From things that bump and grind in the night, may the good RMT deliver me
August 19, 2011 10:49 AM Subscribe
I grind my teeth in my sleep. A friend of mine who is an Registered Massage Therapist ("RMT") tells me that even though I have a night guard I'll destroy the discs in my jaw by grinding, that the fact that my jaw clicks when it opens and shuts is VERY BAD, and that I need to get to an RMT pronto. The dentists at the clinic I go to claim they've never heard of massage as a cure for grinding. So I have two questions: is my RMT friend right, and if so, can you recommend a Toronto-area (preferably central or west-end) RMT who has specialized training in TMJ issues?
I'll destroy the discs in my jaw
Say what now?
The mandible is connected to the skull by a joint, and while said joint does have a known disorder, degeneration of the articular disc isn't really the biggest concern in TMJ. Pain and damage to your teeth are.
And no, massage therapy isn't really used in treating TMJ. Or, really, much of anything, when it comes right down to it. It's an awesome way to relax, and can help with cramps and the like, but that's really about it.
posted by valkyryn at 11:00 AM on August 19, 2011 [1 favorite]
Say what now?
The mandible is connected to the skull by a joint, and while said joint does have a known disorder, degeneration of the articular disc isn't really the biggest concern in TMJ. Pain and damage to your teeth are.
And no, massage therapy isn't really used in treating TMJ. Or, really, much of anything, when it comes right down to it. It's an awesome way to relax, and can help with cramps and the like, but that's really about it.
posted by valkyryn at 11:00 AM on August 19, 2011 [1 favorite]
This really stinks of woo. I'm almost always going to trust the dentist who presumably went to dental school for at least 3 years and spent a fair amount of time working on mouth and jaw related issues over the RMT who had 2200 of training on all aspects of massage when it comes to issues regarding my mouth/jaw.
Bonus points: do a Google search for TMJ massage and see what kind of websites you hit. They are very woo-y. Also: Wikipedia, WebMD, and MayoClinic did not list massage as a treatment. Massage wasn't listed under MayoClinic's Alternative Medical Treatments list for TMJ either.
posted by Mister Fabulous at 11:08 AM on August 19, 2011 [1 favorite]
Bonus points: do a Google search for TMJ massage and see what kind of websites you hit. They are very woo-y. Also: Wikipedia, WebMD, and MayoClinic did not list massage as a treatment. Massage wasn't listed under MayoClinic's Alternative Medical Treatments list for TMJ either.
posted by Mister Fabulous at 11:08 AM on August 19, 2011 [1 favorite]
There are a ton of overpriced and underproven remedies for TMJ, ranging from massage (which probably can't hurt and might at least help your tightened muscles feel better for a while) to weird long-term therapies involving orthodontia and laser-guided MRI and all heck and all.
According to my uncle, who's an actual dentist, the fact that your jaw clicks means you've got a touch of TMJ, and if it's hurting, you should take a couple of aspirin and stick to softer foods -- or at least avoid giant sandwiches -- for a week or so. If it doesn't feel better, or if it gets worse, you can talk to your dentist, but he doesn't really advocate anything beyond a custom-fitted night guard even for more extreme cases.
posted by infinitywaltz at 11:14 AM on August 19, 2011
According to my uncle, who's an actual dentist, the fact that your jaw clicks means you've got a touch of TMJ, and if it's hurting, you should take a couple of aspirin and stick to softer foods -- or at least avoid giant sandwiches -- for a week or so. If it doesn't feel better, or if it gets worse, you can talk to your dentist, but he doesn't really advocate anything beyond a custom-fitted night guard even for more extreme cases.
posted by infinitywaltz at 11:14 AM on August 19, 2011
No offence, Orange Swan, but it sounds like your friend was hoping to drum up some business from you. :(
posted by LN at 11:14 AM on August 19, 2011 [1 favorite]
posted by LN at 11:14 AM on August 19, 2011 [1 favorite]
There are a ton of overpriced and underproven remedies for TMJ, ranging from massage (which probably can't hurt as long as money & time are unimportant to you.
FTFY, infinitywaltz.
Snake oil is snake oil, even when it feels good.
posted by IAmBroom at 11:21 AM on August 19, 2011
FTFY, infinitywaltz.
