January 26, 2010 10:12 AM   Subscribe

How do I change sleeping behaviors that seem to be causing TMJ? What kinds of treatment are effective?

About a week and a half ago, I awoke to find my bite all screwed up. My molars no longer meet along one side, and my lower teeth feel like they are pushed forward and askew. This is totally out of the blue -- no previous symptoms, no popping, pain, nighttime tooth-grinding, etc.

Fortunately, it's not acutely painful -- I can still chew and have full range of motion -- but it's uncomfortable, and I'm concerned about the condition worsening or becoming permanent.

Since then, I've discovered that I can get my jaw back to go back "in" by pressing in the right direction. But I wake every morning to find that it's out again. When I awaken, I have noticed that am often curled on my side with my hand under my chin -- and I believe that this gentle pressure, repeated night after night, may be the root cause of the problem.

So my first question is, how can I train myself to keep my hands away from my face while sleeping? My best idea so far is some kind of soft comfy restraints. Any ideas on how to do this effectively, or information on how long to it takes to retrain sleeping patterns, or other bright ideas are welcome.

In the past week, I've visited my dentist (who is making me a lower nightguard); a chiropractor (who said they couldn't help), and a craniosacral practitioner (who helped the jaw go back in but doesn't seem to have much on how to improve the problem long-term).

So my second question is this: what kind of practitioner should I see to treat this problem long-term, to keep it from becoming chronic or deteriorating? Should I get regular hands-on manipulation, and if so by whom? Surgery? Braces? (Bear in mind that I will likely be paying out of pocket.)

I appreciate relevant links, personal experience, and informed opinions -- and yes, I know you're not my doctor.
posted by anonymous to Health & Fitness (8 answers total) 8 users marked this as a favorite
There is no way you're going to retrain yourself. You'll need a night guard created by your dentist. I just had one done for teeth clenching at night (gee, stressed much??). It was $100.

For practitioner you'll need a maxillofacial surgeon

Braces caused my TMJ so not sure if they will help.

Good luck.
posted by stormpooper at 10:18 AM on January 26, 2010

Use the mouthguard. It's annoying at first and I even had some difficulty where saliva would drip back in my throat and wake me up occasionally. But the more you use it, the more you get used to it and I'm at the point now where I find sleeping without it a little weird.

It helped me when I first started using the mouthguard to sleep with an extra pillow to prop my head up a little higher.
posted by jeff-o-matic at 10:20 AM on January 26, 2010

nthing mouthguard. you need one.
posted by mcstayinskool at 10:51 AM on January 26, 2010

Yes, you'll need a mouthguard. My weeks-old new one was $300 and change. Plan for it -- a lot of insurance plans won't cover it.
posted by jgirl at 10:57 AM on January 26, 2010

jumping on the mouthgard train. same thing happened to me. You also might want to talk to an oral surgeon - that's what my dentist recommended.
posted by Lucinda at 11:06 AM on January 26, 2010

First and foremost, have your dentist do a thorough workup of your joint function and occlusion (bite). Correct long term treatment or management can only come after a diagnosis of your condition.
The absence of pain is a good sign. this may be a temporary circumstance that requires no long term therapy; or it may be some sign that there is an element of your bite, your sleeping habits, the skeletal relationship of your jaws that needs to be addressed.
Simply dishing out money for an appliance that might have nothing to do with your individual problem (or lack thereof) is not good medicine or good advice.
posted by OHenryPacey at 11:34 AM on January 26, 2010

Same thing happened to me, after a clumsy filling broke while on vacation and caused me to grind my teeth down really badly over the course of a week or two - which sounds like your problem.
My dentist created a nightguard that retrained my bite into a better alignment. This was not the usual nightguard, but more like a plastic brace, that fitted over my upper teeth and spanned back about and inch or so into the roof of my mouth. My dentist spent a lot of time on this: first adjusting the slope of the nightguard so that it would force my teeth to slide in the "right" direction if I ground them overnight, then adjusting the nightguard incrementally over the next few months, to get an improved bite. This was in the UK and it cost me 230 pounds sterling, 14 years ago (about $450). You could probably double that now - but it was worth every penny: I had a really bad underbite at the time and I have had no problems since.
I have not found a US dentist who understands this type of nightguard training (although I have not looked very hard) - however, my UK dentist did comment that he learned the technique on his annual US "dentistry update" training course (a working vacation) in California. You'll probably have to call around to find someone who can do this, but it is well worth the cash.
posted by Susurration at 11:48 AM on January 26, 2010 [1 favorite]

You should speak to a dentist who specializes in TMJ; he or she will take a bunch of measurements, and will likely suggest you see a maxillofacial surgeon and/or get an extensive set of x-rays. At least a specialist should be able to tell you whether you're currently causing major, long-term damage and really should pay out of pocket to get it dealt with immediately.

I say this as someone who had to have braces, a splint, and some rather extreme surgery to deal with TMJ issues, and will have to do it again. Don't wait.
posted by you're a kitty! at 6:50 PM on January 26, 2010

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