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Please help. Don't move this thread to another group. What is treatment for tmjd?

U

Useruser

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Hi,
I am having lower jaw pain under the ear, jaw with swelling over the jaw line.Went to different doctors. ENT,Endo,dentist,OMFS.I am from another country and currently living in USA.Dentist said it could be because of upper WT or tooth crack in #30,TMJ issue.Removed my upper wisdom tooth 3 weeks back.still have same symptoms. OMFS told me to see TMJ specialist. I also have pain on side of the neck with swelling. And it hurts sore on top of the head. Right side too of head.
Went to a TMJ specialist today. He said my jaw joint bones on right side scratching each other and left side is ok.
He said why my OMFS and dentist missed it. He gave me a treatment plan and which is very very expensive. For 6 months. He said I need to wear hard guard and soft guard. I am attaching the pan xray. Does my joint damaged? What is the recommended treatment for this? I even don't know if TMJD cause jaw swelling, pain/Swelling in neck and top of head. Not sure if everything because of tooth crack or TMJD. My neck is sore and swollen. My GP told me to take a neck ultrasound. I got that neck pain 3 weeks back. But the jaw pain under the ear, swelling in the lower jaw for 2 months.

Attaching the images. Damaged? I don't know if this treatment is the only way to get relief from tmjd? I never tried a OTC night guard too. Whether the night guard will help or the treatment is the only way?
I would like to know if anyone undergone this treatment? Please help.

I have circled the joint he was talking about. He said, he can see black color between 2 bones on the left side and on the right side, it's scratching each other and no black color seen. I don't know what those called as. Is it condyles? Did anyone see any damage?

@Dentists here,
Please check the attached image and let me know if you see any joint damage.
Administrator: please don't move this thread to another group. Leave it in this dentist group.
 

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Gordon

Gordon

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You haven't circled a joint, if this is what the TMJ specialist has told you is your TM joint I suggest that you run, don't walk to a different practice :)

Your symptoms do fit with TMJ dysfunction, so some kind of treatment might be helpful.

A cheaper approach might do it if your general dentist was prepared to get involved. A soft splint may give you some relief and that would prove that TMJ dysfunction is your issue, so more expensive treatment would be worth thinking about.
 
U

Useruser

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You haven't circled a joint, if this is what the TMJ specialist has told you is your TM joint I suggest that you run, don't walk to a different practice :)

Your symptoms do fit with TMJ dysfunction, so some kind of treatment might be helpful.

A cheaper approach might do it if your general dentist was prepared to get involved. A soft splint may give you some relief and that would prove that TMJ dysfunction is your issue, so more expensive treatment would be worth thinking about.
Thank you doc @Gordon .
You haven't circled a joint, if this is what the TMJ specialist has told you is your TM joint I suggest that you run, don't walk to a different practice :)

Your symptoms do fit with TMJ dysfunction, so some kind of treatment might be helpful.

A cheaper approach might do it if your general dentist was prepared to get involved. A soft splint may give you some relief and that would prove that TMJ dysfunction is your issue, so more expensive treatment would be worth thinking about.
Thank you so much doctor @gordo
 
U

Useruser

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You haven't circled a joint, if this is what the TMJ specialist has told you is your TM joint I suggest that you run, don't walk to a different practice :)

Your symptoms do fit with TMJ dysfunction, so some kind of treatment might be helpful.

A cheaper approach might do it if your general dentist was prepared to get involved. A soft splint may give you some relief and that would prove that TMJ dysfunction is your issue, so more expensive treatment would be worth thinking about.
Thank you so much.

I don't know if that is a TMJ or not. He showed me the pan xray and zoomed in his computer and said on the left side you can see a black color in between those bones. But on the right side , you can't see the black color and it's scratching each other. I don't know if that's true. I really don't see any good reviews for that specialist and I just went in since I got a referral. I regret going there.i just saw the reviews in Yelp and online. Everyone mentioned bad reviews. So I don't know if I can trust his opinion or not.

