What is wrong with me? Do I have tmj/d.

[mjbusch]

I wonder if I tmj/d? I first notice symptoms when I turned 17 or 18 with ear pressure and slight ear pain. It wasn't to bad it would come and go. Not until I was 21 did I have a little more pain. I was more restless and muscles more tense. That same year I got my wisdom teeth taken out. I felt good for about three months. Now I feel like I have a problem with my bottom molar but the doctors have checked it and every thing seems fine. I have had braces when I was a kid but only the top teeth and lip bumper on the bottom. I was suppose to get phase 2 treatment the following year but my family didn't have the money. So my top teeth are fairly straight and bottom teeth are much more crowded. I have a rotated left bicuspid and canines that are pushed in so those teeth are the only teeth I feel when I have a relaxed bite. Also the bottom front two teeth overlap and the tooth that overlaps hits my front tooth with I think a little to much force. I believe my lower teeth are causing all of my pain. Here is a list of symptoms I presently have shoulder muscles are tense. Neck muscles are tense with a slight pop when I rotate my head every once in a while. This is a wierd one that seems not to be on any other websites, it seems I don't think clearly or seem to be out of it sometimes. Ear pressure was my very first symptom and it started when I was 18. Fake tooth aches and sore jaw muscles.

So the first person I contacted was when I was 19 was the ent because of the ear pressure. They told me everything I was experiencing was normal. So back then I looked up some of the symptoms and the websites seemed to say I had tmd. So next when I was 21 I told the dentist I think I might have tmj and they checked by putting there fingers in my ear. They said I was fine. So they also told me that they will have to remove my wisdom teeth because they had cavities and it is a normal procedure in the military. So three months later I still had the ear pressure and this is when the phantom tooth aches appeared. So when I was 23 I was stationed at a new base. I told my dentist that I think I have a toothache in my lower left molar they checked it and I told them my teeth seem to be loose and seem to be moving. All they told me was to make sure I brush well and floss. At that time I also have had tight shoulders and neck pain but at that time I didn't think it was dental related. Now I am stationed near baltimore. So I told the next dentist here all my symptoms. They checked my xrays and teeth and forwarded me onto a oral surgeon. They didn't find anything wrong and prescribe a soft diet which I have been doing anyway and ibprofen. Of course those didn't help and the medication just made me feel more sick and fatigued. So they refered me again to another oral surgeon up at bethesda medical naval station (the one the president goes to). They had me get more xrays and told me the same exact thing the other one said. So again they refered me to a oral facial pain center. I guess there are only a very few in the entire military. The lady there seemed to be very smart and use all these medical terms and told me what they ment. I already new almost all of them since I read about them on the internet. She said that my teeth were fine except the bottom ones but she said that wouldn't be the issue and if I did have to get braces which the military doesn't fund because I am active duty, she said they would just flare out my teeth. She advised me that it was all muscular problems because I told here that I had whiplash a year ago from jumping 20 feet into the water. I recovered from that in about a week. I told her about how I had been diagnosed with right bundle branch block a year ago. So by the end she ordered me flexeral and meloxicam. I even told her before she ordered that I don't like taking medicine unless I have a infection. But that went by the wayside. She said for me to take these preventive steps like posture training, keep the teeth apart, and all the other things that every other websites say. I have done those because they all make sense except I still have these problems. So of course when I received the medication I made sure to read the important information. So I read that flexeral should not be used if diagnosed with a heart block. So I called the next day and she told me not take it. So now I am just waiting to go back. What should I do? What should I tell them? What kind of treatment is the best for the symptoms I am feeling? This has really caused more problems in my life, I am not really social anymore and stay at home all the time because I don't feel good anymore. I think if you would have compared me from 8 years ago I am a totally different person. I used to do a lot of sports, outdoor activies, and worked on many home projects. Now I don't do anything except go to work. Where I fix computers and resolve software issues. I get plenty of days off and all I feel like is going home and sleep. Sorry this is so long but I really don't know what is wrong with me.

I have sent this same message to http://www.michigan-headache-tmj-doctor.com/ where they had ask the doctor.

[dr.j]

It seems as if your spectrum of issues fit under the category of TMD / MPD (myofascial pain disorder). The theory that a bad bite is the sole responsibility for TMD has been debunked. Most of the dental profession now believes TMD/MPD to be a multi-factorial problem of varying etilogies/causes.
I would consider getting an MRI done of your joints and have the results read by a radiologist. If it were your knee you would have had this done years ago. The MRI has the capacity to show swelling, bony degeneration, and importantly the locastion of the articular disc of your TMJ and how it is positioned within the joint. The muscle aches even down into the traps and shoulers is not uncommon.
One of my mentors uses an all inclusive diagnostic and theraputic technique based solely on evidence-based research: MRI and neccessary imaging, diagnosis of the problem, treatment. Treatment may include: oral splints to be worn, "prolo" therapy or steriod injections, or even surgery of the joint/jaw if indicated as a last resort.

His name is Dr. Clifton Simmons (Nashville, TN) and I regard his body of work as some of the best in the US. Look up his research on the Web.
There is no "fix" to TMD/MPD. A doctor can only attempt to help you with your PDQ.:
Pain - Dysfunction - Quality of Life (this is straight from Dr. Simmon's Lecture)

Good Luck

[mjbusch]

I looked at the PDQ. All I have is the Q. I am able to open my mouth fully and move my jaw left to right. Also I do have the a sore trampizius muscle. I think the lady at the oral facial pain clinic said I might need some type of injections. Personally I think it will help as a short term solution but it will mainly just mask the underlying problem. That goes for the medication they prescribed to. I have had a ceph and panoramic xrays and they seem to be fine. Four dentists / doctors have reviewed them.

[dr.j]

A ceph and panorex are not routinely good for accurate diagnosis of TMJ problems - they show no soft tisssue at all. MRI's, Tomograms, Athrograms are the imgaes of choice.