quote:
quote:
If you have bought the best one you can find, seat it as well as possible, and have the bite as close as you can get it, then she SHOULD see some positive results IF this is TMJ related. Then, if she starts having fewer symptoms, you should contact your family dentist to have a real TMJ splint made.

This may worsen the condition. Bulky mouthguards from the drug store may increase interarch distance further aggravating the condition. Further, if it is mal-occlusion, you are increasing the biting forces on the posterior teeth which seem to be the source of her pain. Best treatment is for the patient to potentially get an anterior bite plane to test if it is muscles or joints giving pain. Cheap alternative to test this is to get a tongue blade, and lay it horizontally across the front teeth to where the back teeth don't touch. This will remove the guidance from the posterior teeth allowing the lateral pterygoid muscles to relax.

Ha. You dentist and your opposing suggestions. Proving stereotypes correct, one pt at a time. I think she needs a sleep test so that both of you aren't possibly exacerbating another condition.

This post was edited on 2/23/17 at 2:42 pm

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Posted by uptownsage

New Orleans

Member since Oct 2014

2156 posts

Posted on 2/23/17 at 3:46 pm to Kingpenm3

quote:
Ha. You dentist and your opposing suggestions. Proving stereotypes correct, one pt at a time. I think she needs a sleep test so that both of you aren't possibly exacerbating another condition.

A sleep test may be in order. However it doesn't do squat to alleviate the patient's discomfort. Tinnitus can be caused by inflammation of the retrodiscal tissue and the auriculotemporal nerve. Please explain to me how a sleep test will diagnose TMJ? Yes people who have sleep apnea may have an increased incidence of bruxism. However, usually there is an underlying cause of bruxism such as continual contraction of the masticatory muscles resulting in lower jaw posturing and muscle splinting.

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Posted by ATL Tiger 3

Atlanta, GA (Cumming GA)

Member since Aug 2007

231 posts

Posted on 2/24/17 at 12:34 pm to Jim Rockford

clinical pearl:
recurring otalgia( perceived ear pain) with a normal otologic exam is TMJ inflammation until proven otherwise...

treatment is anti-inflammatory rx and primarily behaviour modification.
bilateral(even distribution) mastication.
soft diet, avoid chewing gum.
wear occlusal guard during sleep if h/o of grinding(bruxism)

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