical therapist but she doesn't live here, unfortunately other wise I'd have her treat me (I hope she would for free!) She told me that the heel lift shouldn't be attributing to the leg cramps, since it's only 8 mm. She told me to lift up the sole insert inside the shoe and place the lift under it. So I did that yesterday and BOY was it way more comfy! I took 3 magnesium/calcium/zinc combined vitamins throughout the day... spread out and I took melatonin and advil pm last night (which DID NOT MAKE ME SLEEPY!) but I decided to take a night off the xanax. And I had NO leg cramps!! PRAISE JESUS! BUT... I was up all night .. couldn't sleep, my heart raced... so I think I needed the xanax or my body became dependent on it. But .5 mg is so small.. I don't think it did. I think I was up because I was worrying about the leg cramps. Lol. Man... Perfect night to sleep and there I am worrying about getting a leg cramp when my legs actually cooperated. Oh I took the hylands leg cramps too. So I took too many things.. that is probably why. My husband is like "I don't think it's good to take that many vitamins" -- speaking of the magnesium/calcium combo. But I looked it up and women should take at least 1000 mg of Calcium a day and I know I am not getting a lot from food. I am a bread eater, unfortunately..

Ok I have babbled on long enough. I hope you are having a good day! I woke up today and say THANK YOU JESUS!! :)
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875426_tn?1325532016
I figure my spine might lean to one side in part at least because the hip/leg is lower/shorter on one side, but I also sit with very bad posture.  Good posture, I've read, is important to the TMJ sufferer, and I don't have tend to have that- bad habits.  That would be something if your back could be comfortably straight, despite the difference in leg length!  Sounds like your scoliosis is mild?

Did the ibuprofen seem to help?  If I lay on my sides for very long, it makes my TMJ pain a lot worse.  I have a Simmons Beautyrest pillow that is impressionable and lay on a slanted hospital type bed.

I think maybe it's easy for things to go out on you and to keep going back to get things readjusted for a lot of people.  I've been some to chiropractors, but not a lot.

Ask her if she would be willing to try putting a heel lift in her shoe for a day and see if she starts to feel uncomfortable in any of her muscle groups in any part of her body.  If she can come back and honestly say it didn't cause any discomfort at all, I'd be surprised.  The body is used to standing whatever way it is used to- an alteration does not have to be much to throw the body for a loop.  That's why I referred to the small pebble in a shoe... it's just a tiny difference, having a tiny pebble in a shoe, but it sure can bug a person!

So, you put the lift under your insert or did you remove the insert altogether?  If you put the insert back in, was it a flat insert or an insert that has an arch in it?  The insert- is it firm insert?  If so, it could be the shape of it is keeping your foot in its comfortable position, which I would think could make a difference.

Don't be too sure even a small dose when your body gets used to it would not cause the problem.  If you stay off of it a little while, your body hopefully will adjust pretty quickly to not being used to the medication at night since it is a small dose though.  But it could be too, that anxiety about the legs contributed to the wakeful hours.  I hope you get a better night's sleep tonight!

I learned taking Calcium supplements can increase your risk of adverse cardiovascular events  (see private message), and it is better to get the slow absorption of food sources, so I started getting a little less of my calcium by supplement and tried to increase my calcium rich food intake.

My TMJ is not doing so great and I got a headache after going outside a little while ago, etc., but I know I am truly blessed in many ways!
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5025679_tn?1363545101
Yes, my TMJ i horrible right now to the point where the right side of my face feels numb and crooked. But the pain is in the left and the tightness. I've been taking ibuprofen for 4 days now, and it eases it a little but not much. I am hoping to get in to see someone tomorrow. I know my dentist treats this so I don't undersatnd why the receptionist told me he doesn't do x rays of the joint...
It aggravates me that she is of NO help. Last time I went in I got charged 52 bucks for NOTHING. He didn't even look at my mouth or jaw -- just looked at my  mouth guard and said I needed to either order a custom one through him or make another one but make it the right way... so I made another one, and it feels great and my bite is different which is probably causing my TMJ to get worse but I think my bite is actually right, right now. So I don't know....
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