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Tooth pain or TMJ pain?

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MountainMama

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Jul 1, 2018
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1,626
I am having pain in my lower left jaw, but I can't tell if it is coming from one of my molars or from the jaw muscle. How can you tell the difference?

The pain is fairly dull, not sharp or throbbing. Most of the time it is in my actual jaw, not directly below the teeth, but behind. There is pain in the muscle when I slide my lower jaw forward or backward, but not severe. No pain when I sleep. It starts after I wake up, and has been fairly consistent the past week, but does not hurt to chew (although I am not eating anything harder than pasta). Sometimes there is slight pain under the tooth, but mostly in the jaw itself. The first molar is sensitive to heat and cold but not lingering pain.

Also, who do you go to for TMJ pain? My dentist dismissed the jaw pain the last appointment. Will an oral surgeon be able to help with it? I really feel comfortable with the surgeon.

I don't want to visit the dentist, as he wants to crown the first molar, saying it is cracked, even though there was no pain on the bite stick test. My gut feeling is that something is wrong with the 15 year old amalgam filling (or decay under it), but he said the x rays were fine. I am terrified to lose ths tooth yet, as they are my only chewing teeth right now.
 
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AshNaz

Member
Joined
Aug 23, 2019
Messages
21
Location
California
Hi there -
When I was dealing with my two molars that failed within 2 months of each other - I was referred to a oral/facial pain specialist to determine if it was the tooth, nerves, etc. He was really helpful and also evaluated TMJ related issues - did muscle tests and other measurements. He seemed to indicate that there are not a lot of folks who conduct the evaluations that he did, but it seems like there should be someone at least nearby to where you are so that you could maybe reach out. I can send you his info just so that you can see his specialty if that is helpful - I realize that you would not be able to see him per se due to the location.
It was clear that his specialty was much different than my dentist.
 
M

MountainMama

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Joined
Jul 1, 2018
Messages
1,626
Hi there -
When I was dealing with my two molars that failed within 2 months of each other - I was referred to a oral/facial pain specialist to determine if it was the tooth, nerves, etc. He was really helpful and also evaluated TMJ related issues - did muscle tests and other measurements. He seemed to indicate that there are not a lot of folks who conduct the evaluations that he did, but it seems like there should be someone at least nearby to where you are so that you could maybe reach out. I can send you his info just so that you can see his specialty if that is helpful - I realize that you would not be able to see him per se due to the location.
It was clear that his specialty was much different than my dentist.
Thank you. Yes, that would be helpful if you could send the info.
 
M

MountainMama

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Jul 1, 2018
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So I did a little research and found a TMJ clinic about 45 minutes away. The dentist there specializes in TMD, and the website makes a big deal about how he studied under Mark Piper, who is an expert with TMJ disorder treatments. I don't know who that is, but it is worth a try. The website listed symptoms and I have quite a few.

They have a free initial evaluation, which is strictly to decide whether or not you even need an appointment. I like that approach already. I am going in tomorrow, as they had a cancellation.

I know something is wrong, as every morning I can't even put my teeth together on the right side. It loosens up throughout the day, but the mornings are awful. I may have both TMD and teeth issues, but at this point I just want to get it sorted out.

I am super anxious about seeing a new dentist, but knowing they will not be poking around in my mouth at this appointment helps a lot.
 
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AshNaz

Member
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Aug 23, 2019
Messages
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Location
California
I am very glad that you found someone reasonably close. The specialist that I saw was very helpful in pinpointing what was going on for me. I had 1 almost 3 hour appointment and a follow up 1 hour appt and was able to figure out my next steps and move forward. Wishing you the best.
 
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MountainMama

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I am very glad that you found someone reasonably close. The specialist that I saw was very helpful in pinpointing what was going on for me. I had 1 almost 3 hour appointment and a follow up 1 hour appt and was able to figure out my next steps and move forward. Wishing you the best.
Thank you. I know tomorrow is just ro decide if I even need to be there, but I hope to get some confirmation of what the issue could be. They said if I need an appointment, it would be about 2 hours.
 
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MountainMama

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I met with the dentist today. He does a pre-eval with every patient to decide if he needs to take their case. Apparently he only sees 2 to 3 patients a day. He asked a bunch of questions and had me detail my ordeal from the beginning. He basically said the same thing I had suspected...that most likely the first tooth being extracted, paired with a habit of clenching at night, probably caused a domino effect of putting pressure on molars, which were then aggravated and removed, perpetuating the cycle. He did not do an oral exam, but his questions were spot on with what I had been experiencing.

He scheduled me in for next week to do a full evaluation, with impressions, x rays of the joint, pictures and an oral exam. I am to bring my nightguard as well.

He said that my case is on the extreme end of the bell curve and that it will not be a typical treatment plan. He was very intrigued by it, though. Lol.