Snake oil is snake oil, even when it feels good.
posted by IAmBroom at 11:21 AM on August 19, 2011
To present a differing opinion: my brother has TMJ, which has caused problems for his saxophone playing (he's a music major). The dentist he saw prescribed muscle relaxants and PT, which as far as I can tell means a combination of massage and training in various exercises and awareness of grinding. (If you can manage to be aware of it when it happens, presumably you can interrupt the cycle at least to some extent.)
Admittedly, I don't have studies I can point to; it's not something I've researched. And I don't think either the relaxants or the PT are treating the underlying cause, just helping manage his symptoms. But your friend may not be completely out in left field, and talking to a dentist who does specialize in TMJ might not be a bad idea, if it's causing you pain. If not, well, lots of people grind; probably cheaper to get a bite guard made and see if that helps first.
posted by spaceman_spiff at 11:23 AM on August 19, 2011 [1 favorite]
Admittedly, I don't have studies I can point to; it's not something I've researched. And I don't think either the relaxants or the PT are treating the underlying cause, just helping manage his symptoms. But your friend may not be completely out in left field, and talking to a dentist who does specialize in TMJ might not be a bad idea, if it's causing you pain. If not, well, lots of people grind; probably cheaper to get a bite guard made and see if that helps first.
posted by spaceman_spiff at 11:23 AM on August 19, 2011 [1 favorite]
As someone who had bad TMJ a long time ago, used a nightguard for a few years, and never had the issue come back -- stick with the proven techniques for now.
posted by davejay at 11:24 AM on August 19, 2011 [1 favorite]
posted by davejay at 11:24 AM on August 19, 2011 [1 favorite]
Response by poster: My jaw doesn't hurt me at all, though I would damn near kill to be able to stop the grinding as I hate having to bother with an icky mouthguard.
My dentist's response to my asking what I could do to stop the grinding was a shrug and a "Reduce stress in your life". Since I once ground my way through the seven nights of a vacation that was the happiest week of my life, I don't really think that's going to help.
And my friend is in the clear here in terms of vested interest. He lives in Ottawa, and I live in Toronto, and his reach just isn't long enough for him to work on me. He got this information about TMJ issues in a special several-day workshop he took some months ago.
posted by orange swan at 11:24 AM on August 19, 2011
My dentist's response to my asking what I could do to stop the grinding was a shrug and a "Reduce stress in your life". Since I once ground my way through the seven nights of a vacation that was the happiest week of my life, I don't really think that's going to help.
And my friend is in the clear here in terms of vested interest. He lives in Ottawa, and I live in Toronto, and his reach just isn't long enough for him to work on me. He got this information about TMJ issues in a special several-day workshop he took some months ago.
posted by orange swan at 11:24 AM on August 19, 2011
Just as a counterpoint: My jaw used to click constantly. It went away on its own. I never used a mouth guard or saw a doctor about it either. Also, I agree about reducing stress and would add that what is really important is reducing stress right before bed. So make sure you take 15 minutes or whatever to read a book or pet your cat or something.
posted by 2bucksplus at 11:29 AM on August 19, 2011
posted by 2bucksplus at 11:29 AM on August 19, 2011
Since I once ground my way through the seven nights of a vacation that was the happiest week of my life, I don't really think that's going to help.
A week really isn't long enough to reverse the physiological effects of chronic stress.
posted by valkyryn at 11:45 AM on August 19, 2011 [2 favorites]
A week really isn't long enough to reverse the physiological effects of chronic stress.
posted by valkyryn at 11:45 AM on August 19, 2011 [2 favorites]
A week really isn't long enough to reverse the physiological effects of chronic stress.
