Expert: Susan Tannenbam - 2/27/2004

Question
Hello!
  I'm a freshman in college, in good general health (as far as I can tell), and I've been experiencing a stiffness and soreness in my right jaw muscle for almost a month now.  It started when I was taking, or attempting to take, a bite of a large sandwich.  The muscle popped once, and since then I have been unable to open my jaw wide or bite down with any strength without experiencing moderate pain in my jaw.  I assumed I just "pulled a muscle," but it has lasted much longer than I originally assumed.  I'm not very familiar with disorders of the jaw, but might this be a form of TMJ?  In any case, do you have any suggestions on how to lessen the pain and/or speed the natural healing process?  Thank you for your time!

Answer
Dear Wade:  i am not a dentist, so you should check everything I say with a professional first.  I have TMJ and feel that if I share with people the knowledge I've attained on this condition, it might help them.  It certainly sounds like you have TMJ.  The first thing to do is to get a nightguard.  it's sometimes called a Splint. It will protect your teeth, as you are grinding at night, even thought you don't realize it, as it happens in your sleep.  After trying several, I found the BEST one to get is a HARD (never get a soft one, even if they offer it to you; it encourages more clenching and can make everything worse). I found a great dentist that also deals with TMJ.  he is the head of the NYU school of dentistry, TMJ dept. His name is Dr. Rozenberg.  Here are some things I do ('did" actually, since I rarely get pain anymore).
l. Aerobic exercise:  This causes the release of endorphines which help pain.
2. Jaw exercises. DON"T DO THESE UNTIL CHECKING WITH YOUR DOC.  MY JAW DOES NOT POP!
a. Open jaw wide, hold, repeat.
b. hold head to one side for a minute, repeat on other side.
c.press into the painful area on the cheek, and release, repeat.
All these exercises stretch out the tight muscles which are caused by TMJ.  By the way, don't be surprised if the pain goes into your teeth, gums, head and neck.  This is all caused by clenching and grinding, which causes the muscles to get very tight. The pain refers into different areas.
3.Hot and/or Cold application.  See what works best for you.
4.accupuncture:  I t took awhile for me to find a good accupuncturist, but it's worth it when you find one.
Ask if they have experience with TMJ.
5.Medication:  muscle relaxants, and anti depressants help.  Start with just hte muscle relaxant.  (Prescription needed for these.)
6.TMJ gel, which is applied topically, and which you also need a prescription for.
7.NEVER EVER chew gum or eat BAGELS!  This will make the whole thing worse.
8.Physical therapy:   ultrasound helped me the most.  you need a prescription from a doc to get physical therapy.  A lot of PTs don't have much experience with TMJ, but I finally found one by contacting a dental school, the TMJ Department.
9.I use the Alpha-Stim 100.  you need a prescription, and it's costly.  You can find it on alpha-stim.com.  It helped tremendously with the pain.
One more note:  TMJ pain is caused by clenching, which in turn causes muscle tightness, which in turn causes pain, and the pain can cause what feels like a toothache (beware of dentists who want you to have root canal for tooth pain...most dentists do not understand that tooth pain can be caused by TMJ),also headaches and neck aches, and pain in the ears.  But all these possible pains very well might not happen to you.  i dont want to scare you on this...just trying to let you know that if you get headaches, etc., that it could be from this conditon.  A lot of people don't get  any pain at all after using the nightguard for a couple of weeks.  You have to use it forever, I think,, though.  (mine is comfortable)

If you get a nightguard ("splint") right away, this will help a lot.  Mine fits over the bottom teeth and is very comfortable.  THe dentist is use is great, and it took me awhile to find one that fitted me with a good one.
Good luck.  Hope this was helpful.