Ear-popping jaw pain stems from TMJ

Keith Roach
 |  To Your Health

Dear Dr. Roach: I have seen several doctors for my TMJ: my primary doctor and dentist, an ear nose and throat doctor, the dental hygienist and also “ask Google.”

I am a 73-year-old female and have had this problem on the left side of my face for at least a couple of years. It started with pain in my left ear that can last for 10 minutes or all day. Now, for months, when I eat almost anything, my left jaw makes a popping sound. The popping does not hurt, but the ear aching does.

My ENT said the jaw is a joint, like your knee or elbow, and it can pop and also have arthritis in it. He suggested I ask my dentist for help, because he’s the expert on this. I did, and he knew of nothing that would help me. Please tell me what I can do for relief or even possibly some sort of physical therapy.

— V.C.

Dear V.C.: Your ENT specialist is quite correct that the temporomandibular joint, like any joint, may develop problems. However, the movement of the lower jaw on the upper jaw is unlike any other joint, so the TMJ may develop unique problems.

TMJ problems affect up to 25% of people and are a major cause of lost work. They are more common in women. People who overuse their jaw (tooth grinding, gum chewing) are more likely to develop TMJ issues, but the factors influencing development of TMJ pain, and how it is experienced by the person, are complex.

Face pain, ear pain, headache and jaw popping all are symptoms consistent with TMJ disorders. Most people have symptoms that are worse in the morning.

A dental evaluation is appropriate because a dentist can correctly diagnose teeth grinding, also called bruxism. This can be treated. Also, unsuspected dental problems can cause a person to change chewing patterns, leading to symptoms. Similarly, your physician can look for other problems that predispose to developing TMJ pain (such as arthritis), or occasionally neurological conditions.

Years ago, TMJ expert Dr. Carol Cunningham wrote this to me:

“I instruct patients to sleep on the edge of the pillow, and to make sure that the pillow ends even with their ear. They should have nothing touching (no pressure) on their face past the point of their ear. The facial muscles want to be neutral and relaxed during sleep. If pressure is exerted on the muscles by a pillow, hand or arm, then the muscle will try to get back to a neutral position. Most often this is done by clenching and grinding. Pressure can be exerted on the muscles and joint, and this results in pain. We see a lot of TMJ problems in people who are stomach sleepers, as this results in the jaw being torqued throughout the night from lateral pressure on the face. I also tell patients to be aware of what they are doing with their teeth during the day. The only time teeth should touch is when you eat (and very briefly during certain words). During all other times, lips may be together, but teeth should not touch.”

If this advice doesn’t give adequate help, find a TMJ expert.

Readers may email questions to [email protected].

Can Clear Retainers Cause TMJ Pain?

If you experience jaw pain from temporomandibular joint (TMJ) dysfunction, you know how uncomfortable it can be. There are many possible reasons a person might develop pain due to TMJ disorder, also known as TMD. If you’re experiencing this pain and also straightening your teeth, you may be wonder whether your clear retainers have caused your TMD or worsened jaw pain you had before. Read on to learn more about this common jaw affliction.

What Is TMJ Pain?

TMD, or temporomandibular joint disorder, is pain and discomfort in the jaw due to dysfunction of the hinge joint (the temporomandibular joint) that connects the lower jaw to the rest of the skull. Although virtually anyone can experience some form of TMD, it is most common in women ages 20-40, people with arthritis, or those who have had a face or head injury. Signs of dysfunction of the TMJ include:

• Radiating pain in the jaw, face, and neck
• Crackling, popping, and clicking of the jaw
• Difficulty opening the mouth to eat, yawn, and speak
• Locking of the jaw
• Muscle spasms
• Ear aches
• Headaches

What Causes TMJ Pain?

A number of factors can contribute to the development of temporomandibular joint disorder.

• Stress and muscle tension
• Teeth grinding and clenching during sleep
• An injury that affects the jaw
• Misaligned teeth and malocclusion

Can Clear Retainers Cause TMJ Pain?

If you experience jaw pain while using mail-order clear retainers without proper oversight of a dental professional, the retainers could be harming your oral health! They could either be ill-fitting or moving your teeth inappropriately, leading to bite misalignment. We do not recommend straightening your teeth using this method.

In contrast, with the guidance of a dental professional, well-fitted orthodontic devices like clear retainers and braces may help improve your TMD symptoms by aligning your smile. After all, a straighter smile makes for healthier, more beautiful teeth! Here at Leesburg Family Dental, we offer ClearCorrect™ aligner therapy, Powerprox Six Month Braces^®, Six Months Smiles^®, traditional metal braces, and ceramic braces. Get in touch with our team to determine whether you’d benefit from a more aligned smile and bite!

What Treatment Is Available for TMD?

Depending on the severity of your TMJ dysfunction, there are several courses of treatment:

• Occasionally taking over-the-counter pain medication; be sure to follow the label’s instructions
• You can also apply an ice pack or heat compress to your cheek to help relieve symptoms
• Stress management, stretching exercises, meditation, and yoga may also help ease pain
• Avoid chewing gum
• If you clench your jaw at night, ask us about getting a nightguard to protect your teeth

Consult with Our Expert Team!

If you have TMJ pain, get in touch with our Leesburg dental office. We’ll recommend a course of treatment that will help ease your jaw pain and discomfort. Contact us today.

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What Does TMJ Feel Like? Understanding the Symptoms

Suffering from pain in your jaw? Jaw pain can be excruciating – especially when you don’t know the cause. 

In many cases, facial and jaw pain is related to the temporomandibular joint (TMJ), the hinge-like joint between your upper and lower jawbones. TMJ disorders occur when this joint isn’t working properly.

