Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 12/19/2009

Question
I have had TMJ problems for six years now.  I cope well with the usual, dull pain it causes me, but on two trips to the dentist for regular fillings in the past two years I suddenly got much sharper pain.  Two years ago this led to me getting two ineffectual root canals and finally having the tooth removed (which did relieve the pain).  Just recently I went back to the same dentist for fillings and now am in similarly sharp pain.

A TMJ specialist told me that the dental work had simply aggravated my TMJ condition, but it did occur to me that although I have had other fillings in the last six years, I only had severe pain after fillings in the last two years - since I started going to my present dentist.  I asked him if he does anything unconventional when he does a filling, and he said no - all he does is wash out the tooth with chemicals and add a 'glass ionomer'.  I asked what this is and he said it was composed of bits of glass!  Could my teeth be reacting to this in the last two cases, or is glass ionomer something that all dentists use?

Answer
James -  There is a possibility, of course, that the dental materials used by this dentist might be causing an inflammation, but like the TMJ specialist said, the dental work itself is probably the stimulus.  TMJ problems go through high and low periods, as I assume you have experienced, but anytime a patient with TMJ problem chews hard for food, does a lot of talking or goes to the dentist, the symptoms can increase.  Stopping all of the above is not a good idea, but after doing any of the above, trying to relax the muscles producing the symptoms with simple warm salt water rinses at the back of the mouth on both sides and warm compresses is a "belt and suspender" approach to help prevent symptoms.