Help me manage my TMJ disorder?
October 10, 2015 1:26 AM Subscribe
What has worked for you, fellow TMJ disorder sufferers?
For about eight years I've been clenching my jaw in my sleep. I've been wearing a splint every night for the past two years, which stops my molars eroding even further but doesn't stop the clenching. It's not so bad that I get migraines or anything, but I can feel the muscular tension going into my neck and shoulders. I will often give myself a jaw/masseter massage, which feels nice but doesn't actually fix anything. I've spoken to my dentist about it and her only advice is to try to reduce stress in my life. While I understand that stress can exacerbate it, I believe the way my jaw is set and the way my top and bottom teeth line up (they don't actually touch at the front teeth, just the back) are the main issues. My jaw also 'clicks' (not audibly) and the bottom jaw kind of slides a bit to the right when I open my mouth past a certain point I am conscious of my posture and jaw position where awake and I do yoga regularly to try to reduce tension.
Some people have said that Botox can help, but I am worried that it'll cause too much muscle weakness and maybe further asymmetry in my face shape (the right side of my jaw already sticks out further than the left side, probably because that's how I'm clenching in my sleep).
An orthodontist once said that the only way to fix my overbite/jaw alignment would be to have a jaw reconstruction, which terrifies me.
In summary, is it worth pursuing an invasive/expensive treatment for my TMJ disorder? My back teeth are still under quite a pressure, even with the splint, and I have already had a small crack show up in one of them. I'm not in pain, but the tension is starting to bother me, and I am worried it's going to become more of a problem if I leave it for too long.
Please share your experiences!
For about eight years I've been clenching my jaw in my sleep. I've been wearing a splint every night for the past two years, which stops my molars eroding even further but doesn't stop the clenching. It's not so bad that I get migraines or anything, but I can feel the muscular tension going into my neck and shoulders. I will often give myself a jaw/masseter massage, which feels nice but doesn't actually fix anything. I've spoken to my dentist about it and her only advice is to try to reduce stress in my life. While I understand that stress can exacerbate it, I believe the way my jaw is set and the way my top and bottom teeth line up (they don't actually touch at the front teeth, just the back) are the main issues. My jaw also 'clicks' (not audibly) and the bottom jaw kind of slides a bit to the right when I open my mouth past a certain point I am conscious of my posture and jaw position where awake and I do yoga regularly to try to reduce tension.
Some people have said that Botox can help, but I am worried that it'll cause too much muscle weakness and maybe further asymmetry in my face shape (the right side of my jaw already sticks out further than the left side, probably because that's how I'm clenching in my sleep).
An orthodontist once said that the only way to fix my overbite/jaw alignment would be to have a jaw reconstruction, which terrifies me.
In summary, is it worth pursuing an invasive/expensive treatment for my TMJ disorder? My back teeth are still under quite a pressure, even with the splint, and I have already had a small crack show up in one of them. I'm not in pain, but the tension is starting to bother me, and I am worried it's going to become more of a problem if I leave it for too long.
Please share your experiences!
Magnesium supplements have helped me quite a bit with my bruxism related TMJ. I take magnesium citrate in the form of Natural Calm but there are a lot of other ways to take it. Another thing that works for me is sleeping on my back without a pillow and with a rolled up towel supporting my neck. May not work if you have a snoring problem, but free to try.
posted by Knicke at 2:01 AM on October 10, 2015
posted by Knicke at 2:01 AM on October 10, 2015
Biofeedback training helped me a LOT. I was a teenager at the time (almost 30 years ago,OMG) and I did many months of weekly sessions. At home I did guided meditations to get to sleep and sleep calmly without grinding my teeth.
posted by PorcineWithMe at 3:32 AM on October 10, 2015
posted by PorcineWithMe at 3:32 AM on October 10, 2015
Methocarbamol and heat kill my 'TMJ' flares. I tried many muscle relaxants with no/little results but that -- sold OTC here in Canada as Robaxin, Robaxacet, in generic form, etc, works.
Once I had to stop at a drugstore, get one of those instant heat pads, and bandage it to the side of my head to manage to drive home, which was no fun at all but kept me safe on the road. I use a heating pad at home.
From some modest reading on this the only two things I have been able to extract are: most invasive procedures are desperate measures with poor success rates, and, experts disagree like crazy on TMJ disorder treatment. Frustrating, yes.
posted by kmennie at 6:18 AM on October 10, 2015
Once I had to stop at a drugstore, get one of those instant heat pads, and bandage it to the side of my head to manage to drive home, which was no fun at all but kept me safe on the road. I use a heating pad at home.