Your temporomandibular joint contains a series of ligaments, muscles, discs, and bones to move your jaw side to side and forward and backward. When something goes wrong within this joint, you’ll know it from the pain and difficulty moving your jaw. 

Do you worry you might be suffering from a TMJ disorder? Learn more about the workings of this disorder, what its symptoms feel like, and how treatment can help you find pain relief. 

TMJ Disorder: What It Is

According to Mayo Clinic, TMJ disorders are a type of temporomandibular disorder (or TMD) that causes jaw pain in the joint and along the muscles that control the movement of the jaw. 

It can be difficult to identify the exact cause of a TMJ disorder. In some cases, these disorders are genetic—other times, they’re caused by arthritis or an injury to the jaw. Jaw pain can also be related to bruxism, or the clenching and grinding of teeth. However, many people who habitually clench or grind their jaw never develop a TMJ disorder.

The pain from a TMJ disorder is temporary in most cases. Many patients find relief with the help of nonsurgical dental treatments and self-managed care. In more severe cases, surgery may be necessary.

What Does TMJ Feel Like? Symptoms and Signs

The best way to identify a TMJ disorder quickly is to understand what the symptoms feel like. Some of the most common symptoms include:

• Tenderness, pain, or swelling in the jaw joint
• Pain through the neck and shoulders
• Headaches
• Toothaches
• Feeling pain or exhaustion within your facial muscles
• Swelling on either side of the face
• Pain around or in either ear
• Discomfort or pain when chewing
• An uncomfortable bite
• Hearing problems
• Tinnitus (ringing in the ears)
• Difficulty opening or closing your mouth, known as locked jaw
• Grating or clicking sound when you open and close your mouth

If you have experienced any of these and think you may have a TMJ disorder, don’t hesitate to reach out and learn more about your treatment options. At Muscaro & Martini Dentistry, we help patients in the Tampa Bay area find relief from jaw pain and other problems caused by a TMJ disorder.

What Causes TMJ Disorders?

While there’s no one cause for TMJ issues, there may be a number of contributing factors that are to blame. A TMJ disorder may develop under any of the following conditions:

• Arthritic damage to your TMJ joint’s cartilage
• A jaw injury such as whiplash, a fall, or a blow to the face
• Erosion of the discs in your jaw over time
• Chronic grinding or clenching of teeth
• Intense anxiety or stress that causes you to tighten your jaw and facial muscles
• Poor prolonged posture
• Orthodontic braces
• Using too much chewing gum
• A disease of the connective tissues around the temporomandibular joint

Am I At Risk for TMJ?

In addition to the causes of TMJ, it’s critical to have a good understanding of who is most at-risk for developing TMJ. Factors that can increase the chance of developing TMJ disorders include:

• Arthritis, including rheumatoid arthritis as well as osteoarthritis
• Long-term grinding or clenching of teeth
• Severe jaw injury
• Fibromyalgia
• A bite that is not in line
• Deformities of the face or jaw

Sometimes, stress-related habits can lead to TMJ disorders. These stress habits that can raise your risk include biting your lips, nails, or frequently chewing on things like gum, candy, or straws. 

In addition to stress and health concerns, age and gender also play a role in determining who is most at risk. Most people who suffer TMJ symptoms are between the ages of 20-40. It is more common in women. You can talk to your dentist if you’re concerned about your risk of developing TMJ.

Risks of Leaving TMJ Untreated

If you choose not to seek treatment for your jaw pain, there are potential risks to your health.

Medical Conditions

TMJ can cause constant pain in some patients who struggle with jaw clenching and teeth grinding. Some patients struggle with insomnia because of this pain or attempt to self-medicate, which can be dangerous.

Symptoms have also been known to contribute to feelings of depression or anxiety. If the pain is keeping you from comfortably eating, it can lead to nutrition issues, especially in elderly patients.

There’s no reason to suffer through any of these additional medical complications associated with TMJ because there are easy and effective treatments available through dentistry.

Dental Health

Your dental health can also suffer as a result of untreated TMJ. Clenching and grinding can lead to worn-down enamel or even fractured teeth. This disorder can also lead you to favor one side of your jaw more than the other as a response to the pain, leading to asymmetrical muscle growth and swelling of the jaw area.

TMJ Treatment Through Dentistry

TMJ disorders can effectively be treated at your dentist’s office along with at-home care. Some non-surgical, non-medicated treatment options include mouth guards, oral splints, physical therapy, and counseling around the habits that trigger your pain.

Along with these therapies, certain pharmaceutical medications may be able to help. Some of the most beneficial medications for TMJ disorders are:

• Pain relievers or anti-inflammatories. These can be over-the-counter or prescription-strength.
• Tricyclic antidepressants. Medications such as amitriptyline can be used in low doses to treat bruxism, sleeplessness, and pain relief.
• Muscle relaxers. These drugs may be prescribed for short-term use to help relieve TMJ disorder pain caused by muscle spasms in the face.

Find Relief For Your TMJ Pain

Are you done with suffering from relentless jaw pain? If you’ve been asking yourself “What does TMJ feel like?” and think you may have this disorder, you need professional treatment. 

Our team at Muscaro & Martini Dentistry is proud to serve patients in the Tampa Bay area. Schedule an appointment to see our TMJ experts and find relief faster. Contact us today to get started.

Could Your Dentist Help Cure Your Jaw Pain By Your Ear?

It’s said that into every life, a little rain must fall. If we’re talking about rain as a metaphor for pain or discomfort, that’s probably true. Unfortunately, a little pain is likely to enter all our lives. And, if that pain starts by your ear, you may be faced with a dilemma about who to consult for help.

