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ANSWER: Hi Anna,

Thank you for your question.  I love questions like these, because I have actually gone through the same thing.

Now, you know you are going to eventually end up in a dentists office, right?  What I would like for you to do is look for a board certified dentist that specializes in TMJ treatment.  But be careful....most dentists will say they treat TMJ, but I would like for you to find one that treats TMJ almost every day they are at the office.  Talk to your family and friends, research on the internet, make some phone calls in finding the right dentist.

Why is it so important to find a dentist who specializes in TMJ?  Because it really takes a lot of practice, lots of cases and experience to be really good at providing TMJ treatment.  One of the things that a TMJ Specialist will probably do is make you an night guard appliance for you to wear at night.  Any dentist can take an impression of your teeth, and send those impressions off to a lab that can make you a night guard....but that's not the hard part.  What is important is the follow-up visits to balance and adjust your night guard so that it fits just right. It is a difficult task, even for the best dentists.  From my experience it took at least 3 or 4 visits to the dentist to get my night guard the way I like it.

In the meantime, and until you get to the right person to treat you, I can make a few suggestions.

First, you want to relax your body and facial muscles as much as possible.  Think about what stresses you and avoid these stresses if you can.  Maintain good body posture.  Sit up straight in your chair, stand up straight, sleep on your back.  I don't know your particular case, but if it were me, I would try and talk less.  Excessive talking can stress your facial muscles and complicate your bite even more.

Second, make it a habit to keep your "teeth apart, lips together."  This is really hard, because it takes a lot of focus to remember to do this.  Keep saying to yourself....."teeth apart, lips together.....teeth apart, lips together."   Your upper and lower teeth should never touch, except when swallowing....and only then, they should touch only barely.

Third, I found an amazing book about TMJ treatment that provides helpful instruction in an easy to understand way.  There are suggestions about what you can do at home.  "The TMJ Healing Plan: Ten Steps to Relieving Headaches, Neck Pain and Jaw Pain" by Cynthia Peterson.   I recommend the E-Book version you can get on Amazon.

By the way.....there is a good chance your neck pain is related to the problems you are having with your bite.  There are some good tips in the book regarding how to deal with neck pain.

Good luck and please let me know your progress!

Best regards,
Patient Point of View

---------- FOLLOW-UP ----------

QUESTION: Hi Jonathan. I was reading one of the questions about Peripheral Neuropothy  I to have a numbing in my right foot and toes and think its due to my spasams in my face .

well any way your so kind to answer my question .I went to a Neuroligist yesterday and he does not think its TMJ but I do. He gave me a script for Baclofin and I took one the first night and yesterday I took 2 .Icould not sleep all night feel like I have flu and my teeth and body are quivering, feel like throwing up and still have numbness in feet also have spasams in face with bad headaches. I'm getting off the meds can't
take the side affects and going to take your advice.If you know any TMJ
SPECIALIST IN THE Largo Fl area or Tampa Fl area please let me know.
Thanks again for your time and advice. Anna

ANSWER: Hello Anna,

I did not know what the drug "Baclofen" was so I Googled it.  At Baclofen is described as a muscle relaxer.  Under a doctors care, and the prescribing of that drug, I think your Neurologist is thinking the right way.  Relaxing your muscles, especially those muscles in your face, could only help.

As far as your doctor thinking it is not TMJ, I don't want to contradict him since he is a trained Medical Health Professional.  But I will say that TMJ is one of the most misdiagnosed physical ailments.  This does not mean that doctors who can't identify "TMJ" are bad.  What it means is that TMJ diagnoses is very quirky.  TMJ Dysfunction is sort of like a basket term for all sorts of complications that effect that area of the body.  I have listened to many, many people describe their TMJ issue to me, and crazy as it seems, no two are the same.  From my experience, and I have seen and spoken to many doctors and dentists about my own TMJ, that the majority of them go by the simple generic definition they learned in medical school, from a colleague, or at a medical conference.  There are so many different patient complaints about TMJ that almost none of them play out in a textbook, like they do in real life.  That is why it is so IMPORTANT, that you find a dentist who has had a large number of TMJ inflicted people come through his office.

But I am glad that your Neurologist prescribed Baclofen.  In my opinion, he did the most of what he was able to do from his perspective and in his specialty. A muscle relaxer seems like a logical conservative first step. Relaxing your facial muscles could possibly help you.

I would also like you to see a board certified dentist who has had many TMJ patients.  I did some internet research in your Tampa area and found Dr. Barry C. Levine. .  I have never met or talked to this dentist, but I really liked his profile.  And as an added bonus, there is also a member on his staff who can help you deal with insurance and financing issues.

