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Dentistry/Relationship between TMJ dysfunction and root canal failure



I've been officially diagnosed that I have a TMJ problem AND a number of root canal failure ( 5 to be exact)). I've visited a multiple 2 endodontist and 2 TMJ specialists for a consultation, and a Nose, ear and throat specialist since I am having a pain on my upper cheek, but there was nothing wrong with the area)
So the diagnosis is correct and confirmed.

One of the doctors I saw said the TMJ problem causes all the root canal failures. Therefore, he told me that just doing implants are not going to solve my problem, I need to address the two issue simultaneously.

It is a very expensive and time-consuming process as you know.
Because of the limited resources I have, I was going to address root canal issue first.

So here is a list of questions I have:

1. Do you think TMJ could be the cause of root canal failure? I'm trying to make a plan to address this issue in the most cost & time effective way.

2. I have a slight underbite, but a lot of people who claim that they have TMJ don't have an under bite. Does under bite have anything to do with TMJ?

3. The last Dr. recommended Invisalign, but he never said Invisalign can be a solution for a underbite. Can Invisalign fix this under bite issue?

4. One of the Dr made me a mouth guard to address TMJ issue as a temporary solution. But the mouth guard is a bit tight. I feel like it's pushing the front tooth crown. Is it possible that a mouth guard can cause damage to other teeth?

I need to do something about these problems. I am becoming dysfunctional for a daily work from massive pain.


Mayumi - I am so sorry to hear how you are suffering.  Let me try to answer your questions and give you direction towards getting better.

TMJ does not cause root canal failure.  Yes if the patient has severe TMJ and grinds their teeth very hard, the nerve of the teeth can become inflamed, but unless their is a direct blow to the teeth which pinches off the blood flow to the nerve of the tooth, TMJ alone will only produce inflammation.  For the decrease of inflammation alone, balancing a bite is important.

Overbite, underbite perfect bite;  any of these can produce TMJ problems.  It is not one or the other.  A Balanced bite with all the teeth lined up properly is best to insure an even distribution of forces to the teeth and no tooth should become inflamed.

First of all, invisalign is a stop gap technique when the dentist is not skilled to align the teeth.  That is unless we are speaking of only a few teeth need to be rotated, tipped or aligned.  An underbite cannot be fixed with invisalign.  I have seen dentists trying, but the results are usually far from obtaining a balanced bite.

Mouthguards are an excellent approach to relaxing the jaw muscles and reducing the grinding and trauma to the teeth.  Just putting a guard in a patient's mouth is wrong.  The teeth are not directly attached to bone.  There is a ligament between the teeth and bone.  These ligaments can be traumatized if the dentist does not properly adjust the bite of the mouthguard to the opposite jaw.  Mouthguards can injure teeth if the bite is not aligned properly.  Excess forces can occur to the ligaments holding the teeth to the bone and that can cause trauma to the nerve in the tooth.

You need a quality dentist who knows how to correct the overall problem. My suggestion is that you seek an evaluation by orthodontist who tries to balance the bite.  It may take a little time to find an appropriate one, but if there is a dental school near you, you might want to be examined by one of the teachers there.

I wish you well and hope you feel better soon.  Anymore questions, feel free to contact me again.  


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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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