I have a packet of paperwork to fill out, which is like journal entries of what it feels like at various times of the day and during different activities.

It sounds like he knows what he is doing for sure. His receptionist told me he spends hours on each case, figuring out exactly what the issue is for each individual person.

I found out he guest lectures at the Pankey Institute in Florida, and has published in dental journals about empathy and patient relationships, so that makes me feel better as well.
 
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MountainMama

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Jul 1, 2018
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Oh, and he warned me not to get any crowns placed for my implants or do any more dental work (unless emergency) until the bite issue is fixed. I hadn't even thought about it, but he said if the TMJ issues are not fixed and I get the crowns, it will only make the problem worse, as they will be part of the "off" bite.
 
krlovesherkids777

krlovesherkids777

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Wow Mountain mama sounds like he is extra thorough and experienced. Sounds like you will get some really solid answers and advice here.
 
K

Kns

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Sep 6, 2017
Messages
106
Please let us know how it goes as you see him again! I hope this will help! I’m facing similar issues with a lot of work having been done and now my left side teeth don’t touch at all unless I try really hard by shifting my jaw severely to the left. And then only my premolars and canines touch. I’m also having nerve pain constantly on my left side in teeth that have no signs of decay...but the teeth feel like they need root canals, despite what the dentists say. The pain is pinching, sharp, gnawing, and awful. I completely get how frustrating and overwhelming this ongoing ordeal has been for you. I really hope you find relief. You have had quite the journey and I am wishing you all the best for a good outcome!
 
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MountainMama

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Messages
1,626
Please let us know how it goes as you see him again! I hope this will help! I’m facing similar issues with a lot of work having been done and now my left side teeth don’t touch at all unless I try really hard by shifting my jaw severely to the left. And then only my premolars and canines touch. I’m also having nerve pain constantly on my left side in teeth that have no signs of decay...but the teeth feel like they need root canals, despite what the dentists say. The pain is pinching, sharp, gnawing, and awful. I completely get how frustrating and overwhelming this ongoing ordeal has been for you. I really hope you find relief. You have had quite the journey and I am wishing you all the best for a good outcome!
Thank you! I will update. After reading all the paperwork he sent home with me, I am actually more comfortable with the appointment now. His philosophy is about conservative treatment and he really tries to build relationships with the patients, so he only sees two or three patients a day. He also has a strong feeling about getting to the root of the problem rather than quick fixes to solve pain.

I know exactly what kind of pain you are talking about. It is similar to what I have, although mine comes and goes.
 
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Aurora10

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Joined
Feb 9, 2017
Messages
298
Location
Canada
Please let us know how it goes as you see him again! I hope this will help! I’m facing similar issues with a lot of work having been done and now my left side teeth don’t touch at all unless I try really hard by shifting my jaw severely to the left. And then only my premolars and canines touch. I’m also having nerve pain constantly on my left side in teeth that have no signs of decay...but the teeth feel like they need root canals, despite what the dentists say. The pain is pinching, sharp, gnawing, and awful. I completely get how frustrating and overwhelming this ongoing ordeal has been for you. I really hope you find relief. You have had quite the journey and I am wishing you all the best for a good outcome!
This is exactly the type of pain I gave been having for the last 2 months, just the same. I have been to my dentist almost every week convinced I have an infection or abcess but they never see anything wrong on the xray He is convinced it's a bite/TMJ issue but the pain is definitely getting to be very old now. I just had a nightguard made and the dentist fitted it yesterday so I tried it last night and it did relax my jaw but the canines have hurt all day long...so irritating and it makes me feel so down sometimes.. and then sometimes it's completely gone and I feel hopeful but then it comes back.
How long has this been going on for you?
 
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Aurora10

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Feb 9, 2017
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298
Location
Canada
Thank you! I will update. After reading all the paperwork he sent home with me, I am actually more comfortable with the appointment now. His philosophy is about conservative treatment and he really tries to build relationships with the patients, so he only sees two or three patients a day. He also has a strong feeling about getting to the root of the problem rather than quick fixes to solve pain.

I know exactly what kind of pain you are talking about. It is similar to what I have, although mine comes and goes.
You have been through so much, I really hope the issue gets resolved for you soon.
 
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MountainMama

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Messages
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Well, change of plans. I went in to my oral surgeon today because I woke up with pain in the front tooth implant area. (Turns out some of the bone graft plate is flaking off and irritating the gums...no infection present but inflammation). While I was there I mentioned the TMJ clinic. The oral surgeon got a funny look and said he couldn't say anything but that he has never referred anyone to the clinic and that I may want to talk with my dentist first. So that gave me pause. I know he couldn't say more but I could tell he did not think I should go. He also did a quick exam manipulating my jaw muscles (he does TMJ surgery at the local hospital) and said it was more a facial muscle pain issue.
 
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