The good news is that you have options to find out more about what’s causing pain near your ear and jaw. By no means will every person living experience serious jaw pain, but it’s common enough that you can start looking for help close to home with your dental care team. Whether the pain is just in your jaw, starts in your jaw and radiates up toward your ear, starts in your ear and radiates down to your jaw, whether it is jaw pain on the left side by your ear, pain under your right ear by the jaw, or is on both sides, your dental care team may be able to help you understand and treat your pain. There’s a common cause of jaw pain by the ear that your dental care team is well equipped to treat.

What Causes Jaw Pain by Ear?

As with any pain, there are a number of possible causes for ear/jaw pain. If you have ear pain with fever, with or without hearing loss, you should speak to your primary care physician as soon as possible. Those are symptoms of an ear infection. An ear infection may require medication, like an antibiotic, to preserve healthy ear function. Women, particularly, should be aware that jaw pain is sometimes part of an atypical presentation of a heart attack. If you are a female with left-side jaw pain accompanied by sweating, nausea, shortness of breath, and feeling faint, check in with your medical care team right away. Luckily, that’s a very rare cause of jaw pain.

Although there are several other possible causes of jaw pain, jaw pain that radiates to the ear without any signs of infection is frequently caused by TMD, particularly in younger people and women.

What is TMD?

TMD is an acronym that stands for Temporal Mandibular Disorder. That’s just a technical way of specifying a problem with the joint that lets your jaw open, shut, and move. The joint that lets you move your jaw is called the temporal mandibular joint. It gets its name from the two parts it connects: the temporal bones in the head and the mandible bones in the jaw. The TMJ is an incredibly mobile joint that not only goes up and down but also allows side to side movement. This flexibility lets you chew and talk, but it also leaves the joint more susceptible to injury. Pain from the joint, difficulty moving the joint, and inflammation of the joint are all referred to as TMD, and it is estimated to affect as many as 10 million Americans.

What Causes TMD?

One frequent cause of TMD is clenching of the teeth or tooth grinding, clinically called bruxism. Often associated with stress, clenching and grinding can be really hard on your teeth and your jaw joint. Of course, any injury to the jaw can knock the joint out of alignment and cause pain and problems. Arthritis, either osteoarthritis or rheumatoid arthritis can cause joint problems and pain in the jaw. Even yawning really widely can knock things out of alignment and cause TMD.

What are the Symptoms of TMD?

Pain in the jaw, of course, is the primary symptom. Swelling can also happen. Sometimes, you may even have your jaw “frozen” or locked in place, or your jaw may be difficult to open and close. You also may hear a clicking sound when you move your jaw. Your dental care team can help you identify symptoms and confirm that TMD is the cause of those symptoms.

How to Treat Pain Near Ear and Jaw

There are steps you can take at home to get immediate relief from TMD symptoms. Ice or heat applied to the sore spots can help, as can massaging the jaw muscles. Over-the-counter pain relievers can also be helpful. Chewing carefully, sticking to soft food when the pain flares up, and not chewing on gum or other non-foods (i.e. pencils, your nails) can also give your body time to heal.

If you have pain from clenching and grinding teeth—behaviors that happen more frequently at night—your dental care team may recommend using a night guard while you sleep to help cushion your mouth and lessen the pressure in your jaw. You may also want to try stress relief strategies to help address the root problem.

You don’t need to suffer from jaw pain by the ear. If you’re experiencing symptoms, make an appointment to discuss your options with your dental care team or your primary care team.

Sudden Jaw Pain on One Side? Temporomandibular Joint Dislocation

If you’re experiencing sudden jaw pain on one side, there are many ailments it could be. You might have a cavity or a broken tooth. You might also have jaw pain because you have bruxism, which means you clench or grind your teeth.

There’s another reason you might have jaw pain on the left side or jaw pain on the right side. You may have dislocated your temporomandibular joint. Jaw pain on one side of your mouth indicates a possible dislocation of the joint.

Here’s some information on what dislocating your jaw joint might feel like, and how dentists treat it.

Why Does My Jaw Hurt on One Side?

One of the biggest symptoms of a TMJ dislocation is jaw pain on one side of your face. You will find your temporomandibular joint at the ends of your jaw, just in front of your ear. It’s a ball-and-socket joint, much like your hip. When you open your mouth, the ball leaves the socket and comes forward. When you close your mouth, the ball goes back into the socket. A series of muscles, ligaments, and a cartilage disk hold your TMJ in place.

Dislocation

When you dislocate your jaw, it’s because the ball part of the joint pops out of place and doesn’t return. For some reason, your ball joint gets stuck in front of a piece of bone and can’t pop back in place. Sometimes, the dislocation happens because of accident or injury. However, if the ligaments in your jaw are too loose, they allow your mouth to open too wide. There are times that the joint will return to its place naturally. But there are also times when the joint doesn’t return without treatment.

There is one huge signal that you have a dislocated jaw. Your jaw stays open despite your best efforts to close it. You’ll be unable to close your mouth at all. You may also experience a significant amount of pain. Your jaw will feel frozen or out of position.

How is Temporomandibular Dislocation Fixed?

First, the dentist will look at the position of your jaw. He or she will also have to check to see if you can open or close your mouth. Dentists also use X-rays to determine whether you have dislocated your jaw. The standard treatment for TMJ dislocation is to move the joint back into place. While this sounds painful, some medications can help alleviate the pain.

Your dentist will glove his or her hands or put gauze on them. He or she has to put his or her thumbs inside your mouth to pop the jaw back into place. Your dentist will place his or her fingers on your back molars. The dentist will, then, move your chin up and your teeth down, which should move the jaw back into place. After the jaw is back in place, the dentist may wrap it in gauze to allow it to rest for a few days. You may also take anti-inflammatories, as this will help the pain and reduce the swelling. You might also apply ice packs to reduce the swelling. You may experience a swollen and tender joint for a few days.

