Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 4/24/2008

Question
I am 60 and have Multiple Sclerosis. I have unbearable pain in my right jaw and neck between the jaw and ear, and cannot tolerate any sensation in my back upper and lower molars. I am on a fixed income and cannot afford anything very expensive.

I am on Clav-Amox for sinus infection which finally has no congestion or pain since a week ago.

I do have a molar on the other side that needs to be extracted due to an old weak filling and nerve dying and roots way under the tooth in front of it. I have not had it removed yet, and haven't had any more pain with it since the one episode in 2005 when a periodontist examined it (I still had insurance then).

OK--The current problem. Without insurance, I called the low cost dental clinic who said if it is swollen and/or I have a fever to stand in line before they open and take a ticket--get an exam and later to get the treatment I need.
I am too disabled to stand in line and then wait hours to get called.  

I don't have fever or swelling, but get shooting pains when I move my jaw--My back molars don't meet when I chew, and when I'm not chewing,  it feels like my muscles are trying to hold my lower jaw in place, and spasm a lot. When I allow my jaw to relax, it falls back toward my neck, and I also get the pain then.

I have been in at-home physical therapy for neck, arm & back muscles, and when I massage the neck muscles right under the ear, I get the same pain shooting thru my lower right jaw. PT said he has seen this with people like me who have very weak neck front muscles due to bending my neck forward too much.   When I press on the sore place on that muscle I get the pain in the TMJ and all the way along my jaw to my chin.

Your answers are very thoughtful and informative. I'd like some feedback on what I can do till I can afford a dentist.
Thanks.  

Answer
Becke - I wouldn't worry about the other things you talk of as long as they are not now producing a problem.












Becke -  Whether your symptoms are related to the MS or not, you have symptoms of spasms of the muscles that help open and close your mouth.  It sounds like your molar bite, the foundation of the jaws, is not the greatest.  When this occurs, the muscles that help open and close your mouth often go into recurrent episodes of spasms.  

My suggestion is for you to begin a regimen of warm salt water rinses for 5 minutes 4-5 times a day.  Try to concentrate the rinses back in the mouth on both sides.  In addition use warm moist compresses from the temple region to the bottom of your jaw on both sides of your face at the same time.  Use the compresses for 10 minutes also 4-5 times a day.  The warm most treatments and rinses should begin to relax the muscles in 2-3 weeks.  

So try the heat treatments first and see if it helps.  If you have any additional questions, feel free to contact me again.