An Inconvenient Tooth

January 7, 2010 4:47 AM

My jaw muscles and cheeks have been getting progressively tighter and more painful for weeks now. What is going on?

For the past 6-8 weeks my jaw has been extremely sore on both sides (top and bottom muscles). It started as mild discomfort that would only present itself later in the day, but for the past several days the pain has been constant and intense.

Back in August I had a root canal on my second molar. My dentists has assured me, however, that my bite is fine and that the procedure was a success.

I have, however, been under a great deal of stress for the past couple of months (pregnant wife, new baby, promotion at work, etc.). Working under the assumption that I was possibly grinding my teeth at night I visited my dentist for a night bite guard. A few weeks of wearing it while I sleep has yielded no results. In fact, the discomfort has risen.

I try to relax my mouth during the day but that doesn't help. It has gotten to the point now where both opening and closing my mouth to varying degrees is proving difficult. Chewing and even talking is becoming an exercise in pain tolerance.

What could be going on? My dentist assures me that I have no infection. Any ideas as to what may be causing this and how to prevent it? I'm also unsure as to whether this is an issue for a dentist or a doctor to be dealing with.

posted by Tenacious.Me.Tokyo to health & fitness (13 answers total)

Get checked for Tetanus. Lockjaw is the first symptom.
posted by knz at 4:55 AM on January 7, 2010 [1 favorite]

IANAD but I'm still voting for tension/stress. Depending on the kind of night guard you've got, it may prevent your molars from touching but still not prevent you from tightening up your jaw muscles while you sleep. (From what my dentist tells me, if you've got the kind that looks like a "retainer", it won't stop you from tightening the muscles. If you've got the kind that's a little block of plastic that clips onto your front teeth, it WILL stop you from tightening.)

I've got a similar tendency with my jaws when stressed, so I can relate to what you're saying.

The only thing that's worked for me is to be REALLY vigilant about noticing when I'm doing it and then spending a few moments to relax those muscles. Usually this involves making weird faces -- stretching my mouth and jaw into "ooooo" and "eeeee" shapes and massaging the muscles. Obviously, that's not easy to do if you're in the middle of a meeting or such.

It might help for you to schedule specific times throughout your day to go through a muscle relaxing kind of procedure. Maybe once every hour -- even if you don't think you're feeling especially tense -- take five minutes to stretch out the muscles and massage them while thinking calming thoughts.
posted by rhartong at 5:04 AM on January 7, 2010 [1 favorite]

Stress worsens TMJ -- google it, there are ways to improve it. (I've had it on and off for years too.)
posted by keener_sounds at 5:17 AM on January 7, 2010

TMJ. Do you know if you grind your teeth while sleeping? People experiencing high stress often do this, which can lead to the issues you present.
posted by Thorzdad at 5:32 AM on January 7, 2010

See a new dentist for a second opinion on possible infection.
posted by bunny hugger at 5:50 AM on January 7, 2010 [1 favorite]

I had this same kind of pain last year during a period of high stress and believe it or not what worked to dissipate the pain was to consciously clamp my teeth together several times a day - not hard, just to make sure they are touching. For some reason the stress was causing me to keep my teeth apart all day and my jaw muscles didn't like that. The pain was totally gone in less that a month, now whenever it comes back I remember to do it and it goes away immediately.
posted by any major dude at 5:51 AM on January 7, 2010

Agreeing with rhartong. I had a full-mouth night guard that didn't stop the clenching at all, but the NTI-tss night guard works for me (and also reduces the number of migraines I get significantly).

My dentist also prescribed valium as a muscle relaxant, which helped a lot; now I use a different muscle relaxant, carisoprodol. I think that taking magnesium malate at bedtime, two 1250 mg pills, which works out to 70% of the US RDA for magnesium, has helped me, too. (Magnesium oxide doesn't work for me, due to poor absorption, but magnesium citrate does; I take it only at bedtime to avoid problems with the side effect of sleepiness.)
posted by Ery at 7:08 AM on January 7, 2010

I grind my teeth at night. First I got a soft mouth guard from a dentist. It was basically a more sturdy version of the one you use for sports. I protected my teeth but didn't help the jaw pain.

I have a hard mouth guard that was expensive and needed to be fitted over a number of visits. This not only protects my teeth from grinding, but because of the fit, it keeps me from grinding at night. My mouth still gets "clenchy" when I'm tired or stressed but it doesn't hurt when I wake up or when I chew or when I have to hold it open.
posted by Gor-ella at 7:20 AM on January 7, 2010

Definitely look into magnesium citrate/malate supplements; those have helped me tremendously with similar stress-related jaw pain, and they are cheap, fast, and benign.

For me, upper body tension (shoulder and neck) exacerbates jaw tension. Besides relaxing your jaw muscles, try to make an effort to stretch your shoulders and neck frequently. Look into your posture - rounded shoulders/forward head from sitting at a computer all day always makes things worse for me - it's better when I sit up straight.

What position do you sleep in? When the pain was at its worst, I found it helpful to sleep on my back with a rolled up towel under my neck, no pillow. This seemed to relax my jaw and reduce clenching. YMMV.
posted by Knicke at 7:58 AM on January 7, 2010

One fun trick my RMT gave me to loosen clenched jaw muscles is this:

- Sit down at a table or some other hard surface
- While clenching your teeth, use your index & pointer fingers to find the ball of muscle that pops up in your cheek
- Now, stop clenching but keep your fingers at that same point
- Lean your elbows onto the table. The pressure from your arms lets your fingers get into that tight ball of muscle.
- Lean!

I've found it surprisingly effective at getting my jaw to loosen up.
posted by machine at 8:30 AM on January 7, 2010 [1 favorite]

IANAD but TMJ. I got it and when I'm stressed out it acts up. Either that or you are using your jaw muscles too much. I doubt it's lockjaw. I think you would remember being cut by anything rusty. Try heat to relax your jaw. Or if that doesn't work try icing it.
posted by Mastercheddaar at 8:49 AM on January 7, 2010

I have the same thing about once or twice a year. I went to urgent care because it hurt so bad once and they did a blood test to make sure it wasn't something serious (I don't know what that something was unfortunately). If it is just in the muscle, it could be myocitis, what I was diagnosed with. Though, I only have it on one side or the other, usually not both.

Muscle relaxants and ibuprofen will help with the pain/swelling. A hot compress also really helps to loosen things up, but until the swelling/inflammation goes down, there's nothing you can do but grit your teeth (ooh bad, sorry).

If you have never had any symptoms of tmj before, I would have a hard time believing it just started for you, then again I am not a dentist or a doctor.
posted by TheBones at 11:32 AM on January 7, 2010

You may be a clencher (like me). When focused or stressed I tend to bite down and this causes the pain you described. I often stick my tongue between my front teeth (mouth closed and no one notices) when typing, reading or any time I am focused. This keeps me from clenching.
posted by saradarlin at 9:58 PM on January 7, 2010