I am working with medical doctors on diagnosis

Good evening. I am a new member of this group and reading posts and learning a great deal. Let me explain my situation. In March I had three fairly long dental appointments, cleaning, a crown, etc. in about eight days. I have always had some tightness in my jaws after dental work but nothing that did not pass in a day or two. When I left the last appointment, the jaw pain on the left side by the ear was excruciating. For three days I could not chew and had to take strong pain Meds to try to control it. It just would not let up so I talked to the dentist and had teeth x-rayed and everything looked fine. Then I started feeling numbness in my cheeks and even a strange feeling in my throat. Medical doctor had jaws x-rayed and they showed nothing. Over a couple of weeks the pain let up some and then returned. I am now at a point where the pain and numbness in cheek and chin and throat area is almost constant. I have tried OTC pain Meds, ice, heat, eating only soft foods, and there is no improvement. The jaws are quite literally in spasms when I eat and it is hard to open my mouth. So I tried a prescription muscle relaxant which helps some until I chew, then the tightness and what I assume are muscle spasms return. I am scheduled for an MRI of sinuses and TMJ areas with contrast early next week. I have a long history of sinus issues so even went on antibiotics for ten days thinking maybe this was a sinus infection. So what I am trying to figure out is why did this come on suddenly after dental appointments and if it was injury, why does it not settle down after weeks and weeks of the symptoms and home treatments I described? What else can I try that might help the spasms to lessen? I have a normal bite, do not grind teeth, but I suspect I do clench teeth when stressed. I am open to feedback and advice wince all of this is new to me. I am on Medicare and know that Medicare would not pay for anything done by dentist so right now I am working with medical doctors on diagnosis. I did consult a good dentist who checked teeth, x-rayed teeth, and can find no dental problems. Thanks for whatever you can share.


Discussion


Jill Mitchell
If I had to guess…… The crown doesn’t fit exactly right….. It’s throwing off your bite just enough to cause everything. Classic. Dentists do this all the time to people and have no idea how to fix it. It’s maddening. For now…… Use moist heat and possibly some mild muscle relaxers to sleep until you can get to someone who can help

Jeanne Herman
I did go to a second independent dentist in another town and asked them if they saw any bite problems. Showed them x-rays as well. The dentist checked bite with paper and crown which is on the bottom was ok. She found nothing wrong but was concerned that I tore or displaced something in jaw/joints. Muscle relaxer does help some. Thanks for your response.

Jill Mitchell
With all due respect just checking with paper may not show what is up. Even if you’ve had disc damage fixing the bite is crucial. I feel for you because I had irreversible damage done by a dentist a long time ago which spiraled me into a 28 year nightmare.
Best advice. Don’t do anything until you research and talk to many. I fly from chicago to Boston for my dentist and it saved my life.

Pietro Paolo Costa
Jeanne Herman in a first step your mouth must recover mobilty lateral and protrusive to the right and left.
Giving a chance to your mouth to catch these movements , the pain should go in no time .
Try to smile and see on which side your smile line remains higher

Jill Mitchell
FYI seek out a Gneuromuscular dentist who knows how to do Full mouth restorative work and has taken a lot of the OC courses. Just my opinion.

Marcus Decimus
Hi Jill Banks is the denist that you are seeing in Boston a GNM dentist?

Thelma Louise Davis
You may have to wait to see the results of the MRI to better know if this is due to tm disc displacement or if its primarily muscular and bite related. Were impressions taken prior to the recent dental work being done?

Jeanne Herman
Yes, impression was taken. I think my concern is that I have never had any major problems with jaw or bite. This pain and numbness was sudden and I suspect due to holding my mouth open during three hour long appointments. Seems odd that this would be bite related given no history of major problems. I am anxious to have MRI and see what it shows. The muscle spasms are tough to handle.

Thelma Louise Davis
good as you may need to have someone examine them more closely for occlusal issues should the MRI not show an issue with the discs. Have you tried any anti-inflammatory meds, ie NSAIDs?

