TMJ Problems


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		*TMJ Question 1: Teeth Clenching & Headaches* I am a 47 year old single mother with multiple life stress factors. I am not sure what is causing my severe teeth clenching. I also get severe headaches about once every month or 2, and don't know if it is tension from various external sources or if it is the various multiple medications I am taking. My jaw is so `out of whack' that I am wondering which comes first, the headache or the clenching. A few years ago I felt there was something in my left ear (that is the side the jaw hurts the worst) and they didn't find anything but mentioned allergies and/or tmj - I went on to be tested for allergies and since I was highly allergic the tmj issue was forgotten - until now and I feel it is really getting out of hand - my neck and shoulders get incredibly stiff as the jaw gets worse and my ear hurts (even my teeth!) My family practitioner finally referred me to an oral surgeon, but my question is this - my family practitioner seemed suspicious of tmj - is this because tmj is something we should really be able to control ourselves? Do I need dental attention or should I `get a grip'?



	Contributing factors to TMJ dysfunction are multifactorial. Certainly stress, malocclusion, and medications may be factors in this patients clenching and headaches. It is worth investigating the possible contribution of the masticatory system to the overall symptomatology. On that basis I would suggest seeing a dentist orthodontist or oral and maxillofacial surgeon familiar with investigative modalities that can help determine the role of the masticatory system in this patients condition. Dr. R.P. Harper Assistant Professor Oral Surgery/Pharmacology

TMJ Question 2: Bite Splint Situation

I have a severe tmj disorder and have been wearing an upper splint for 2 months, during this time I've had about 10 relinings of the splint. Just recently, I discovered my upper right lateral incisor has crossed slightly over to the upper right central incisor. I reported this finding to my tmj dentist, and he said that the splint could not have moved the tooth and that I must have had gum disease--I have never had gum disease and have always had straight teeth. I have not achieved a good bite since the splint has been used, I continually have to go in for adjustments or relingings, and I am wondering if this has something to do with the tooth moving. Can you help me to understand what may have happened and also how I can speak to the tmj dentist without him denying the problem at hand?

The answer as to whether the cause of the tooth displacement is due to the occlusal splint can be addressed by removing the splint for a period equal to the time the splint was in place. Since the time period has been so short, the tooth should relapse back to its normal postion if it has in fact been displaced by the splint. It seems to me that because of the need for so many adjustments and relines no harm could be done by discontinuing the splint and beginning again after a short period of time.

Dr. R.P. Harper
Assistant Professor
Oral Surgery/Pharmacology

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