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Clicking noise/pain in my mouth

Discussion in 'Dental' started by osushi gurl, Apr 20, 2004.

  1. osushi gurl

    osushi gurl Member
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    :scared:

    Dear dental students/dentists,

    I get frequent clicking on my left side of my mouth when I eat. It didn't bother me much before but it has recently started to hurt. Sometimes in the middle of my meal, my jaw will lock and my mouth won't open as wide to continue eating.

    My dentist said it was TMJ and it was stressed related and it will dissappear one day. He didn't explain much to me after telling me that. :confused:

    Is this true?? Is there any way to make the pain go away...or better yet, make this jaw problem go away?????? :eek:

    Thank you,
    osushigurl
     
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  3. UBTom

    UBTom Class '04 official geezer
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    For your situation, I would:

    1) Get a panoramic X-ray which will show your jaw joints. Sometimes joint derangement can be seen on the pan (normally, the condyles should look smooth and round-- Deranged condyles will have a duckbill shape).

    2) Ask your dentist which condition is it that is affecting you: Is it a muscular condition (myofascial pain) or is it something with the joint itself (the clicking, which may be corroborated with any joint derangement visible on the pan), or both.

    3) Your dentist also needs to assess what kind of clicks it is. Is it a grinding noise (which is a signal that something is definitely wrong), is the clicking at the same place when you open or close, or is it at different places when opening and closing (disc derangement)?

    4) Ask your dentist if your teeth has any signs of excessive wear, which would be a clue that you subconsciously grind your teeth during sleep or during times of stress. Such parafunction can actually cause TMD if severe enough.

    Appropriate treatment will depend on the answers to the above questions.

    Yes, sometimes Temporomandibular Disorder can be stress-related. Stress management would be a good place to start. Only use pharmacological means or surgical intervention as a last resort.

    HTH!
     
  4. osushi gurl

    osushi gurl Member
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    Thank you UBTOM. I will ask my dentist at the next check up in August.
     
  5. HBomb

    HBomb Senior Member
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    I'll be an incoming dental student in the fall, so I'm qualified to give the following diagnosis: I agree with UBTOM. No, actually, I have no idea if UBTOM is right or wrong, but it sounds good to me.

    The reason I actually posted was to congratulate UBTOM on his upcoming graduation. So...UBTOM, Congrats!!! I know you've posted on other threads that you're a bit nervous about life after graduation, but in light of this post and all the other posts that you've contributed to, I think you'll continue to be a asset to the dental community and to your clients.

    Take care and good luck.
     
  6. no2thdk999

    no2thdk999 Senior Member
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    This is a hard diagnosis to make without actually being in the room with you, but what kind of discussion would it be if we just left it at that.

    Around 80% of us have some popping or clicking sounds when we open and close our mouth. This is not problematic and usually warrants no treatment. If the popping or clicking turns in to a grinding sound (like concrete on concrete) or you have pain or your range of motion is compromised then further investigation is indicated.

    Since you're having pain and reduced mobility I would want to dig a little deeper than a generic diagnosis of "TMJ" Your symptoms sound like you have an anteriorly displaced disc without reduction. All that means is that the little piece of cartilage between your condyle and your skull has moved out of it's normal place and is now in front of the condyle limiting how far you can open your mouth. This is not a rare occurence, more common in women (y'all have more flexible and therefore sprainable joints, tend to carry your stress worse, and tend to seek treatment earlier than a male would) and is usually self limiting. Consider it a "sprained" joint that needs rest to heal properly. A rough estimate would be 6-8 weeks with appropriate rest of the joint and therapy. I've made a spiffy little pamplet I give to patients with similar symptoms on how to speed their recovery if you or anyone else would like a copy by e-mail.

    I agree with Tom that a pan is indicated to rule out anything hugely wrong but in most cases all a pan shows me is you have a condyle, not necessarily it's condition.

    Stress is definitely associated with increase risk of TMD-related pain. This month's JADA has an article claiming people with TMD type pain are more likely to have psychopathology and poor coping skills.


    JMHO
    Rob
     

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