So, what was the one I rounded? And in my image, do the bones really hitting each other? Or is it normal? Any abnormalities shown in the image?

I really don't know what is the treatment for this? The specialist spoke for a minute and left. The manager came in and asked me how am I going to pay and told the fee. I asked what's the treatment? He said I have to come once a week and they will check for changes in the jaw joint and bite guards will be given. That's all. Nothing more explained.

I am very anxious to go to my regular dentist too. He is not very helpful too and rude when I am anxious. So can't expect much from him. I don't know how to proceed further. Feel so frustrated.
 
krlovesherkids777

krlovesherkids777

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I really don't know what is the treatment for this? The specialist spoke for a minute and left. The manager came in and asked me how am I going to pay and told the fee. I asked what's the treatment? He said I have to come once a week and they will check for changes in the jaw joint and bite guards will be given. That's all. Nothing more explained.

I am very anxious to go to my regular dentist too. He is not very helpful too and rude when I am anxious. So can't expect much from him. I don't know how to proceed further. Feel so frustrated.
This would totally be frustrating ,exhausting and disheartening. so sorry you are going through all this and not getting the answers in a straight solid way. but seems they are pretty focused on getting you minimal information on their end .
 
U

Useruser

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"I really don't know what is the treatment for this? The specialist spoke for a minute and left. The manager came in and asked me how am I going to pay and told the fee. I asked what's the treatment? He said I have to come once a week and they will check for changes in the jaw joint and bite guards will be given. That's all. Nothing more explained.

I am very anxious to go to my regular dentist too. He is not very helpful too and rude when I am anxious. So can't expect much from him. I don't know how to proceed further. Feel so frustrated. "

This would totally be frustrating ,exhausting and disheartening. so sorry you are going through all this and not getting the answers in a straight solid way. but seems they are pretty focused on getting you minimal information on their end .
Yes. I feel so.
Don't know why. Been to many places considering the pandemic and very scared to go out. Still been to many doctors to get some answers.
Nothing helps.
 
M

MountainMama

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Yes. I feel so.
Don't know why. Been to many places considering the pandemic and very scared to go out. Still been to many doctors to get some answers.
Nothing helps.
I would be very wary based on what you said about them asking how you were going to pay, yet not explaining the treatment to you.
Maybe you could ask your GP what they think about the treatment plan? Or an ENT?
 
U

Useruser

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I would be very wary based on what you said about them asking how you were going to pay, yet not explaining the treatment to you.
Maybe you could ask your GP what they think about the treatment plan? Or an ENT?
Yeah..I will check with my GP. Hope she will have some answers. She ordered me an neck ultrasound too. I have to do that too.
My GP mostly accepts the specialist treatment plans. Seen that before. So she will not refuse. I will ask her tomorrow.
 
Gordon

Gordon

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Medical GPs know almost nothing about dental issues, so don't expect her to tell you anything useful.
The films you uploaded are useless for diagnosing TMJ issues, unless things are extremely severe they don't show up on x-ray anyway.
May I suggest what I said months ago, you need to find a general dentist who you are comfortable with and take things from there. Jumping from specialist to specialist is a waste of time and money.
 
U

Useruser

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Medical GPs know almost nothing about dental issues, so don't expect her to tell you anything useful.
The films you uploaded are useless for diagnosing TMJ issues, unless things are extremely severe they don't show up on x-ray anyway.
May I suggest what I said months ago, you need to find a general dentist who you are comfortable with and take things from there. Jumping from specialist to specialist is a waste of time and money.
Thank you @Gordon.

The TMJ specialist took a pan xray. I didn't get a copy of that yet I have to pay them to get those images .These images are from previous dental office. I don't know if both are same or different. Will there be any difference in the pan image which TMJ specialist took?
 
