TMJ

January 13, 2006 at 09:33 PM · I've started violin somewhere around 4-5 years of age. Now that I'm 20 years of age, and still practicing, I've taken a slight toll and things have gone awry. Ever since my freshman year at Peabody Conservatory, every November, my mandible dislocates while I'm asleep. I'm already a third year student, but just last week, my mandible dislocated once again, this time out of the routine November deadline.

Now what I should mention is that having this dislocated mandible problem leaves my entire body (more particularly my back, arms, and legs) sore and virtually incapacitated for days and even weeks. This ain't too good for my fiddlin', and I had to actually cancel my degree recital because of this problem.

Here's what actually happens when I wake up to my TMJ disorder: I am only semi-conscious; my mouth is left wide open; I cannot physically close my mouth; my jaw muscles are very sore; my body is in a fight-or-flight situation; people around me take me to an ER, where I get fixed up. How they fix me up is by yanking down my jaw, pulling it outwards, and then shoving it back in. Sound fun, I know... but by then, my jaw muscles are already numb and pain is kept to a minimum... that is... until a few hours later when my body starts giving into stress and pains.

Yesterday, I went to a neck and head specialist who said the only permanent way of actually fixing this problem is via surgery. One type of surgery will have me in a jaw brace for an entire year, while the other will not guarantee me TMD-problem-free.

Have any of you experienced any of the above? Whether it be dislocated jaws/mandibles/TMJ, or jaw surgery, or even slight growth problems in the jaw?

Replies (15)

January 14, 2006 at 04:51 AM · I have TMJ, but not NEARLY as badly as you have it O.o

I have gotten my jaw stuck open only once, and I was actually able to pull my jaw out and push it into place myself. I understand that depending on the person, the jaw either tightens and can't be pushed into place without relaxants or the jaw CAN be pused back with some discomfort, like in my case.

I hate my TMJ, it hurts to chew dried fruit if it's too fiberous, I get those annoying clickeys and the jaw pain. I'm SURE violin's not good for it, but I don't think it's the main souce of my problems. The real problem is I grind my teeth in my sleep, so I mess up my teeth AND my jaw.

Anyway, sorry to hear about your TMJ. I know of a person who has had successful surgury, but I understand it's pretty unreliable. Good luck to you.

January 14, 2006 at 04:41 PM · One of my colleagues years ago (I'm a psychologist) was both a dentist and a psychologist, and he was at that time an expert in the TMJ problem (He is no longer living). Dentists and physicians would send him their tough cases and he would cure most of them. I wish I could say I knew how he did it. He also cured my wife of TMJ by doing something in one session that in a very specialized way changed her bite. She hasn't had a problem since.

I would say that if you are not getting a resolution, surgery is probably a very last resort. Before you agree to that, I would get several other professional opinions. Try to find who the current experts are in the field, and contact them. Even if everyone agrees on the diagnosis, maybe there is someone somewhere who has a particular key to resolving (or at least considerably easing) the problem without surgery.

Good luck. I know it can be a very uncomfortable and debilitating problem.

Sandy Marcus

January 14, 2006 at 04:59 PM · Hi david,

I have problems with TMJ, too. Though my jaw has never dislocated, I have other very painful symptoms. I went to the doctor 3 times thinking I had an ear infection, but treatment never worked. My ear buzzed and ached all the time. I was afraid I was losing my hearing, since my Grandma had a lot of trouble with her ears and eventaully went totally deaf. It turns out that the problem was with my jaw. The tendons and muscles in my jaw were so inflamed that the irritation was radiating up into my ears. My dentist told me to never, ever allow my teeth to rest together, and to wear a mouth guard. since then. my ears have been totally fine. My jaw still clicks all the time, and I believe I am still grinding my teeth at night because my teeth are incredibly sensitive.

It seems like there is no simple solution to this frustrating problem. I imagine my teeth worn smooth eventually. Hopefully something in this thread can shed some more light on our dear friend TMJ.

January 14, 2006 at 07:48 PM · Just as an afterthought, make sure you have a dentist take a very, very careful look at the evenness of your bite. Even the slightest unevenness can create headaches and all kinds of jaw pain and problems.

January 15, 2006 at 12:08 AM · Have you seen a TMJ specialist? They aren't necessarily abundant, but if you can find one you might get some more ideas. My specialist considered surgery a last resort (thank goodness). I have a (very, very pricey) splint that has made a HUGE difference. I also worked with a physical therapist for a few sessions. Physical therapy worked very well for my brother. Most PTs don't do jaws, though... There might also be things you can do to decrease the recovery time after dislocations, like massage, ultrasound treatments, medications, etc.