From some modest reading on this the only two things I have been able to extract are: most invasive procedures are desperate measures with poor success rates, and, experts disagree like crazy on TMJ disorder treatment. Frustrating, yes.
posted by kmennie at 6:18 AM on October 10, 2015
Cutting out caffeine is the only thing that helped me.
posted by misskaz at 6:31 AM on October 10, 2015
posted by misskaz at 6:31 AM on October 10, 2015
How long ago was your consultation with the orthodontist? I was told I'd need jaw surgery by my orthodontist in highschool (upper jaw was slightly over expanded and my natural bite has just my front right and back left teeth touching) , but several years later my dentist thought invisiline could correct it.
Obviously, ymmv, but another consultation might be worth it. I mostly ignore my TMJ, so I never pursued invisiline, but my sister has said she's happy with her results (her TMJ was a migraine trigger).
posted by ghost phoneme at 6:33 AM on October 10, 2015
Obviously, ymmv, but another consultation might be worth it. I mostly ignore my TMJ, so I never pursued invisiline, but my sister has said she's happy with her results (her TMJ was a migraine trigger).
posted by ghost phoneme at 6:33 AM on October 10, 2015
I am not a dentist or doctor, but to me it sounds like you have some things conflated.
In my experience with a severely misaligned bite (underbite, in my case), clenching, and mystery jaw pain, my severely misaligned bite exasperated the pain I felt from clenching, but it wasn't the cause of the clenching. My bite is now fixed, and I still clench. My orthodontist told me once that he clenches. It sounds like you're saying you think the reason you're clenching is because of your bite. Before pursuing treatment for your bite, you may want to clarify this point with any doctors you see. I will say that my pain from clenching is much less now that my bite is correct.
Some things that helped me with clenching:
- My orthodontist made me a special retainer - he referred to it as a bite plate - that physically prevented me from clenching because of the way it made my teeth touch. Basically my front teeth touched but my back ones didn't, but the mouth won't continue to try to clench if there's pressure on the front teeth. I'm sorry I can't provide a better description. I made it sound like voodoo science, but this absolutely worked for me.
- Previously, prescription muscle relaxants or prescription pain killers.
- Personally, I think I clench more when laying flat with no pillow and less when propped with my head up.
Also, I'm not sure how old you are, but yes, I found that my jaw problems got worse when I got older, which is part of what pushed me to finally fix my bite in my 30s.
If you really want to fix your bite, I think you'll find the general consensus among the AskMe jaw surgery crowd is that the process is long and difficult but so worth it if that's what you really want for yourself. It's also surprisingly common these days. I've been surprised by the number of people who told me they had the same thing done as a kid. Just make sure you get a primo surgeon. Good luck.
posted by unannihilated at 7:13 AM on October 10, 2015
In my experience with a severely misaligned bite (underbite, in my case), clenching, and mystery jaw pain, my severely misaligned bite exasperated the pain I felt from clenching, but it wasn't the cause of the clenching. My bite is now fixed, and I still clench. My orthodontist told me once that he clenches. It sounds like you're saying you think the reason you're clenching is because of your bite. Before pursuing treatment for your bite, you may want to clarify this point with any doctors you see. I will say that my pain from clenching is much less now that my bite is correct.
Some things that helped me with clenching:
- My orthodontist made me a special retainer - he referred to it as a bite plate - that physically prevented me from clenching because of the way it made my teeth touch. Basically my front teeth touched but my back ones didn't, but the mouth won't continue to try to clench if there's pressure on the front teeth. I'm sorry I can't provide a better description. I made it sound like voodoo science, but this absolutely worked for me.
- Previously, prescription muscle relaxants or prescription pain killers.
- Personally, I think I clench more when laying flat with no pillow and less when propped with my head up.
Also, I'm not sure how old you are, but yes, I found that my jaw problems got worse when I got older, which is part of what pushed me to finally fix my bite in my 30s.
If you really want to fix your bite, I think you'll find the general consensus among the AskMe jaw surgery crowd is that the process is long and difficult but so worth it if that's what you really want for yourself. It's also surprisingly common these days. I've been surprised by the number of people who told me they had the same thing done as a kid. Just make sure you get a primo surgeon. Good luck.
posted by unannihilated at 7:13 AM on October 10, 2015
My brother has managed his TMJ for years with Vitamin B-complex. He usually takes one capsule each day but when he is particularly stressed he takes one at every meal for a few days. YMMV of course.
posted by Soda-Da at 9:10 AM on October 10, 2015
posted by Soda-Da at 9:10 AM on October 10, 2015
I'm an intractable bruxer. I started grinding as an infant. And I lived with chronic head pain every single day for years and years.