My "patient point of view" advice would be to proceed carefully and slowly.  If you end up liking this dentist, then continue.  If your gut, tells you to find another, than do that.  I am hoping that "splint therapy" or the wearing of a night guard will be the path you're taken.  It would be a red flag if I heard the word "surgery" early on.  Conservative, non invasive treatment is the way to go.  There is a delicate balance of your jaw and facial muscles.  So the less tinkering you do on the way to recovery, the better.

As far as your, right got me there.  You can mention it to your dentist, but you may end up having to discuss further with your neurologist or orthopedist.  It is amazing how some parts of the body, can effect other seemingly unrelated parts.

Anna, good luck and give me a progress report!!

Best regards,
Patient Point of View

---------- FOLLOW-UP ----------

QUESTION: Hi Jonathan, Thank you again.

Forgot to ask you if you ever heard of the Next Generation TMJD. It's a
mold they make for your ears instead of a bite splint. Thanks Ann

Hi Ann,

Years ago I visited a TMJ Dentist in Manhattan who was tops in the field of TMJ treatment.  The very first thing he did was take his pointer fingers and put one in my left ear, and the other in my right ear.  He said "open, close, open, close."  It was a quick way for him to check how my Temporal Mandibular Joints were behaving.

Yes, I have heard of the Next Generation TMJ Device.  I have not used it or know anyone who has.  But I am interested in exploring the possibility of trying it myself.  Maybe I'll wear a nightguard during sleeping hours, and wear the Next Generation device during the day.  I'm going to need time to evaluate the product.

I would still like for you to follow through on some of my other suggestions.  Go see a dentist to evaluate you. If you do decide to order the Next Generation device, then I would advise you bring it with you on your first visit.  Let the dentist look at it.  It would be interesting to see what he or she thinks.

Please keep me posted!

Best regards,
Patient Point ov View  


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My area of expertise from the patients point of view would be 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 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 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 come from a family of dentists. My first house growing up was one of those residential/dentist combination homes and I was around the dental practice all the time. My teeth had always been perfect, and in many respects they still are. I have never had a cavity and my teeth are straight. About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." I have learned a lot over the years as I tried to figure out my problem from the Dentists, Speech Pathologists and assorted doctors that I have visited. I will try and recall information or experiences that may be helpful to you.


Twenty-Five years ago after my wisdom teeth were removed, my bite did not feel right and then had trouble speaking. 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. The years of searching for proper treatment has underscored the importance of understanding the relationship between dental and speech methodologies.///// To this end, and to further my research, I recently attended the American Speech-Language-Hearing Association Convention (ASHA) in Atlanta. At ASHA I learned about a specialty within Speech Pathology termed “Orofacial Myology”. In laymen's terms Orofacial Myology Disorder (OMD) deals with the establishment of correct functional activities of the tongue, lips and jaw. OMD is a motor speech disorder that impacts the normal flow of speech, chewing or swallowing.///// If you believe that your struggles with your teeth also present speech, chewing or swallowing challenges, you may want to seek out a licensed Speech Language Pathologist.....preferably one that has training with Orofacial Myology Disorder.

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Abridged Version of a Letter I Sent to a Health Care Professional (3/14/13): "..In my early 20's I had my wisdom teeth out. Almost immediately within a few days, something did not feel right in my mouth. I had trouble speaking. When I raised my tongue to try and touch my palate, I felt mostly just teeth. It is very cumbersome to talk and my bite also became a little bit off. If feels almost as if someone put a fork in my mouth and said "now try and speak." Very difficult. My articulation is fine, so to an observer I sound normal. But it takes a monumental effort, so I hate situations like talking on the phone or when somebody asks me to "tell them a story." ..I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. They just automatically gravitate to what they have heard about TMJ and assume I am either stressed, or just imagining it. Years later, I look back at all those dentists and doctors and I am amazed at how little they really knew about my condition. I have seen the best dentists, including my dad who is a Orthodontist in New York, to TMJ Dentists in Atlanta and Florida. No one ever suggested that Speech Pathology may be a direction I should explore. ..And I was frustrated by the fact that several MRI's over the years, showed nothing. How could the MRI’s show nothing, and at the same time, I know something does not feel right? I do wear a night guard to sleep in, but it does not fix the trouble that I have when I try to talk. ..I went with a Speech Pathologist friend of mine to the American Speech Language Hearing (ASHA) Convention last October in Atlanta...There was a Speech Pathologist at ASHA who was saying that sometimes when you have your Wisdom Teeth taken out "late" that it could possibly cause damage to the Trigeminal Nerve and surrounding muscles.” POSTSCRIPT: At ASHA, I discovered OROFACIAL MYOLOGY (OMD) which is a specialty in Speech Pathology that addresses Oral Muscular Issues.

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