Expert: Susan Tannenbam - 9/7/2006

Question
Im a diabetic, been trying to get a new splint for a year but every time seems I need another root canal and crown. had 3 this year. Is it advisable to just start pulling teeth I think the diabetes is getting the better of them. Been told not to pull back teeth with TMJ that it will make it worse. Any exercise for TMJ and pain relief would be appreciated. Thanks Cindy

Answer
Dear CIndy:  Pain from TMJ can refer into the teeth, making it feel like a bad toothache, when there is really nothing wrong with the tooth.  Few dentists know this and a lot of people get unnecessary root canals and extractions.  It happened to me until I realized that my teeth were fine.  Now if I get an ache in a tooth, I know that it is usually caused by referred TMJ pain.  You should keep this in mind next time you are advised to pull a tooth or get a root canal.

I am not sure if pulling back teeth will make the TMJ worse but of course it is better not to pull teeth!  If your dentist does not understand that TMJ pain can refer into the teeth and gums, you might want a referral from a dental school near you that has a TMJ department.  Unfortunately, this does not guaranteet that those dentists will be aware of this situation either, (I speak from experience!), but you have a better chance.  You can refuse to get a root canal/extraction and wait to see if the pain comes and goes - that might be a sign that it is the TMJ refrred pain.

THese exercises should be done as often as possible during the day.  THey loosen up muscles that get tight when you clench/grind:

l.  Look to the right side and turn your head to the side so you can almost see your back.  Hold this for thirty seconds andthen do the other side.
2.  Hold the head down as if to reach the shoulder, and holod for thirty seconds, then to the other side.
3.  place top of hand under the jaw, open the jaw one inch and resist with your jaw as you press upward with your hand.  Hold for 5 seconds and repeat 6 times.
4.  open and close the mouth approx. one inch open, with the tongue placed on the roof of the mouth.  open andclose several times.
5.  Open the mouth two finger widths wide and hold for 30 seconds. THen close your mouth!
6. open the jaw slightly.  Move your jaw to the right as far as you can go, hold, then go to the other side.

These are all GENTLE stretches so don't over stretch while doing them.

Ultrasound and acupuncture are very good also!  Also, I have used the alpha-stim100. THeir website is www.alpha-stim.com
It's expensive but excellent for pain relief!!!!
Your dentist can give you TMJ gel.  It is applied topically and numbs the pain.  Or try an arthritis over the counter cream that does the same.
Avoid chewy bread, bagels and gum.
Klonopin is used as a sedative and it can be taken once in awhile to relax the facial muscles thus giving great pain relief (mucsles get very tight from clenching).
Good luck.
If you live in the NY area, I recommend Dr. Barry Rozenberg of Valley Stream, NY and NYC.
Susan