'Erie (-:

January 16, 2006 at 01:17 PM · I am a specialist in repetitive strain injuries, and TMJ is a condition that happens when the masseter muscle becomes so tight that it pulls the jaw out of alignment. It can prevent you from opening your mouth properly, and if it happens on both sides of your mouth you will have "lock-jaw."

I've written several books that teach people how to reverse repetitive strain injuries, including TMJ. The technique is easy.

Place your three middle fingers directly above your back teeth. Your fingernails will be pressing into your cheekbones so if your nails are cutting into your skin put a piece of cloth between your nails and your skin. Your fingerprints will basically be pressing into your back teeth. Location is everything with this technique so keep feeling around until you are confident you are in the right place.

Now, start pressing into the masseter muscle that goes from your cheekbone down to your jawbone. This is the muscle that shuts your mouth and enables you to bite. If you clench your teeth you'll feel the muscle under your fingers.

As you feel the muscle you will find one or more "bumps." These are actually spasms that are shortening the muscle so that it can't stretch fully when you are trying to open your mouth. Every one of them is a knot in the muscle fibers, and they need to be pressed out and then stretched.

The way you do that is to hold the pressure on just one side of your jaw at a time. It's usually too painful to do both sides at the same time although you can if you want. Find a bump and center your middle finger directly on the knot. Then press in. You'll want to go as deep as you can, but not so deep that it's extremely painful, it should hurt but still be tolerable.

Hold the pressure for 60 seconds and then slowly release the pressure, but keep your fingers in the same spot. Then do the same treatment to the other side of your jaw. Do this several times, finding different knots if there are more than one. After you do it 3-4 times on both sides of your jaw, now you can do a stretch.

To stretch the muscle you hold the pressure on both sides of your jaw and SLOWLY open your mouth all the way. You may feel your jaw popping over to one side or the other, that's because the muscle is still tight and needs more treatment.

Do this treatment several times a day, whenever you think about it. Also, do it first thing in the morning. You are probably gritting your teeth at night so the muscle is being contracted for hours at a time. Be aware during the day to not be gripping your mouth shut.

If you need pictures to understand what I just told you, you can find the book ("How to be Pain-Less...A Beginner's Guide to the Self Treatment of Muscle Spasms") at http://www.aboutcts.com.

If you have any questions about shoulder, arm, elbow or neck pain, I have a free forum on the website and I'll be happy to help you.

Wishing you well,

Julie Donnelly

January 17, 2006 at 06:21 AM · Great exerercise Julie!

That one helps me. So does one where I bring my back teeth together with my tongue curled down and pointing as far backwards as possible and then try and open my mouth with the back teeth holding steady as much as possible. Doing this one several time a day for about 15 secs each time has been quite beneficial.

Some other muscles that can be a problem, and are for me in addition to the masseter, are the sternocleidomastoid and the temporalis. Misunderstanding of these muscles will cause all sorts of problems. Trigger points may be found on them as well and the same pressure technique Julie mentions can bring great relief. After a stretching and pressure session, use heat to help relax things.

If you do clench you should get a bite plate.

January 17, 2006 at 10:15 PM · It sounds like you have an extremely serious TMJ disorder. I also have the disorder but to a lesser extent. If they're talking about surgery with you then it's probably what you're eventually going ot need. Doctors usually try everything else before surgery (I'm doing many of the exercises up above, I don't have teeth-clenching TMJ, I have just always had it because my jaw doesn't fit terribly well). I know a friend's sister who had it. It is a very big surgery and you it will take a while to recover. The girl I knew had to use a special device that would help stretch out her mouth quite a few times a day. However, she was also a musician and was back playing within 5 weeks. Go to a specialist about this and don't be afraid to get a second opinion. From what I understand about the disorder, it's better to fix it sooner than later. Good luck- I'm so sorry you have to suffer through this problem.

January 18, 2006 at 03:38 PM · Thank you so much everybody for your responses! I actually have an underbite, and before I had braces, my jaw actually closed to the right a little bit. During the time I had braces, I actually had to wear rubber bands to help pull my jaw a little to the left; however, my underbite still remained. I actually went to a Head and Neck specialist a week or so ago and received two similar opinions concerning surgery. Both doctors suggested that either I undergo surgery to fix my underbite or fill in the gap in front of the TMJ so the dislocation would be a little easier to fix. Fixing the underbite would supposedly take 12-18 months to recover from, while the other "filling-the-gap" would take only a few weeks.