You can prevent temporomandibular joint dislocation. You need to limit the motion of your jaw. If you open it too widely, you could dislocate it again. That’s because once you have dislocated your jaw, you are more likely to dislocate it again. When you yawn, put a fist under your jaw, so your jaw doesn’t open too widely. You also need to take smaller bites when you chew. If you continue to dislocate your jaw, you may need to have a small surgical procedure to shorten your ligaments. Another procedure will shave a piece of bone off your ball-and-socket joint.

If you’re having trouble with your jaw, contact Maiden Lane Dental. We are in the Financial District of Manhattan, NYC. We would love for you to come and experience a dental appointment like no other. 

Jaw Pain: What Could It Be?

Creative Commons image by laudista (Flickr)

Have you ever woken up with pain in your jaw? Or maybe you’ve had pain that developed over a few days that you could not pinpoint. Is it your ear, your neck, your jaw, or a tooth? Here are some reasons your jaw might hurt, along with some tips on what to do about it and when to call a dentist or doctor.

Swimmer’s Ear

One surprising reason for jaw pain might not even stem from the  jaw at all, but from the ear. If you swim often or otherwise find yourself with water in your ears frequently, you could be at risk for this very painful, but also very treatable, condition. Jaw pain that is actually stemming from the ear might hurt when you open and close your mouth, but it will definitely hurt when you tug on your outer ear. Pressing around where your jaw meets your earlobe will often bring about more pain. Other symptoms can include an itchy ear canal, clear discharge from the ear, and, in some cases, muffled hearing.

If you suspect swimmer’s ear, see a doctor promptly. Left unchecked, it could spread, but it’s usually easy to treat with prescription eardrops.

TMJ Problems

The joint that connects your jaw to your skull is called the temporomandibular joint, or TMJ for short. Pain in front of the ears where this joint is located can be caused by disorders of the joint. These disorders can be acute or chronic, and can be caused by anything from grinding your teeth, to arthritis, to an irregular movement of the ball of the joint. The main symptom is pain on one or both sides of the jaw. You might also have trouble opening your mouth all the way or feel clicking when you open or close your mouth.

If you think you might have a TMJ disorder, make an appointment with your dentist. He or she can advise you on how best to treat it, based on the cause. In some cases, a nightguard to prevent clenching and grinding can help, as can relaxation exercises and medications. You might need dental work if a faulty bite is to blame, or, in severe cases, surgery.

Tooth Problems

If you have an abscess or infection in your jaw from a decayed or dying tooth, it can cause jaw pain and swelling. Some patients are surprised to find that pain on the lower jaw is caused by an abscess on a top tooth, or vice-versa; pain can be referred from the upper to lower jaw on the same side of the face. If the swelling and pain is accompanied by fever or a feeling of general malaise, this can indicate a serious infection.

See your dentist promptly if you have severe pain or swelling, as an infection can quickly spread through the bloodstream and become a serious health matter.

If you are having jaw pain, make an appointment right away so we can get you treated and back to enjoying being pain-free.

an atypical presentation mimicking temporomandibular joint disorder

Abstract

A 50-year-old female presented to a chiropractic clinic with left jaw pain consistent with temporomandibular joint disorder. Examination revealed a large ulcerated mass on the posterolateral margin of the tongue which was later diagnosed as squamous cell carcinoma. Squamous cell carcinoma is the most common of the oral cancers. These cancers are often detected late making treatment more complicated and reducing the chance of survival. In the early stages squamous cell carcinoma can be asymptomatic. Symptoms can be similar to that of temporomandibular joint disorder making examination of the patient’s mouth important to rule out oral cancers. Oral cancers should be considered when patients present to a chiropractor with pain in the area of the temporomandibular joint. Risk factors such as chronic tobacco and alcohol use should raise concern in these patients. Suspicious lesions should be referred immediately for further investigation.

Keywords: squamous cell carcinoma, cancer, temporomandibular joint disorder, chiropractic, diagnosis, differential

Résumé

Une femme de 50 ans se présente à une clinique chiropratique. Elle souffre de douleur à la mâchoire gauche correspondant à un trouble de l’articulation temporo-mandibulaire. L’examen révèle une grande masse ulcérée sur l’angle postérolatéral de la langue. Cette masse a été diagnostiquée comme étant un carcinome épidermoïde. Ce type de carcinome est la plus fréquente forme de cancer de la bouche. Le traitement du cancer buccal est difficile puisqu’il est souvent diagnostiqué trop tard. Aussi, la chance de survie en est réduite. Au stade précoce, le carcinome épidermoïde peut être asymptomatique. Ses symptômes sont similaires à ceux d’une pathologie de l’articulation temporo-mandibulaire et il est donc primordial de procéder à un examen buccal afin d’éliminer toute possibilité de cancer de la bouche. La possibilité d’un cancer buccal doit être prise en considération lorsqu’un patient se présente à la clinique et qu’il souffre de douleur dans la région de l’articulation temporo-mandibulaire. Les facteurs de risque tels que le tabagisme et l’abus d’alcool doivent être une source de préoccupations pour ce patient. Les lésions suspectes doivent immédiatement être soumises à un examen approfondi.

