Two weeks ago began a spontaneous pain during chewing

The pain is unilateral

Two weeks ago began a spontaneous pain during chewing . The pain is unilateral . It becames harder early in the morning .the patient suffer from bruxism is using bite guard by night taking pain killers antiinflamatory drugs bu the pain still continues during night and movemens back of the jaw ?! Any opinion please .


Discussion


Vera Kaloumenou
I’d ask for a CBCT of the patient’s TMJ, Matilda. There is lack of space between the condyle and the fossa. Condyle;s shape is not perfect, either. A CBCT will give you info in multiple layers, with minimum radiation exposure to the patient. Plus ask some history questions and check out the appliance he/she’s wearing. Did something happen two weeks ago? Αn accident, a fight, a very stressful situation (emotionally, physically, mentally stressful?).? Is the appliance hard or soft? Is the occlusal surface flat or does it follow the anatomy of the teeth occlusal’s surfaces? How long is he wearing it? Has it been occlusally adjusted lately? etc…

Matilda Zoto
The only problem and fear of te patient is if he had any cancer of condile. Ive referd him for a resonace . Still waiting for the results. Thankyou mis Vera

Vera Kaloumenou
Pain from cancer usually is constant, there is pain all day and it is usually just as strong all day and night. Bruxism on the other hand, causes worse pain in the morning. If there is fear for cancer of course he should be referred for a CT , CBCT or MRI. Would you let us know the results?

Matilda Zoto
Sure as soon as possible and if the patiend will bring it in my office.

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