Haha, yeah, this. This is a much-longer process. As someone who for quite some time could barely get his mouth open, and who used to shock people in restaurants with the horrifyingly loud POP when he could get it open, it takes a sustained and prolonged effort. I actually found massage quite useful, along with mouthguards, yoga, and changing about 75% of the stressors in my life. These things take time, and it's all the more annoying because the process is both sort of mysterious and also mystified and muddied.
posted by RJ Reynolds at 11:50 AM on August 19, 2011
Haha, yeah, this. This is a much-longer process. As someone who for quite some time could barely get his mouth open, and who used to shock people in restaurants with the horrifyingly loud POP when he could get it open, it takes a sustained and prolonged effort. I actually found massage quite useful, along with mouthguards, yoga, and changing about 75% of the stressors in my life. These things take time, and it's all the more annoying because the process is both sort of mysterious and also mystified and muddied.
posted by RJ Reynolds at 11:50 AM on August 19, 2011
This is my experience. YMMV. A few years ago, I was very stressed. During this time, my jaw would click and feel out of alignment. I sometimes would bite down on things in order to "click" my jaw back into place. My shoulders and neck were also very tight, to the point where I couldn't lift my arms over my head without pain. I went to a massage therapist who remarked on how tight my shoulders and neck were and proceeded to only massage them for the next few visits. When the tightness and pain went away, so did the problems with my jaw. I never mentioned the jaw issue with her. I never saw a dentist about it. For me, I think my issue with my jaw was due to stress and the massages resolved it. Now I am more cognizant of when I am clenching my jaw (before I wasn't aware I was doing it). Now I recognize that it is a sign that I am under stress.
posted by elle.jeezy at 11:51 AM on August 19, 2011
posted by elle.jeezy at 11:51 AM on August 19, 2011
I have a similar storry to elle.jeezy. Started at a desk job four years ago, neck and shoulders were hurting, and my jaw would lock - like I couldn't open my jaw all the way and it would click/pop when I got it to. I didn't grind my teeth. Saw an opsteopath (memailing you to provide details) and she found that two of my upper vertebrae were stuck together and once she released them, I had no more jaw locking/clicking and it's never come back.
posted by foxjacket at 12:19 PM on August 19, 2011
posted by foxjacket at 12:19 PM on August 19, 2011
Here's another case of well this what worked for me and YMMV. I developed a really severe problem with TMJ (this was in the early 90s). Got to the point where I could barely open my mouth (I was surviving on soup and protein shakes). After not getting any real satisfaction from dentist, I went to a TMJ clinic at Tufts Medical Center in Boston. The dentists/doctors there used both conventional treatments (such as guards - I had both a night and a day guard) as well as alternative therapies-- what would most likely be described as woo woo stuff on Ask Mefi. Examples of the alternative treatments included teaching patients accupressure points, use of biofeedback machines, etc. I was also sent for massage therapy with a physical therapist, although this was because I developed shoulder problems. Basically the TMJ/locking of my jaw was creating problems all the way down that side of my body. So I can see where there is a case that it might help. On the other hand if your jaw is bothering you, then I wouldn't worry about it.
posted by kaybdc at 1:51 PM on August 19, 2011
posted by kaybdc at 1:51 PM on August 19, 2011
ughh. Of course I meant "if your jaw *isn't* bothering you, *than* I wouldn't worry about it."
posted by kaybdc at 1:53 PM on August 19, 2011
posted by kaybdc at 1:53 PM on August 19, 2011
Yeah, not the isn't part, but *then* i got flustered. Weirdly then/than is something that I've only been 2nd guessing myself over lately after several decades of managing to construct grammatically correct sentences. My kingdom for an edit or delete button.
posted by kaybdc at 1:56 PM on August 19, 2011
posted by kaybdc at 1:56 PM on August 19, 2011
I feel like I say this in every teeth grinding thread, but mine goes away when I take a Multi-B plus Magnesium supplement. (I stop taking them, eat poorly, and sometimes have a recurrence, but not in several years since I've been eating more B5 foods.) I see an effect within just a few days to a week. According to the link, you could use just B5 and Magnesium. It's cheaper and easier than just about anything, so if it doesn't work, you haven't invested much time or money.
posted by oneirodynia at 2:43 PM on August 19, 2011 [3 favorites]
posted by oneirodynia at 2:43 PM on August 19, 2011 [3 favorites]
I totally understand wanting to believe in just about any treatment for something chronic.
RMTs have an encyclopedic and hands-on knowledge of how (all the) muscles connect to one another - usually far exceeding that of any general practitioner. However, TMJ and teeth grinding are not usually muscle related.