Introduction

Temporomandibular joint disorder (TMD) is a condition that presents to a chiropractors office on a somewhat regular basis (1–2 times per month).¹ Chiropractors should be expected to do a thorough history and examination when accessing TMD. One of the less common causes of pain in the area of the temporomandibular joint are oral cancers. The most common oral cancer is squamous cell carcinoma.² These cancers often present in the later stages of the disease where the treatment is more complicated and survival less likely. It is important that any chiropractor treating TMD be aware of oral cancers to help detect them in the early stages of the disease. We present the case of a 50-year-old female patient with squamous cell carcinoma on the posterolateral margin of the tongue who presented with persistent left sided jaw pain consistent with TMD.

Case report

A 50-year-old female was referred to a chiropractic office by an ears-nose-throat specialist (ENT) for assessment of a left temporomandibular joint problem secondary to arthritis that was possibly provoked by two assaults over 20 years earlier. At that time, she stated that the jaw pain had started after a bout of the flu. She felt that her jaw pain had been aggravated by coughing. The patient delayed following through with the chiropractic consultation until 6 months later.

She presented to the chiropractic office with left jaw pain that was worsening (10/10 on a numerical rating scale) with radiation to the left ear. The pain was described as continuous and was aggravated by chewing and lying on her left side. She reported having recently broken a lower left molar. Within the last month she had started having difficulty swallowing. She was a chronic smoker (1–2 packs a day) for the last 34 years and a social drinker. There was a history of depression and she was currently taking Zoloft. She had been treated for peripheral vascular disease with vascular surgery being pre-formed on the left inner thigh. She had tested positive for hepatitis B infection. The jaw pain was being managed by acetaminophen.

The patient was a women who appeared older than her stated years. She had poor dental health and was missing several teeth. Examination revealed full cervical range of motion with mild pulling on right lateral flexion. Postural evaluation revealed mild anterior head carriage. Jaw movements aggravated her pain and she was reluctant to open her mouth to the extreme. Palpation of the left temporomandibular joint elicited tenderness although there was more sensitivity to palpation in the submandibular region. The patient became apprehensive on intraoral examination reporting that she had broken a tooth 3 weeks earlier which was irritating her tongue. Upon inspection of the area a large ulcerated mass was observed near the base of the tongue on the left. The mass was 3 to 4 times the thickness of her tongue. When questioned about the mass she related it to her broken tooth. Due to her poor dental health it was difficult to determine whether her tooth was in fact broken. The ENT specialist was immediately called and an appointment booked the following week. The patient was not seen by the chiropractor subsequent to her initial visit. Three days after seeing the ENT specialist a biopsy was performed which was positive for squamous cell (T3) carcinoma at the left posterior oral tongue.

The patient was referred to a regional cancer centre where she was seen 13 days after the biopsy. She was examined by a head-neck surgeon who prescribed pain medication and scheduled her for surgery 14 days later. CT imaging of the head and neck showed lymphadenopathy ipsilateral to the mass which was not palpable on examination. Radiation therapy was recommended after the surgery.

Surgery consisted of a left commando resection via a lower lip splitting incision, two incisions in the left neck, a mandibulectomy and adjacent large glossectomy and reconstruction with a radial forearm osteocutaneous free flap. She was fitted with a percutaneous endoscopic gastrostomy tube.

Two days post surgery the patient had a major myocardial infarction and was transferred to an intensive care unit. She made a slow but full recovery over several weeks. Upon discharge from the hospital she was still on a feeding tube with a weight gain of 3 to 4 pounds. She was able to make verbal sounds but her speech was limited with about 25% of her words being discernable.

Radiation therapy was attempted on this patient. She was unable to lie down as was required. Radiation therapy was postponed until she was able to tolerate lying supine.

The patient was examined by the head-neck surgeon 6 months post surgery. She was continuing to gain weight and had no discomfort or pain. She was still achieving all of her nutrition with a feeding tube. Examination at this time revealed a soft tissue proliferative mass at the junction of the free-flap and remaining left base of the tongue. The patient died within nine months of the recurrence of the intraoral lesion.

Discussion

Cancer of the oral cavity accounts for only 4% of all cancers, squamous cell carcinoma being the most frequent. Oral cancer is on the rise and worldwide is estimated to be the sixth most common cancer. It is primarily a disease occurring after 45 years of age and is most likely to affect the tongue, lips and floor of the mouth in 90–95% of cases.^3,4 Squamous cell carcinoma presents intra-orally as a non-healing ulcer which appears as a white (, ) or red patch.⁵ Oral cancer is more prevalent in males and is associated with tobacco use in all forms and alcohol drinking.^6,5 Most authors agree that either substance alone can induce oral cancers, however, most cases result from a combination of smoking and drinking.^3–6

T2 squamous cell carcinoma on the ventral tongue.

The patient after radiation therapy to the squamous cell carcinoma.

*With permission, Dr. Ian Hodson, Associate Professor of Medicine, Department of Radiation Oncology, Hamilton Regional Cancer Centre, Hamilton, Ontario, Canada.

The Canadian Cancer Society along with the National Cancer Institute of Canada publishes yearly statistics on cancer in Canada.⁷ They have estimated for 2003 that there will be 139,900 new cases of cancer diagnosed and 67,400 deaths that year due to cancer. Oral cancers will account for 3100 of these new diagnoses of which 2100 will be in males and 1000 in females. Deaths due to oral cancers will occur in approximately 730 males and 360 females. The lifetime probability of developing oral cancer is 1:185.2 in males and 1:400 in females. The importance of different types of cancers can be measured with the death to case ratio. In Canada the death to case ratio for oral cancer is .36 which is listed as a fairly good prognosis (a ratio of over .5 being a poor prognosis and under .3 being a good prognosis).