U

Useruser

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Medical GPs know almost nothing about dental issues, so don't expect her to tell you anything useful.
The films you uploaded are useless for diagnosing TMJ issues, unless things are extremely severe they don't show up on x-ray anyway.
May I suggest what I said months ago, you need to find a general dentist who you are comfortable with and take things from there. Jumping from specialist to specialist is a waste of time and money.
Thank you @Gordon.
I got some courage to get an appointment with a new dentist office. He is a general dentist. I do see in his website that he treats TMJ pain.

I called the office and said I have been to multiple places and have x-rays. I want to know if my pain is TMJ issue or tooth pain. I also have to confirm that these are not getting the tooth crack on#30. So, I told them I will email them the x-rays. Immediately they were not happy with my answer. I don't know why. They said if the images which you have is if good quality, we will use it or we have to take new one.
I have taken 4 panaromic , 1cbct, bitewing and periapical in 3 office in the last one month. So,I don't want to repeat one more pan xray. Front office said I will be pan xray to check my jaw pain.

The office said, the dentist will check for TMJ pain and in few cases, we will refer to TMJ specialist. So, in that case, should I tell the doctor upfront that I have been to TMJ specialist during the visit? Or should I wait till he diagnose and say something? I don't know how to proceed like this second opinion visits? Should we need to hide what the other dentist say or say as much details as possible??
 
letsconnect

letsconnect

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So, I told them I will email them the x-rays. Immediately they were not happy with my answer. I don't know why.
Why don't you call 5 or 6 dental offices that have good reviews? If they were "unhappy" with you on the phone, it doesn't sound as if they'll be right for you.

Here's a video about choosing a dentist. While it's aimed at abuse survivors, most of the tips apply to anyone:

 
U

Useruser

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I did check the reviews and got this office. It's difficult to get 5 or 6 based on good reviews. Will try to see more.
This office is ok to accept the images, but they are not happy and clearly told me that the image quality should be good and not compressed. I think if we send in the email, it will be compressed. I have to see how to send the good quality.
Since I said I don't need x-rays in their office, they marked the new appointment at limited exam. That's what I heard over the phone when the receptionist was talking to me. He was whispering to himself. I don't know why they did as limited exam. I want it to to be a complete consultation. Since x-rays are not included, I don't know if that's called as limited. I will ask that when I go for the appointment.
 
U

Useruser

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Another question.
Do we need to tell the new dentist the entire history when we go for second opinion? They said they will refer to tmj specialist of required when I asked if they see TMJ pain patients.
Do I need to tell the dentist during my visit that I have already visited the TMJ specialist and got the treatment plan? I don't know if I should say that or not?
 
U

Useruser

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Hi,
I posted my queries and I don't know if I can add this to my existing queries. So, i started a new one.
I have bad lower jaw pain, under the ear pain, neck pain and top side of the head pain. Only on the right side.
I have removed my upper wisdom tooth 4 weeks back. My site is healed and I went for a follow-up.

I am trying to sleep on my back and not on the sides. If I lie down, I have pain on top of my head right side above the ear. It's like sore pain.
I noticed that I am opening my mouth in the sleep and I am waking up in the middle of the sleep and cautiously closing the mouth. It hurts to close the mouth. I wake up few times in the sleep to close the mouth. It hurts on the neck and head. So I try to sleep on the left side.
I am closing the mouth if I sleep on sides, but the head hurts badly. It's very sore pain on top of the head which is exactly above the ear. It's sore to touch on the head. i.e scalp. Is it normal symptoms of TMJ?
Is it normal To sleep with open mouth? And sore pain in neck and head? My head really hurts if I open or close the mouth.
I am taking muscle relaxers at night. I am not sure if this is because of that. Any thoughts anyone ?
 
U

Useruser

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You haven't circled a joint, if this is what the TMJ specialist has told you is your TM joint I suggest that you run, don't walk to a different practice :)

Your symptoms do fit with TMJ dysfunction, so some kind of treatment might be helpful.

A cheaper approach might do it if your general dentist was prepared to get involved. A soft splint may give you some relief and that would prove that TMJ dysfunction is your issue, so more expensive treatment would be worth thinking about.
@Gordon,

I just received the pan xray from the TMJ office. He was showing me about the circled one here. Attaching it here. He said there is a gap on the left side and scratching on the right side. I don't know what is called as.

