Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 3/22/2007

Question
Hi there,

Ive had TMJ for 7 years now.

1. What other types of mouth cushions are available, and which are most effective? (ive only used a soft mouth cushion, which didnt help)

2. Also, ive been diagnosed with Ehlers danlos syndrome (hypermobility type), which means i have connective tissue ligament laxity and fragility. It seems if i relax too much my jaw and ears hurt much more in a morning, does this seem possible? (as oppose to being tense and locking the jaw so teeth dont meet)

Many Thanks

David, 27, UK

Answer
David -  Let me first say that whomever suggested or fabricated a soft mouth guard for you did not know anything about TMJ.  Secondly, with Ehlers Danlos Syndrome, using a mouth guard that is soft only enables the loose joint of the syndrome to not be set into an appropriate position.

The mouth guard, not cushion, you need and always needed is an acrylic guard.  It is made possible only by seeing a knowledgeable dentist who is skilled in TMJ type symptoms and can take an accurate impression of your upper and lower jaws.  At that point an appropriate bite is determined by having you bite down on a substance that gives an accurate impression of where your lower jaw's relationship to the upper jaw should be.  The skilled dentist then sends the impressions and bite registration to a lab and a solid mouth guard is constructed.

This guard will allow a stable fixed end point in your bite.  The soft mouth cushion never allows a stable bite relationship and accentuates muscle inflammation indicative of TMJ and secondarily only accentuates the Ehlers Danlos.

To find a skilled TMJ dentist you may want to see a board certified oral and maxillofacial surgeon.  I personally have fabricated these appliances for years with wonderful results so I would suggest that you locate a surgeon and, if he does not do the appliance, I am sure he will recommend you to the appropriate doctor.

Any further questions, please feel free to contact me again.