Several years ago I did a thorough literature review. I tried all of the interventions with reasonably strong evidence to support them. (For me, there was insufficient evidence to support the use of surgery or bite realignment. Specifically, I didn't see a causal relationship between a misaligned bite/jaw and clenching.) Nothing worked. And then I ran across an early paper from a group out of an academic medical center on the efficacy of botox in treating bruxing. It was life changing. No more constant headache.
For me, botox has moved me closer to bilateral symmetry - no more bulging masseter. I think the key to success (e.g. minimizing the risk of complications) is working with an excellent clinician with a deep understanding of anatomy and extensive experience using botulinum toxin. Feel free to memail me if you'd like to discuss more.
posted by mattbcoset at 11:45 AM on October 10, 2015
Several years ago I did a thorough literature review. I tried all of the interventions with reasonably strong evidence to support them. (For me, there was insufficient evidence to support the use of surgery or bite realignment. Specifically, I didn't see a causal relationship between a misaligned bite/jaw and clenching.) Nothing worked. And then I ran across an early paper from a group out of an academic medical center on the efficacy of botox in treating bruxing. It was life changing. No more constant headache.
For me, botox has moved me closer to bilateral symmetry - no more bulging masseter. I think the key to success (e.g. minimizing the risk of complications) is working with an excellent clinician with a deep understanding of anatomy and extensive experience using botulinum toxin. Feel free to memail me if you'd like to discuss more.
posted by mattbcoset at 11:45 AM on October 10, 2015
I use a splint at night that takes pressure off the joint by pushing my bottom jaw down and forward, which has improved matters significantly.
I used a program provided by my work to have a physiotherapist come and adjust my desk, chair and monitor positions. There are guides to setting up desks ergonomically online, if this is something you haven't done yet.
I use a heat pack filled with rice to apply moist heat first to the jaw joint, then the back of my neck during flare ups.
I do five minutes of legs up the wall pose a day.
It sounds like you've consulted mostly dentists - you may benefit from a second opinion from a physio who specialises in TMJ.
posted by PercyByssheShelley at 7:35 PM on October 10, 2015
I used a program provided by my work to have a physiotherapist come and adjust my desk, chair and monitor positions. There are guides to setting up desks ergonomically online, if this is something you haven't done yet.
I use a heat pack filled with rice to apply moist heat first to the jaw joint, then the back of my neck during flare ups.
I do five minutes of legs up the wall pose a day.
It sounds like you've consulted mostly dentists - you may benefit from a second opinion from a physio who specialises in TMJ.
posted by PercyByssheShelley at 7:35 PM on October 10, 2015
Response by poster: Thanks everyone. I think the last time I went to the ortho was around age 20 (I'm 26 now).
I already take Magnesium supplements for other benefits but I'm not sure it has had much effect on the TMJ issue.
I think my psych meds also exacerbate the problem; I have a coffee every morning but I don't think that's the culprit. Anti-anxiety meds and muscle relaxants might help but I don't want to mess with the chemical balance I've got at the moment...in the past those sort of medications have turned me into a bit of a zombie.
I'll look into getting a pillow that supports the neck/cervical spine - the only issue with that is I've been sleeping on my side for as long as I can remember so it'll take a lot of conscious effort to retrain myself to sleep on my back.
At this point I'm leaning towards Botox.
In any case I'll look for a specialist in my town. Thanks for the suggestions everyone!
posted by sweetshine at 7:48 PM on October 10, 2015
I already take Magnesium supplements for other benefits but I'm not sure it has had much effect on the TMJ issue.
I think my psych meds also exacerbate the problem; I have a coffee every morning but I don't think that's the culprit. Anti-anxiety meds and muscle relaxants might help but I don't want to mess with the chemical balance I've got at the moment...in the past those sort of medications have turned me into a bit of a zombie.
I'll look into getting a pillow that supports the neck/cervical spine - the only issue with that is I've been sleeping on my side for as long as I can remember so it'll take a lot of conscious effort to retrain myself to sleep on my back.
At this point I'm leaning towards Botox.
In any case I'll look for a specialist in my town. Thanks for the suggestions everyone!
posted by sweetshine at 7:48 PM on October 10, 2015
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posted by lovableiago at 1:37 AM on October 10, 2015