I have to get the notes from his office. They are charging me to get the notes. It's little pricey though. I have to get it. Just got the x-ray today. Screenshot_20200803-111605__01~2.jpgScreenshot_20200803-111605__01.jpg
 
Gordon

Gordon

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You haven't circled the TM joint.
Panoral films like this cannot diagnose TMJ issues. They're a useful quick screening tool but that's all.

This might be too technical for you:

I'm not sure what you expect to get told here, your symptoms sound like they could be TMJ related, as best as I can guess from very limited information, so basic TMJ treatment would probably be some help, at least to confirm the diagnosis. There's not a lot else anyone here can tell you.
 
U

Useruser

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You haven't circled the TM joint.
Panoral films like this cannot diagnose TMJ issues. They're a useful quick screening tool but that's all.

This might be too technical for you:

I'm not sure what you expect to get told here, your symptoms sound like they could be TMJ related, as best as I can guess from very limited information, so basic TMJ treatment would probably be some help, at least to confirm the diagnosis. There's not a lot else anyone here can tell you.
@Gordon,
Just following up on this thread. I went back to my general dentist whom I trust and I couldn't meet him since this issue started. He said the first one is to remove the upper wisdom tooth and I did that already in July. And he said try an aqualiser and it's a temporary thing to see if it helps. I didn't get an aqualiser. I read about it and seems like it's temporary and it's around 150$ from his office. It's like water filled mouth guards.
I asked if he can give a mouth guard. He said he will fabricate it. I am yet to get that done. He also told me to try RCT on my lower molar as the incomplete fracture (my Endo said it's complete fracture) can cause these symptoms.
I did rct last week. And my bad. Still the same symptoms. I have severe lower jaw pain (like burning pain)under ear and side of the neck. I have some spots which is like a small lump and hurts to touch. Ringing in my ears and ears clogged.
My neck is so sore and burning. My throat is so tight and feel like something stuck in the throat. I even have sore pain on top right side of the head above the ear. The scalp on one spot hurts to touch on the head where it's sore.
I have pain in the base of the neck till shoulder blade. Trapezius muscle is so sore and tight.
I went to my PCP and she told me to do neck ultrasound and I did it. No abnormalities found. She told me to try physical therapy for TMJD. I started PT and did few sessions. It makes my pain worse and I did try dry needling too.

I asked my PCP if I need further imaging or diagnosis. She keeps saying that to try pt for few more weeks and see how it goes. My pain is very severe and am on pain medicine and NSAIDs.

I have to get the crown done from my dentist. After the crown, I will get night guard from the dentist.
I have read online more about my symptoms and something called eagle syndrome. I don't know if my symptoms comes under eagle syndrome or TMJD.

I have seen a tmj specialist who took a pan xray and said that my bones are scratching each other and disc displaced. I don't know how he said that with pan xray. He quoted me 5500$ for the splint. It's very expensive and not under insurance.

I have to ask my dentist again if he think I need more imaging or diagnosis. I have been dealing with this pain for 4 months now. Do you have any idea about eagle syndrome?

Does PT helps with TMJD? Any thoughts doctor @Gordon ?
 
Gordon

Gordon

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Yes PT helps a lot with TMJD. I have no knowledge of eagle syndrome, sorry.
 
U

Useruser

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Yes PT helps a lot with TMJD. I have no knowledge of eagle syndrome, sorry.
Thank you doctor @Gordon. Appreciate it.

I am still wondering if anything on that tooth that is still causing the pain after root canal. Is that possible to miss the root crack or fracture during the root canal. Whether they could cause these pain and symptoms or tmjd?

Whether tmjd cause these symptoms ? Have you seen in your year did experience? Is it like from crack/fracture or tmjd?

I am also getting a night guard from my dentist. I didnt get the temporary crown done on that tooth yet.
 
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