What can I do to help severe TMJ pain that's lasted 6 months?
Doctor Answers 2
The upper teeth and lower teeth should fit together like two puzzle pieces. Your back teeth (molars) have Peaks and Valleys. The peaks are the cusps and the valleys are the the fossa between the cusps. When the upper peaks fit directly into the the lower valleys (fossa) of the lower teeth there is harmony in the bite. If the upper peaks hit the corresponding lower peak or any part other then the center of the fossa then there is disharmony in the bite. The forces of the upper teeth must transfer down the center of the tooth in order for the forces to get absorbed properly into the jaw bone without casuing any harm. The intelligence of the body tries to keep as much harmony in the system has possible. Accordingly, the lower jaw might skew its posture to achieve maximum harmony possible in the given situation with the individual not even knowing what is happening. If the lower jaw is skewed then the muscles are overworking and over time that can cause referred pain to teeth. The overworking muscles may also feel fatigued.
The Temporomandibular joint can be thought of as another puzzle piece. There is a physiologic rest position of the jaw joint where the jaw muscles are most relaxed. When the puzzle pieces of the TMJ and the puzzle pieces of the teeth fit together properly, there is Harmony between the teeth, joint, and muscles in between. When the puzzle pieces don't fit together then there can be pain in any part of the masticatory system.
In normal function and rest, teeth never touch each other. Even when you are chewing food there is food between your teeth and the body knows when to come apart. When excess load is placed on teeth by clenching or grinding then that overload can cause muscles to overwork and if the forces are not distributed properly then the forces will cause harm where it goes. This happens over time and not overnight. For example, if the forces of a back tooth gets transferred to the front of the coressponding lower tooth then you migh get recession or you might get a notch at that gum line. If you find yourself clenching or grinding then you have to stop yourself. You have to reprogram your mouth to stay apart. You can do that by keeping your tongue to the roof of your mouth right behind the two front teeth. That will automatically keep you jaws apart and may help relieve some of your pain.
These are some major points in a complex system. There is a lot more that I could write about but I just wanted to give you an overview. Hope this helps!
Chronic Pain After Dental Work: Neuromuscular Dentistry Evaluation
TMDAlliance.org has a list of organizations of dentists who treat TMJ disorders and links to those organizations
Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Diplomat, American Academy of Pain Management
Diplomate American Board of Dental Sleep Medicine
Chair, American Alliance of TMD Organizations
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.