Patients diagnosed with intraoral cancers tend to have unfavourable outcomes when detected in later stages. Examination of the oral cavity can be easily performed and will readily reveal abnormal changes; therefore, early diagnosis should be possible and outcomes for these patients should improve.⁸ Unfortunately, only 30–40% of patients survive an average of 5 years despite recent surgical advances.⁷ The short survival time is largely due to late detection and treatment.^9,8 Shira⁸ found that the average time lapse between symptoms and consultation is 4.6 months, while Bruun⁹ found it to be 4.9 months. Both Bruun and Shira^9,8 discovered that it was another 5.6 months before these patients were referred for further examination and treatment.

This delay in diagnosis and treatment of oral cancers can be attributed to three things. First, public awareness of oral cancer is low compared with other forms of cancer; therefore, patients generally ignore early signs and symptoms.⁶ Second, health professionals like dentists and specialists who routinely diagnose more common complaints of the oral cavity may overlook the risk of a possible malignancy. On the other hand, health professionals not as familiar with diagnosis and treatment of oral complaints realize the need for referral sooner.⁸ Third, oral squamous cell carcinoma presents in a variety of ways, and most early lesions are asymptomatic.⁶ One study found that 15% of patients with intraoral squamous cell carcinoma did not exhibit any subjective symptoms even when the tumor was greater than 4 cm in diameter.¹⁰ Furthermore, there is usually a lack of “red flag” symptoms such as persistent ulcers and neurologic disturbances.⁸ According to Bruun and Shira,^9,8 the most frequent complaint of oral cancer was swelling followed by pain. These are generally banal complaints and may occur with much more common disorders.^9,8

Temporomandibular joint disorder (TMD) refers to a collection of painful symptoms affecting the joint formed by the mandible and the temporal bone of the skull. It has been estimated that approximately 85–90% of the population will show at least one temporomandibular joint (TMJ) symptom in their lifetime. TMD is more common in women but has no predilection for age.¹¹

TMD can be a difficult disorder to diagnose and treat for four reasons. First, it is not a well defined condition. TMD tends to be a multi factorial disorder that includes structural, functional and psychosocial factors.¹² TMD may be due to any number of underlying causes. Most commonly it is associated with dysfunction and myofacial pain as a result of teeth clenching, jaw grinding, or repetitive motions like gum chewing. Less common causes include joint disorders like osteoarthrosis, and mechanical problems.^13,14 Many authors have suggested that cervical spine dysfunction can give rise to TMD; however, one study using an anamnestic self-administered questionnaire did not support this theory.^12,15 Therefore, not only are there a number of causes of TMD but conflicting opinions as to the etiology as well.

Second, it rarely signals a more serious disease.¹⁶ The classic presentation of TMD is pain in front of the tragus with radiation to the ear, lower jaw, cheek and temple.¹⁴ Interestingly, patients with intraoral malignancies may also present with similar complaints of pain.

Third, TMD presents with a myriad of symptoms. These include acute and/or chronic pain and/or tenderness of the muscles of mastication, facial muscles, and the cervical-thoracic musculature, ear pain with or without radiation to the jaw and cheeks that worsens with chewing, a feeling of fullness in the ear, neck and/or jaw stiffness, ringing in the ear, clicking and popping sounds, malocclusion and worn teeth, mouth and tooth pain especially upon chewing, vertigo, numbness, inadequate jaw opening (less than a 3 finger opening), and headaches that are usually temporal in location.¹⁷ With such a wide array of symptoms, disorders of surrounding structures may be easily mistaken as TMD.

Fourth, there is a lack of people seeking intervention for TMD. According to Walling,¹⁴ only 5% of adults with TMJ symptoms seek medical help. Hawk and associates¹⁸ found that out of those people seeking chiropractic intervention for musculoskeletal conditions (which is the predominant reason for office visits to a chiropractor), only 0.46% were treated for TMJ pain as their chief complaint. Consequently, there is a lack of experience in dealing with TMD. This may lead to an inaccurate diagnosis.

When a patient is suspected of having TMD, the diagnosis is often made by ruling out other conditions. Consequently, a detailed physical history is imperative. It should include a description of the pain and related symptoms as well as information relating to the dental and medical history. This is essential in uncovering any underlying conditions.¹⁶ A thorough examination of the temporomandibular joint requires checking the jaw range of motion during opening and closing, palpating the joint for tenderness, clicks or pops, and examining the ear, teeth, mouth, neck, jaw and salivary glands including the surrounding nerves, muscles and soft tissue.^16,14 This means looking into the oral cavity and observing any lesions. Since the oral mucosa is easily examined and changes can be readily observed, suspicious lesions should be immediately referred for further evaluation. Only then can the clinician rule out conditions that may mimic TMD.

Unfortunately, a significant number of studies on TMD did not discuss typical differential diagnoses. Only one article was found that discussed neoplasms of the temporomandibular joint that could mimic TMD. No studies were found that mentioned intraoral cancer as a differential diagnosis for TMD. Furthermore, very few studies emphasized the need for intraoral examinations in order to rule out more sinister causes of facial, jaw and ear pain.

Consequently, the difficulty in diagnosing and treating TMD combined with the relatively low prevalence of oral cancers has contributed to a poor understanding of how pain from disorders of the oral cavity can mimic TMD. In turn, this may lead to an inaccurate diagnosis of TMD.

