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Dentistry/Severe tooth decay/TMJ.


Hiya Jonathan.

I'm Charlotte, 26 years old and I am wondering if you could give me a bit of advice.

I believe I have TMJ (perhaps a very mild form) although I've never actually been diagnosed with it. The reason I believe I may have it is that the jaw on my right hand side (so left hand side if you were to be looking at me) becomes stiff and seems to 'lock' so that I have to scrap my teeth and click my jaw until it 'unlocks' it feels stiff and uncomfortable until I do click! This can happen several times a day!

The very back tooth on that side has fallen out, but only the middle part of the tooth, the outside of the tooth is still there! The middle of it is now just a dark bump! Another tooth on that side seems to have a cavity in the middle! Just recently all of the teeth on that side have become sensitive - they are not painful to eat on or to touch, but they ache (it's probably the gum). It's not constantly painful, it's usually a dull ache but last night was absolutely excruciating! To point it actually made me cry from pain and frustration! When I woke up this morning I was pain free again, but through out the day the dull aching has returned! I also suffer from mild headaches sometimes, could that be related?

The tooth with the hole in the middle isn't really painful and it's been that way since about March/April of this year.

Is there any advice at all on how to stop this? I am 26 and have not been to the dentist for many years! I would rather not go if it can be helped, partly because I find it very overwhelming and daunting, but also affording may be difficult!

Is there any massive danger in not going to the dentist? I have read some horror stories of infected teeth spreading to other parts of the body, and that possibility terrifies me!

Thank you for reading, any help would be great.

Thanks again,

Hi Charlotte,

I think deep inside you know what to do.  You know that you should see a dentist and you are scared.  You are also worried that this could be an expensive undertaking.  But I can assure you, the longer you wait to see a dentist, the more you will end up paying for it in the end.

There are several red flags here.  When teeth start falling out of your head.....that's not good....and I am saying that with a little added sarcasm.  Does teeth falling out of your mouth seem like a normal event?  Of course not.  Not unless you are seven years old maybe.

And you also mentioned that you are aware of the stories about infections and how dangerous that is.  Yes, it is something to be addressed sooner than later.

You also touched on one of my other favorite topics....TMJ.  Temporal Mandibular Joint Disorder or TMJ as it is most commonly referred to as, is sort of a catch all category for all kinds of things that people experience with their jaw.  When something does not feel quite right in your mouth, such as locking, clicking, malocclusion of your bite, challenges with speech.....any of these things could fall into the TMJ category.  Anything that impedes the normal motion of your jaw could be construed as TMJ.  From your description, it does sound to me like you have TMJ.  I have definitely had people with TMJ describe that locking or clicking feeling.

I am concerned about you.  You are definitely doing the right thing by beginning the process of seeking help.  You are also lucky that you sent your question to me because I can relate to the patient experience, better than anyone else I know.

First, do not let the financing of this problem discourage you from seeking the help you need.  Sometimes dental insurance or even medical insurance can cover at least part of the costs. Some things you may want to try to attempt is to get pre-approval from the insurance company.  Also, many dentist offices are used to dealing with insurance companies due to the high costs. There is usually a "benefits person" in a dentist's office who knows how to file these claims with the insurance companies.  You can also talk with your dentist about spreading the costs into 18 or 24 month payments.  So if you need to skip the iPad this holiday, than do so.  You will be glad you did.

Second, visit a good board certified dentist right away.  Try and find one that also deals with a lot of TMJ cases.  All dentists will claim they are familiar with TMJ, but I want you to find a dentist that deals with TMJ issues every week and constantly. TMJ treatment frequently involves a dentist making and fitting an night guard appliance for you.  Dentists that have dealt with a lot of TMJ cases have had a lot of practice in making and fitting night guards.  So the question is not can a dentist just put a piece of plastic in your mouth, but rather, can they make and fit a properly balanced night guard for you.  It really does take practice, even for the best dentists.

Third, write down your list of questions before going to the dentist, so that you hit on the most important points.  One line of questioning I would ask about is that you may also want to see an oral surgeon that also has an MD.  It sounds like you do have some serious issues with teeth falling out, jaw clicking, etc, so I like the idea of an oral surgeon looking at you.  Please ask them about getting an MRI for you.  An MRI is usually something that they like to do because it can reveal a lot more about your problem, then just a traditional x-ray at the doctors office.

Charlotte, this should give you a good head start with some important tips.  But don't wait.  Your condition could get worse by ignoring the warning signs.

Good luck and please check back in at and let us know how you are progressing!

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Jonathan at PatientBabble


My area of expertise from the patients point of view would be Dentistry/TMJ plus the speech challenges that these jaw and bite problems sometimes represent. Over the years I have seen a multitude of dentists, orthodontists, oral surgeons, speech therapists, neurologists and other health professionals who all had an opinion about my TMJ/bite problem. I AM NOT A DOCTOR...but would purely be a patients point of view type person. I "get it" when people say they tried to explain to their dentist what their TMJ/bite problem is and that they are misunderstood. I can listen to people's trials and tribulations and there is a good chance I have been down that road before. I can make suggestions as to what people can do at home, or what questions to ask their doctor or dentist when they visit. I will try and recall information or experiences that may be helpful to you.


About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." For whatever reason, the first sensation I remember was not that my bite was off.....but rather that my normal tongue and speech patterns had been impeded. I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. The majority of dentists believe they can treat TMJ, but only those whose primary focus is TMJ treatment, are really any good at it. Any dentist, can take an impression of your teeth, send that impression off to the lab and have them make a night guard. That is the easy part. The tricky part is what the dentist does with the night guard, once receiving it from the lab. The dentist has to do a "fitting" where they tailor the night guard to be evenly balanced and comfortable in your mouth. Sometimes it can take a few visits, because further adjustments need to be made to the night guard appliance, to get it just right. I have found that dentists, who have had the most practice, do a better job at fitting your appliance. It's almost like an art form.

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