Pietro Paolo Costa
Dear Jeanne , you’re knowing dell’TMJ symptoms .
Something has precipitated your previous precarious balance dell’TMJ .
To put to rest the muscles of the mouth you have to increase the vertical dimension of your mouth .If there is an asymmetry of the line of your smile the highest part will have to return in line with the lower part . The occlusal problem must be seen after they were eliminated the pains that will pass only through a bite that fixes the asimmentria of your mouth

Julie Vandervelde-Moll
Sounds to me like you are having muscle spasms from being open so long. You said the muscle relaxant worked until you tried chewing so use the muscle relaxant and a soft no chewing diet for 4-6 weeks and let everything calm down. Once things have settled down if you still have pain get an MRI and CT scan to see what’s going on in the joints. Use warm moist heat on the areas alternate 800mg of Tylenol and Motrin every 2 hours ( if your kidney and liver function is okay) and massage the area gently

Luis Redinha
Jeanne Herman – With your finger tips palpate just on front of ear canal and inside ear canal while moving your jaw. If there is no pain in those spots probably it´s not tmj related. Then I would go with muscle spams. Follow the advice of Julie M Vandervelde-Moll . I would also prescribe Vallium 5mg at dinner time for 5-6 days ( potent muscle rellaxing secondary effects)

Jeanne Herman
Just got Valium so will give that a try and will continue on soft foods and moist heat. Thank you.

Luis Redinha
Keep us posted… All the best

Luis Redinha
Jeanne Herman if you have a smartphone download an app called “No Clenching”.Follow the advice, set the timer and you´ll get some help to avoid clenching and at the same time yuo´ll be able to evaluate in a more precise manner your symptoms evolution

Jeanne Herman
Luis Redinha will do it today. Thanks!

Luis Redinha
Unless there is a gross desahrmony on the occlusion contact of the new crown do no get involved in adjusting or touching anything on your byte, you´re on a distorted positon now, due to the increase in muscle activity

Jeanne Herman
Yes. Two independent dentists and dental and medical x-rays suggest bite is normal. I have always taken care of teeth so everything there is healthy. I do not for he minute belief this is some malocclusion. This was a sudden event after hours of holding mouth open and dentist struggling to get to the tooth she was working on since I cannot open my mouth very wide. I truly think MRI will show something is displaced on left side.
In meantime I following all your advice about home care and what I can be doing to reduce spasms and pain. Getting really tired of soft mushy foods since I am vegetarian. Miss my crunchy fruits and veggies.

Luis Redinha
In front of a mirror with you teeth touching, move your chin forward. if it goes forward on a straight line, now check side to side movment with teeth touching. if it goes on a balanced manner to both sides of about 8 to10 mm I wouldnt do the MRI. TMJ mechanics would be ok, and the reason to not opening would be a shortening of closing muscles

Marcus Decimus
Jeanne Herman You said that you had some crown work done. Could you provide further details about this? I also suffer from muscle/jaw related issues which i believe started after I had my front crown replaced. Also I think it’s interesting that you said “I have always had some tightness in my jaw after dental work”. Could you provide further details about this as this may indicate that you already had some kind of jaw related condition which got worse after your last dental treatment.

Eva Willer-andersen
Jeanne Herman when you say numbness in the chin area is it real numbness as in if you touch your chin you can’t feel the touch ?

Jeanne Herman
No, it is not paralysis or total loss of feeling. It is more pins and needles and a perception that face feels puffy or less sensation.

Eva Willer-andersen
Ok that’s good . The alveolar nerve gives sensation to the chin and lips

Jill Mitchell
Ugh. You don’t need to go and start doing CT’s and MRIs ….. You need to get to someone who truly knows occlusion and GNM principles. If you started to have pain after a crown it’s not that hard to figure out your occlusion was offset by this.

Marcus Decimus
But it may be due to the fact that he caused some damage to his muscles or joint when he was opening his mouth for a long period of time during treatment. He said that he experienced muscle tightness in his jaw before when he receieved treatment. Anyway I am no expert and have much to learn and I am not saying anything with any conviction. Just making a suggestion based on logic.

Luis Redinha
you are correct. There are studies that show that if you activate muscle isometric contraction in otherwise pain free indivuduals they will have soreness, pain and decreased range of motion

Jeanne Herman
I think you guys are right on. This is injury to soft tissue from holding mouth open and I am going to have an MRI to try to see soft tissue issues.

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