It is essential to understand the neuroanatomy of the head and neck in order to realize how intraoral malignancies can lead to an inaccurate diagnosis of TMD. The principal innervation of the TMJ is the auriculotemporal nerve.¹⁹ It is a branch of the posterior trunk of the mandibular nerve which originates from the trigeminal nerve, one of the largest cranial nerves.²⁰ The trigeminal nerve is a mixed nerve (motor and sensory) that provides sensory innervation to the face and mucous membranes of the nasal and oral cavities, and motor innervation to the muscles of mastication.²¹

The sensory root of the trigeminal nerve exits the pons with the motor root and expands to form the trigeminal ganglion or the gasserian ganglion. At this point it gives rise to three trunks; the ophthalmic, maxillary and mandibular divisions. The mandibular trunk joins the motor root of the trigeminal nerve to form the mandibular nerve. After leaving the skull via the foramen ovale it travels in the infratemporal fossa and divides into four main terminal branches. These are the motor branches, the lingual nerve, the inferior dental branches and the mental branches. The lingual nerve is of interest since it conveys sensation from the anterior 2/3 or oral part (the body) of the tongue and lower gums. The mandibular nerve also supplies the skin of the lower lip, jaw, chin, tympanic membrane, auditory meatus and upper ear.²¹ Sensory information including noxious stimuli from these structures terminate on the spinal nucleus of the trigeminal nerve within the brainstem. The information is then conveyed to the thalamus (predominantly the ventral posteromedial nuclei) via the trigeminothalamic tract.²¹ Finally, pain can be consciously appreciated.

The patient’s lesion was located on the left posterior oral tongue; however, her chief complaint was severe left jaw pain with radiation to the left ear. Since the spinal nucleus of the trigeminal nerve receives nociceptive information from the jaw, ear and oral tongue via the mandibular nerve, pain may be perceived in any of these areas when the origin was actually the anterior 2/3 of the tongue.²⁰

Examination of the oral cavity is important in any patient presenting with symptoms of TMD. Chiropractors should perform a thorough history and examination. History is important to elicit risk behaviors, history of head and neck radiotherapy, family history of head and neck cancer and personal history of cancer. The examination should include visual inspection and palpation of the head, neck, oral and pharyngeal regions. Visual inspection should be done with a good light source. Mirrors can be useful in seeing area of the mouth that are difficult to normally see. Palpation should include the nodes of the neck and floor of the mouth and tongue. Protraction of the tongue with gauze can help visualize the posterolateral tongue and tongue base.²²

90,000 We help relieve ear pain radiating to the jaw and temple

When the ear hurts, it radiates to the temple and jaw, a person can “sin” on dental problems. But more often than not, in such cases, the teeth have nothing to do with it. This symptom is a reason for consulting an ENT specialist. We figure out why the pain from the ear gives to the jaw, and how to relieve it!

Varieties of pain

There are different types of ear pains that radiate to the jaw. They are classified by intensity and character.

Intensity

In strength, ear pain can be acute and dull. Acute usually manifests itself in cases of inflammation or injury and lasts for several days. Dull is more typical for the chronic phase of the disease.

Character

When the ear pain radiates to the teeth, it can be pulling or pulsating (shooting). The first is constantly present, and the second rolls in periods – after chewing, talking, brushing teeth, touching.

Possible causes

There are 2 main reasons why the ear hurts, radiates to the jaw and temple – inflammation in the ears and in the trigeminal nerve.Also, sometimes the pain syndrome is actually caused by dental problems.

Inflammation in the ears

The most common cause is secretory otitis media. This is an inflammation of the middle ear, in which fluid accumulates and stagnates in its cavity. It cannot go out through the auditory tube, therefore it provokes a feeling of squeezing. That is why the pain that characterizes otitis media radiates to the jaw. A similar symptom manifests itself in exudative and purulent otitis media.

When otitis media gives back to the teeth, the pain syndrome usually manifests itself on one side.It can be aching or throbbing – it all depends on the degree of development of the inflammatory process. In addition to pain, a person notices ear congestion, hearing loss and malaise.

Inflammation of the trigeminal nerve

The trigeminal nerve comes from the brainstem, its main node is located very close to the ear. From it there are three branches – the eye, maxillary and mandibular. That is why, with a cold trigeminal nerve, the ear often hurts, gives it to the temple and jaw. Also, pain can be given to the neck and eyes.As a rule, it has a shooting character and appears after chewing, brushing teeth and other movements of the jaw. Along with pain, accompanying symptoms appear – spasms of the chewing and facial muscles, redness of the face.

Problems with teeth

Sometimes pain symptoms are associated with inflammation of the wisdom tooth, which is located close to the ear. This occurs at the advanced stages of caries, when soft and bone tissues, nerve fibers are affected. In this case, the jaw hurts and gives it to the ear and temple.

What to do if your ear hurts and radiates to your teeth and temple?

When ear pain radiates to the jaw, you need to contact an otolaryngologist, dentist or neurologist. How to know which doctor to go to? Press on the ear tragus – if the pain intensifies, then you should go to the ENT. In case of spasms of the facial muscles, they go to a neurologist, and if the pain increases with pressure on the tooth, they go to the dentist.

What can not be done

If your ear hurts, gives to the jaw, do not try to cure it yourself.Warming up the sick side is strictly prohibited – this can intensify the inflammatory process. Also, do not rub and scratch the sore spot – this will spread the infection. Finally, you cannot prescribe antibiotics and analgesics to yourself – you do not know the exact cause of the pain.

Diagnostics

To determine the reason why a person has a sore ear, temple and jaw at the same time, it is carried out:

• Otoscopy – done by an ENT doctor, so you can diagnose otitis media
• Examination of the oral cavity at the dentist’s appointment – allows you to detect caries
• CT and MRI of the head – shows inflammatory processes in the facial nerves, ears and bone tissue

Treatment

If the ear hurts, it radiates to the jaw – how to treat it? It all depends on the cause of the symptom.For otitis media, antibiotics, anti-inflammatories, and medications and treatments are prescribed to remove fluid and pus from the ear. Dentists and neurologists have other treatments.

