Tell me what you know about tooth pain caused by TMJ
March 23, 2021 10:04 AM   Subscribe

So this "toothache" is still going on and I went to a root canal specialist who said there is no sign of infection and it seemed to him that the pain was coming from my jaw muscle spasming all to hell. When he said that it all clicked and I was like OMG. Do you have any knowledge, experience or remedies to share?

I have always had issues with my jaw and I have been forcing it into an unnatural position for years because I was self-conscious about how my face looks otherwise. So it makes sense to me that now it's all messed up. I can also feel the pain starting from my jaw now that I know to look for it there.

The endodnodist said that he's not a specialist in this area but probably if I just do a lot of anti-inflammatories, warm compresses, & massage the muscle will calm down, and if not I can see a facial pain specialist.

The thing is it still hurts like hell even after taking aleve & those new advil + acetometaphin pills. I also tried putting Salonpas lidocaine liquid on there. If it doesn't go away soon I"m going to ask my primary care doc if I could try some Gabapentin.

I am consciously now trying to keep my jaw relaxed & not let my teeth touch. I'm pretty sure I'm not grinding my teeth, just that my jaw has always been fucked up and now it can't pretend it's not anymore.

Do you know of anything else I can try? Or any good specialists in the Bay Area?
posted by bleep to Health & Fitness (14 answers total) 4 users marked this as a favorite
This may not actually have any effect on what's going on with you, but I recently learned that some of what I believed to be "toothache" pain is actually from sinus inflammation where the sinus is very close to the roots of the teeth. Recommended allergy medicine this time of year to help reduce the inflammation, which actually made a lot of sense in my situation.

I'm also a nighttime grinder and all the time jaw-clencher, and it's bad enough lately that my jaw is always sore. I do quite a bit of massaging the joint, which helps some. My dentist recommended a nightguard to help with both... I haven't tried it yet, even though I bought it, because I have to boil the darn thing to shape it, and I only seem to remember at midnight...
posted by stormyteal at 10:10 AM on March 23, 2021 [2 favorites]

Would you consider massage? I have the clenching/grinding kind of TMJ and it really helps. Unfortunately, with the pandemic I haven't been able to keep on top of it, but I've had other kinds of massage from this place and they're excellent. This may be something that you have to attack from a few angles.
posted by *s at 10:21 AM on March 23, 2021 [1 favorite]

You might do a timed experiment with Sudafed/Drugstorefed (the real pseudoephedrine you show ID for, no other cough/allergy stuff added) + nsaids to see if one 4-hour dose or 2 over 8 hours makes a significant change in your pain levels. I have had can't-sleep-grade "tooth" pain resolve in half an hour with Sudafed. A thing that even TMJ specialists can miss is pain/swelling in the Eustacian tubes and the multiple lymph nodes that will press up against your jaw when they swell, which is often at least part of the searing pain of an "earache".

I did not especially believe in topical CBD until my father was recommended a lotion for edema and joint pain in hospice, and then I used it as part of my pain management routine when I broke my leg and trashed all the soft tissue in my knee, and now I use it regularly - it made a marked difference in my vaccination soreness this weekend. I get mine from Milk Barn Farm (the proprietor is technically Metafilter's Own but maybe not active anymore), the salve is really nice-smelling and the oils in it are gentle enough I can use it on my face without triggering (and in fact it does soothe) my rosacea, but the danker-smelling roll-on is easier to really spread around (the smell fades in a few minutes).
posted by Lyn Never at 11:25 AM on March 23, 2021 [3 favorites]

I'd recommend seeing a dentist about your jaw alignment. I was having jaw issues from clenching - headaches, jaw pain, pain in my neck - that were wildly improved by a night gaurd, but I suspect your issues are more extreme than mine so I would wonder if you need a more consistent alignment intervention.

I'd also see if your dentist or doc and can give you a short course course of muscle relaxants. This was also prescribed to me when my issue was most acute. The pain meds aren't going to do much for you if the muscle is locked up. Ahead of doing that, hot compress may help loosen it up.
posted by amycup at 11:28 AM on March 23, 2021 [3 favorites]

Wearing a mouth guard to sleep may help with the pain even if you’re not grinding your teeth. It’s a relatively cheap fix to try out.
posted by bq at 11:34 AM on March 23, 2021 [3 favorites]

Mouth guard, exercise, facial massage, even this little guy:

It's spendy, but it does the work. It's lightweight and the cut/shape does what's necessary to keep muscles separate, so they can flex or relax.

Muscle relaxants or injection when it's the worst. It's a really frustrating experience, especially if it ties into other muscles in the face and head.

Realistically, exercise and controlling any external stressors.
posted by firstdaffodils at 12:04 PM on March 23, 2021 [1 favorite]

I just got Botox in my masseter muscles to address this exact issue. It does not affect jaw function or chewing, and the relief is substantial. You need two treatments 3 months apart to begin with, and a top up yearly if needed. It will slim your jawline somewhat as the muscles become smaller.

I always clench more with a mouthguard at night, idk why, but it hurts my jaw even if my teeth are protected.
posted by ananci at 1:01 PM on March 23, 2021 [1 favorite]

1) GET A BITE/NIGHT GUARD. start with a drugstore one and if it helps at all, spend the money on a custom fit one from the dentist. it is expensive but so freaking worth it.
2) heating pad and self massage, professional massage if you can swing it.
3) go to a dentist and talk about your jaw and see what they say.
posted by misanthropicsarah at 1:09 PM on March 23, 2021 [1 favorite]

What I've found helpful is:
- A real night guard, from the dentist. I tried a couple cheap ones but only the real deal helped. It was like yoga for my jaw.
- TMJ massage from a massage therapist. Not going to lie - it sucked on multiple levels. It was painful and also I deeply did not enjoy having the massage therapist's fingers in my mouth, but it did help.
-Self massage - I started with this video and I also copied what the massage therapist did as best I could (thumb inside my mouth, index and middle finger outside opposite it sort of pinching the muscle between top and bottom jaw right in front of the joint.
- Physiotherapy - my physio prescribed a strength training technique where I push on the side my chin as hard as I can without actually moving it to the left or right (so I have to sort of "push back" with my chin/jaw to keep it from moving).
posted by velocipedestrienne at 1:20 PM on March 23, 2021 [3 favorites]

anci if you see this, please check dms!
posted by firstdaffodils at 2:30 PM on March 23, 2021

I had a mouth guard. I had my wisdom teeth pulled. I was treated for sinus infections. It turns out to be chronic migraine.
See a neurologist.
40 years later I still get a couple of migraines a week, but at least I have a diagnosis.
posted by Enid Lareg at 4:48 PM on March 23, 2021 [2 favorites]

How is the pain connected to your shoulders and shoulder blades? What is your posture like? I've been releasing loads of historic tension in my neck and back and it's been doing all sorts of weird things to my jaw tension!
posted by london explorer girl at 5:17 AM on March 24, 2021 [1 favorite]

What cured my TMJ finally was low-dose xanax.
posted by wens at 1:33 PM on March 24, 2021 [1 favorite]

Response by poster: Hi everyone, thanks for all your help. I've been throwing at it every kind of painkiller I can get my hands on, here are the ones that have helped so far in order of perceivable effect:
1. CBD pain cream
2. Something in a green tube called Sports Creme
3. Diclofenac arthritis gel
4. Benedryl cream
5. Benedryl liquid before bed
5. Icy hot
6. Aleve + Aspirin + Tylenol
I also am working on getting an appointment with a TMJ specialist.
posted by bleep at 6:13 PM on March 27, 2021

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