Ill-fitting bridge caused my TMJ?

Question

I have been suffering from pain in my ear, eyes etc... i went to docs who referred me to an e.n.t specialist. The said i have tmj, so i had my teth chck out by a dentist. A bridge i had fitted was having alot of contact on the teeth below it, Could this be the cause of my tmj? The pain is in the same side as the bride!

Kevin Coughlin, DMD · Answer

Their is debate over this issue in the dental community... I personally believe an ill fitting bridge, removable bridge, or filling can be a precipitating event. In most cases the patients will have predisposing issues and the ill fitting bridge makes the issue worse. Remember TMJ is a catch all term, the pain can be caused by muscles, damage to the joint, or neurogenic in nature. Proper diagnosis is the key and remember that a patient can have a combination of issues. A decrease in range of motion or popping and clicking many times indicates muscle and or joint damage. Good luck

	 

	Kevin Coughlin DMD, MBA, MAGD  CEO of Baystate Dental PC.

Jay Neuhaus, DDS · Answer

Anytime a person's occlusion (the way upper and lower teeth meet) is not perfect, the TMJ can suffer. You mit have been right on the brink of TMJ disaster, and the alteration of your bite by the new bridge might have sent you "over the cliff".

Olga Kharevich, DMD, PhD (in memoriam) · Answer

In the cases when occlusion is changed with more than 2-3 units, it should be watched closely and adjusted. If the patient has pain and symptoms of a disorder it should be immediately addressed and corrected. If the pain persists get a consult from TMD specialist.

Ira Shapira, DDS (in memoriam) · Answer

TMJ is not a disease but a body part, like a knee or elbow.  What you have is referred pain to your head and ears that is connected to your jaw function.  Establishing a cause and effect relationship can be difficult, luckily it is usually possible to correct the problem with Neuromuscular Dentistry.  Most pain in patients with TMD (temporomandibular dysfuction) is actually from muscle not  from the TM Joint proper.

	You stated that "the teeth were having a lot of contact with the teeth below it."  This may be due to a displaced disc or by muscle contration that shortens the muscle and causes early contact.  A common problem is when a bridge is made that includes the last posterior tooth.  If the patient closes even one time without posterior support it can immediately create a displaced disc.   More common is to have MPD, Myofascial Pain and Dysfunction where there are taut bands and trigger points in the muscles that cause chronic pain and muscle shortening.

	The first step in treatment is to have a Diagnostic Neuromuscular Orthotic  made to attempt resolution of symptoms.  If this is successful a long term solution can be explored.  It is essential that a thorough differential diagnosis be considered as part of your evaluation.  I Hate Headaches.org has excellent information about Neuromuscular Dentistry and the treatment of chronic pain.

David S. Frey, DDS - Account Suspended · Answer

Many times the bite can bring on tmj like symptoms. If the bridge was new, I would adjust the bite to see if that helps. If it does not, most likely the muscles of the head and neck are straining to maintain a homostasis comfort level. Once your bite was disrupted, the muscle strain became too great and you started to experience symptoms. We use a TENS machine(transcutaneous electrical nerve stimulator) to relax the muscles of your jaw and a computer actually tracks the location of your lower jaw in this relaxed position. We can see if a discrepency exists between true physiological rest of your jaw and its habitual tense location. A bite adjustment can be done from this correct position or an oral orthotic can be made. Good luck.

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