Should I get a mouthguard?

March 26, 2015 8:27 AM

A little over a month ago I was in an auto accident, and after experiencing some jaw pain that has since dissipated, my dentist thinks I might want to get a mouthguard to prevent the pain from returning and worsening in the future. Is this sound advice?

To be thorough, let me say that I was rear-ended while at a complete stop: the velocity was enough that my car had severe structural damage, but my airbags did not deploy. I had some neck/body pain for a few days, some dizziness immediately after the accident, but for the most part I was feeling normal except that I noticed that since the accident, my jaw was stiff, and it ached when I chewed hard foods. I had a few related headaches (I almost never get headaches). I didn't immediately make the connection, but I found some info online that suggested that TMJ pain can be accident related.

At the recommendation of my internist, I went and saw my dentist. He made the case that TMJ pain can be caused by an accident, but present itself years and years after the fact. Note that at this point, I'm not really having much acute pain at all, though I did have a tension headache after leaving the dentist's office after he ran some tests on my jaw.

The bottom line is that he is recommending that I get a mouthguard to prevent future onset of TMJ pain. Can an auto accident really cause TMJ pain years after the fact? Would a mouthgaurd (occlusal splint) really help align my jaw in such a way as to prevent this?

The research I have read online ranges from skeptical to uncertain on both points, but at the same time it does seem to me that my recent pain was related to my accident. So I'm ambivalent: I don't want to contradict expert advice, nor do I want to deal with a mouthguard if there's nothing to it. Insurance will likely cover this, and I can take the hit if for some reason it doesn't.

Incidentally, my dentist also recommends seeing a chiropractor just in case, though I have no lingering pain or soreness from the accident. This recommendation was given by the same reasoning: that an adjustment now can mitigate or prevent pain down the road. What do you think?

posted by millions to Health & Fitness (9 answers total)

I was adjusted after a concatenation of events that aggravated my occasionally minor TMJ pain into serious migraine territory. I'd ended up with a compressed nerve or something that mild traction helped put right.

I've not had much TMJ pain since, but I made the decision to get the mouthguard. The one my dentist put me in is a very thick clear plastic that they took molds of my teeth for.

Out of pocket it was about $600 but only because I didn't want to wait 4-5 weeks to find out what insurance or dental would or would not pay, am hoping for reimbursement.

Dentist also told me the thing, with care, would last 5-10 years.

I'd say see the chiro and see what he says (I was seeing a PT who also did weird things to release "trauma" in my skull, wtf). I'd say have the dental office start the process with insurance and get a pre-approval so you aren't out of pocket as much.

For me, having $600 to pay "today" to help prevent a pain setback was worth it, though in the month since I got it I've hardly worn it and have not yet been reimbursed. But I figure it's $60 a year for ten years if it keeps me from missing work and insane exhausting pain.
posted by tilde at 8:50 AM on March 26, 2015 [2 favorites]

I'm in PT for TMJ right now. PT has been very helpful. The therapist explained to me that most of the time, TMJ is related to many more factors other than direct trauma. In my case, it's bad posture, neck pain from a previous car accident, and anxiety (I have woken up clenching my teeth).

In PT, she's done head/neck massage, massage inside my mouth, and dry needling (similar to acupuncture). I'm also taking long-term medication for anxiety, getting plenty of low-impact exercise, met with a counselor, and am taking care of my mental state so I don't get so anxiety-ridden. PT has shown the best results in only about 2 weeks of going twice per week.

I think treatment for TMJ boils down to if it feels good, and relieves your pain, do it. No one can predict how you will respond to treatment, but don't discount the possibility that TMJ will need to be treated in a more holistic way. I hope you feel better soon.
posted by FergieBelle at 9:38 AM on March 26, 2015 [2 favorites]

I have minor TMJ, and I do use a custom mouthguard. It makes the "popping" that my jaw does much less painful, among other things, like less teeth wear and tear from grinding.
posted by Ms Vegetable at 9:50 AM on March 26, 2015 [2 favorites]

I have a biteguard (for teeth grinding) and I believe it is causing some TMJ pain (but not popping) that I didn't have before--- just another data point!
posted by H21 at 11:00 AM on March 26, 2015 [1 favorite]

I can't speak to the mouthguard, but I did have TMJ pain and locking up that could potentially have been caused by a rear-ending accident and/or by stress. I went to a chiropractor because I was also having other pains, all mainly focused on my left side, and I suspected that something had gotten knocked out of alignment. He fixed them all, including the jaw! It took several months worth of treatment, if I recall, and I go back every few months or so if I feel if things are locking up again.

Be careful what chiro you go to, though. Mine did very little "cracking" and never tried to foist woo-woo supplements on me; most of what he did was the kind of electrode stimulation therapy (on my back and shoulders) that I'd had in PT for other issues, plus ultrasound and laser therapy on my jaw.

Good luck!
posted by velvet_n_purrs at 11:11 AM on March 26, 2015 [1 favorite]

Best answer: IAAD but NYD. My view is that chiropractic is woo, and treating symptoms that don't exist is also woo.
Myofacial pain (what folks often refer to as TMJ, a term that we use to refer to the joint and only the joint, not symptoms associated with it) can arise from many factors, and a history of whiplash injury is often among them, but if there is no pain at this moment then there is no pain.
If your teeth come together the way they always have, and you don't have a history of destructive nighttime grinding or clenching, then there is little to anticipate that this injury will change that over the course of a time frame that doesn't allow for future re-evaluation, and action if symptoms arise.
Of course if you wait and see and 5 yrs from now you have facial or jaw pain and everyone points to the injury but then tells you insurance won't cover it this long after the fact you might regret not having the guard made now, but this is a dialogue i have with my patients as part of deciding to intervene or not.
posted by OHenryPacey at 12:19 PM on March 26, 2015 [2 favorites]

(A sidenote: I don't know where your dentist recommends getting your mouthguard, but my wife had one custom-made by her dentist for $300, lost it, and replaced it with a $15 boil-and-bite mouthguard from a local sporting goods store. Both worked fine for her nocturnal grinding habit. I am not a dentist.)
posted by davcoo at 3:17 PM on March 26, 2015 [1 favorite]

I had a custom mouthguard for a decade (they really do last forever), but lost it for awhile recently while packing and moving and bought a $15 one at the store that you melt then mold to your teeth.

I haven't noticed any difference in sleep quality/pain in ~2-3 weeks.

Maybe try one of those and see what it does for you. It won't last for years, but really did mold well to my teeth and works.
posted by OnTheLastCastle at 11:13 PM on March 26, 2015

Response by poster: Given that even the most conservative feedback here cautions against the possibility of being out of luck in the case that pain might resurface down the road (and that my jaw has been feeling a little out of sorts even recently) I am going to proceed with an abundance of caution and get the mouthguard. If it ends up coming out of my own pocket and proves pointless anyways, I will get over that sooner than I would the eventuality of having to deal with chronic pain down the road for going against my dentist's advice.

Sincere thanks to everyone who responded.
posted by millions at 3:46 PM on March 29, 2015