In any case, I'm going to try out the exercises y'all have provided to me. I don't think I gnash or grind my teeth while I'm asleep, considering that I can't even grind them when I'm conscious, with my underbite and all... Once again, thanks for all of your help!

January 19, 2006 at 03:36 AM · Please be very careful with the exercises, David! Actual dislocation is completely different from the clicking, catching, locking and pain of "usual" TMJ--often caused by the cartilage disc slipping out of place in the joint. Muscle tightness/spasms/knots cause TMJ symptoms, but if things are so loose the actual joint is dislocating, you don't want to go making things more unstable. (Unless the tight muscles are what's pulling it out in the first place, but I'd be surprised if that were the case). I have a condition that causes all of my joints to dislocate frequently, and I have to be very cautious about making things any looser than they already are.

'Erie (-:

January 19, 2006 at 04:17 AM · I have an unusually severe and complicated case of TMJ. I know that it can cause indescribably awful pain in many parts of your body. For myears I went to one dentist after another and got no relief. Then I found someone who actually new many ways to ease my pain, and I will be forever grateful to him. You're in luck; he is in Baltimore. Dr. Edward Grace, head of the Myofacial Pain Clinic at the University of Maryland Dental School in downtown Balto. Call him and see him ASAP, and tell him I sent you. If you want to discuss it in more detail with me, just write to me.

January 30, 2006 at 03:31 PM · Checkout also for this:

http://www.painfoundation.org/page.asp?file=documents/doc_043.htm&menu=1

http://www.diagnose-me.com/cond/C191024.html

http://www.highpointdental.com/dentistry/tmj.html

Some immediate action for you from this last one:

"Self-care treatments can often be effective as well and include:

o Resting your jaw

o Keeping your teeth apart when you are not swallowing or eating

o Eating soft foods

o Applying ice and heat

o Exercising your jaw

o Practicing good posture "

January 30, 2006 at 11:56 PM · Hi! I also have TMJ and have had similar symptoms. Please find a TMJ specialist. They will give you a retainer to wear in your mouth. That retainer will prevent your jaw from slipping during your sleep. The pain is from your jaw muscles tensing up really badly, which only makes your jaw want to pop out again. I have not found any other way of getting rid of the pain. There are, however, some facial massages that can help. One caution though, since TMJ is a psuedo dental/medical issue, medical and dental insurance sometimes does not cover it. Check your coverage before you find a doctor. Also, this is not curable. It's a condition you'll have to live with. Lastly, I always find it bad form to follow medical advice from the internet, but I will sometimes you a muscle relaxant, such as Aleve (vs. Tylenol) in order to help the pain. But the retainer is where it's at. Go see a *TMJ* doctor.

Also, about surgery. My dad's a neurologist and he doesn't recommend surgery. He has seen too many people end up in his care due to surgeries gone bad. Try the non-invasive approach first. If it STILL doesn't work, well...then maybe...but I wouldn't do it.

If you want to chat more about this, email me off line.

January 31, 2006 at 04:38 AM · Greetings,

of course the advice about specialist. However, there is another aspect of this that you may not have considered that does play a large role.

This kind of problem is part of the whole package of what your body does in the same way that organs of the body, tendons and muscles all link up in very profound and subtle ways. thgus the food you eat is also a factor in the problem. In terms of Chines emedicine the condition is a manifestation of an extreme yang condition where you are as contracted as hell. So you might do a bit of reading around what constitute yang foods. Do you for example take a lot of salt (the most yang) eggs (next I think.) and then red meat. Not suggestinting you switch to being a vegetarian (good idea though) but you could start substituing poultry for red meat or even better, fish which takes you into the middle range of balanced fgoods such as grains and vegetables.

Being very yang is often also a swing response to overconsupmtion of yin foods. So if you are a big consumer of medicine (the most yin) sugar , coffee (or all three) that will be settign up the conditions where your body demands excessive yang food to counterbalance. If you are not familiar with this kind of stuff then you could check out the Kushi Institute on the web.

A useful guideline from an altenrative source is the Candida Diet which is also detailed on the web,

Cheers,

Buri

February 1, 2006 at 09:20 PM · Hi, Diane.

I noticed you are in Cambridge. Do you, by chance, know of any TMJ specialists in this area? I haven't needed one since moving to Boston last fall, but it's good to have a name in case of emergency... :-)

'Erie (-:

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