... Unless it is. I have a high esteem of RMTs*, but if I were you I'd see a different RMT than the person who was blabbing about discs and such.
Hypothetically, RMT muscle work might help with the grinding if, hand-waving-here, there are certain muscles say in your neck that are pathologically tight or shortened which connects to other muscles that lead to grinding blahblahblah, some massage work could help reduce the severity of the grinding.
Wouldn't hurt to talk to a 3rd party RMT and see what they think.
*within their sphere of expertise; "workshop," however raises red flags - cons getting fees from professionals, professionals getting new ideas on what to diagnose clients (clients - not patients) with to get more business, &c&c.
posted by porpoise at 6:57 PM on August 19, 2011 [1 favorite]
RMTs have an encyclopedic and hands-on knowledge of how (all the) muscles connect to one another - usually far exceeding that of any general practitioner. However, TMJ and teeth grinding are not usually muscle related.
... Unless it is. I have a high esteem of RMTs*, but if I were you I'd see a different RMT than the person who was blabbing about discs and such.
Hypothetically, RMT muscle work might help with the grinding if, hand-waving-here, there are certain muscles say in your neck that are pathologically tight or shortened which connects to other muscles that lead to grinding blahblahblah, some massage work could help reduce the severity of the grinding.
Wouldn't hurt to talk to a 3rd party RMT and see what they think.
*within their sphere of expertise; "workshop," however raises red flags - cons getting fees from professionals, professionals getting new ideas on what to diagnose clients (clients - not patients) with to get more business, &c&c.
posted by porpoise at 6:57 PM on August 19, 2011 [1 favorite]
You might want to start with some self-massage. I've worked on people with TMJ and managed to decrease their jaw pain and increase their ability to open their jaw (from 1/2 inch to 1 inch plus). The key seems to be the masseter muscle (the first pictures on this page). Try pressing the points indicated (the round dots) and see if the pressure causes the pain to reoccur. If so, you may be on to something.
This is about trigger points, and not 'woo woo'. Travell and Simons' Myofascial Pain and Dysfunction is the definitive text. For a much lighter in weight and cheaper option, read Clair Davies' The Trigger Point Therapy Workbook - it's easy to read for the layman, and my go-to recommendation for clients who are willing to do some homework.
posted by sazanka at 7:38 PM on August 19, 2011 [1 favorite]
This is about trigger points, and not 'woo woo'. Travell and Simons' Myofascial Pain and Dysfunction is the definitive text. For a much lighter in weight and cheaper option, read Clair Davies' The Trigger Point Therapy Workbook - it's easy to read for the layman, and my go-to recommendation for clients who are willing to do some homework.
posted by sazanka at 7:38 PM on August 19, 2011 [1 favorite]
TMJ can destroy the disk of cartilage -- I know, because I've seen my X-rays. I had TMJ pretty bad (similar to elle.jeezy, in that it affected the muscles in my head, neck, and shoulders). I went to doctor and dentist specialists. In addition to a mouth guard, I also took prescription-strength ibuprofen for over a year, and went to a physical therapist. I'm not sure that an RMT can offer what the physical therapist did, but she worked with me on some exercises, things I could do at home (like, lay down with my neck on a sock that had 2 tennis balls tied up inside it), set me up with some cushions and such for chairs to improve general posture, and the most amazing thing -- which offered immediate relief -- used some sort of ultrasound wand cranked up to give off heat, directly on the joint.
But, if it's not bothering you then why go to anyone about it? If the cartilage is gone, my understanding is that it never comes back but you can still use your jaw fine. You may have some teeth shifting and some enamel loss to your teeth but (other than pain, which you don't have), I don't believe their are any important problems stemming from TMJ.
posted by Houstonian at 7:55 PM on August 19, 2011
But, if it's not bothering you then why go to anyone about it? If the cartilage is gone, my understanding is that it never comes back but you can still use your jaw fine. You may have some teeth shifting and some enamel loss to your teeth but (other than pain, which you don't have), I don't believe their are any important problems stemming from TMJ.
posted by Houstonian at 7:55 PM on August 19, 2011
This thread is closed to new comments.
posted by introp at 11:00 AM on August 19, 2011 [8 favorites]