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539209 tn?1225972263

Help me please...apparent TMJ problem

Hi everyone! In march last year, i had a bone removal of the 38 and 48 due to chronic pain. Just weeks after surgery, i returned to the dentist with more pain. Within 6 months after the surgery, i went back to the dentist 3-4 times, and he finally fitted me with an occusal splint. The pain in the right side of my face continued, usually every 6-8 weeks and lasting for a few days. On the 5th of April this year, a very bad pain became present on the right side of my face...it is still there to this day. The pain is present at the joint, cheekbone, temple, behind the ear, neck, jawline, throat and tongue. I have already seen a prosthedontist, had extensive physiotherapy and seen two oral & maxillofacial surgeons, and the problem has not been solved. The first surgeon only proposed botox to the muscles. The second surgeon believes that according to the x-rays and scans, there is absolutely nothing wrong with my jaw. He believes that some damage to the nerve has happened during surgery and now i need to see a nuerologist. Does this sound correct?  I am currently taking OxyContin, Endone and Valium to treat pain because it is so severe. Does anyone have any ideas?
8 Responses
Avatar universal
Hi,  I would recommend that you find a trained and experienced orofacial/craniofacial dentist.   Your symptoms are complex and could be caused by nerve damage, bone infection/necrosis, muscle spasms, or internal derangement of the TMJ.  It will take a lot of knowledge and experience to make what is called a differential diagnosis. You won't get better until the true cause is found and addressed.  There are people who can help, you will have to look to find them.  Judging by some of the spellings you use I'm guessing you may not be in the USA.  But check the American Academy of Craniofacial Pain and American Academy of Orofacial Pain websites for someone in your area.   Look for either a Fellowship or Diplomate status--you need someone with experience.  Good Luck
539209 tn?1225972263
Thank you very much for your reply. I am actually in Australia and have already seen two oral & maxillofacial surgeons (are they the same as orofacial/craniofacial dentists?) and the problem is yet to be diagnosed. the neurologist believes that it is 'A Typical' facial pain. I am now taking high doses of morphine, valium, Lyrica and Endep to treat the pain. Even this amount of medication does not rid all of the pain. I am beginning to get concerned about my genera health because a 19yo should not be taking these medicines for this long. What are your thoughts about this problem?
Thanking you
Avatar universal
We have a lot of Australian members in the American Academy of Craniofacial Pain.  Go to our website referral area and you'll find someone.  Oral surgeons in my experience are not well trained in the pain diagnosis and treatment.  Neurologist are well trained but get little exposure to orofacial pain.  I share you concern for the medications you are on.  You need to find the problem, not treat sypmtoms.  I'm not as familiar with Australia as I'd like to be.  The one dentist I know well enough to recommend is Dr Anthony Simeone in Maroochadore, Queensland.   Your symptoms are not consistent with atypical facial pain--which is a nerve problem.  Your's sounds muscle/skeletal.  By the way, wisdom teeth seldom cause chronic pain.  Acute pain yes, but not chronic.  Sorry I didn't answer sooner--vacation and then payback for taking one(busy).    
Do you know Dr Simeones new practice address?
539209 tn?1225972263
Thank You very much for that referral. I am seeing him tomorrow and am trying to stay optimistic. I am hoping that this problem will be resolved.
Thank you very very much for your help

p.s. what is your name, so i can let Dr. Simeone know who referrred me.
Avatar universal
Your descriptions do'nt complete fulfill diagnostic criteria of paroxysmal hemicrania or hemicrania continua.Please google the above entities to get detailed information. In brief, indomethacin is almost the cure of paroxysmal hemicrania.
Avatar universal
I have had tmj for eight years. Right now I on a year long, daily, painful bilateral temporal headaches. It is terrible. I would suggest seeing a chronic pain specialist. i am on Tramadol right now and just had a second set of injections of botox to help with the pain as i know it is not a fix for my problem. I saw another tmj specialist who has been to Austria for his education and his has a lot of experience. he says he can help me-80%. so get someone with experience in tmj. I still don't have enough condyle space and a new mouthguard will fix that so it bring my jaw forward to get the space I need and the teeth come together in a fix top and bottom fit.
Just a few things I have recently tried.
Good luck.
624326 tn?1223829190
Hi it is such a shame you are only 19 and in so much pain, have your wisdom teeth some through yet, have you looked into a condition called NICO.

google NICO pain see of it matches.

hope this helps,



619343 tn?1221359507
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