Peculiarities of treatment at Betterton

If you get otitis media in your teeth, we will help you in our ENT center. It uses modern diagnostic methods to accurately determine the cause of the pain. Then our doctors prescribe an effective treatment that helps to remove inflammation and relieve pain.

Possible complications

Pain indicates an inflammatory process that can lead to serious consequences.For example, when otitis media spreads to the jaw, inflammation can spread to the facial nerve, bone, and meninges. With purulent processes, fistulas, phlegmon and abscesses that threaten human life are possible.

Prevention

To avoid excruciating pain enveloping the ear, temple and jaw, simple recommendations will help:

• Protect ears from water ingress
• Protect your head from drafts and hypothermia
• Maintain oral hygiene, treat caries on time

If you feel pain, see your doctor right away.Sign up for a consultation with us to find out how to relieve pain!

Do not try to treat yourself! Consult otolaryngologists at Betterton Hearing Centers in the capital ×

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90,000 Diseases of the temporomandibular joint / Lipetsk City Dental Clinic No. 1

General Description

The temporomandibular joint is located directly in front of the ear.It consists of the lower jaw and the temporal bone. A variety of diseases sometimes appear in this area. The lower jaw is connected to the skull by muscles. This allows us to chew, open our mouths, etc. In this case, the movements occur synchronously on both sides. When various diseases occur, disorders of the joint, its muscles and nerves are determined. The symptoms of these ailments can vary. Soreness often appears. The mouth can only open partially. In some cases, it becomes difficult to speak, eat.A number of diseases cause the jaw to move when the mouth is opened. Diseases of the temporomandibular joint, the symptoms of which are varied, can be manifested by a crunch. Sometimes there are headaches, tooth sensitivity. Various factors can cause this discomfort. Most often these include injury, infection, stress. Strong emotional stress leads to the fact that the muscles are in constant tension. This leads to a tight clenching of the jaw. This is especially noticeable at night, when a person begins to grind his teeth in a dream (bruxism).Stress leads to pain in the facial muscles, in the neck. The teeth become sensitive. Their enamel is erased. Headaches can also be a common symptom. An incorrect bite can also cause diseases of the jaw joints. This situation occurs when teeth are extracted. The bite height in this case is reduced. In addition to these factors, excessive physical exertion, weightlifting, overvoltage can lead to the appearance of various ailments. Wrong lifestyle, bad habits and unhealthy diet only exacerbate the situation.Diseases of the TMJ are the responsibility of the orthopedic dentist.

Arthritis

One of the most common diseases of this type is arthritis of the temporomandibular joint. This pathology often occurs after trauma. Allergies can also trigger the development of arthritis. A common cause of the onset of the disease is the presence in the body of a general or local infection in the TMJ area. As a result of the listed pathologies, an inflammatory process may develop.This is arthritis. This disease can be of several types. Distinguish between traumatic, non-infectious and infectious arthritis. The disease can be chronic or acute. Symptoms can vary considerably.

Stages of the disease

In the acute stage, arthritis of the temporomandibular joint is manifested by severe pain. When you open your mouth, it intensifies. Joint movement during this period is limited. When you open your mouth, the jaw shifts in the direction where the inflammatory process develops.The face may become asymmetrical. This is due to swelling due to inflammation. The skin around the joint may turn red. The pain increases with pressure. When the acute stage passes, the disease becomes chronic without proper treatment. In this case, the pain becomes less noticeable. It appears periodically, especially when you open your mouth. Joint mobility is impaired. This is especially noticeable in the morning. When pressing on the area around the joint, the soreness increases. In the chronic stage, destructive changes may appear, osteoporosis develops.Treatment of arthritis of the temporomandibular joint must be timely. The more advanced the stage, the greater the likelihood of complications.

Arthrosis

Arthrosis of the temporomandibular joint is a very common disease. It refers to dystrophic pathologies. Arthrosis is a consequence of various injuries, inflammations, endocrine system disorders or metabolic processes. Muscles in the course of the appearance of certain deviations begin to adapt to them.This leads to the appearance of compression in some areas, and stretching in others. In this case, the head of the lower jaw suffers from excessive stress. Cartilage takes over it. They do not become unable to withstand the load over time. As a result, the nerve endings are pinched. Bone tissue is gradually destroyed. If you do not take any measures to treat the disease, degenerative processes will be irreversible. This will lead to disability, inability to open your mouth or speak.Therefore, it is impossible to start the disease. Arthrosis of the temporomandibular joint is accompanied by pain. This is caused by trauma to the nerve endings during movement. Blood circulation is disturbed here. The joint is not moving correctly. When you open your mouth, the lower jaw moves to one side. Poor-quality prosthetics and loss of teeth can cause such an ailment. The jaw takes the wrong position when moving, chewing. If you need to perform prosthetics, you need to contact a trusted specialist.Otherwise, it will take a while to face such a problem as arthrosis.

Symptoms of arthrosis

Treatment of arthrosis of the temporomandibular joint largely depends on the cause that provoked it, the stage of the disease and the characteristics of its course. The symptoms of this disease are similar to other types of ailments in this area. Therefore, the diagnosis should be carried out by an experienced specialist. With the development of arthrosis, a crunch appears when moving the jaw. Her movements can become difficult, constrained.This is especially noticeable after active conversation or chewing. At an early stage of the disease, a clicking sound appears in the joint. Muscle pain may appear. It extends to the ear or radiates to the area under the jaw. The palate, tongue, throat and even shoulder may hurt. There is no discomfort when pressing on the joint. The jaw moves in waves when opening the mouth. If a full-fledged diagnosis is carried out, it will be established that the teeth are in contact in different occlusions incorrectly. Also, similar pathologies occur in people who chew on one side.On palpation, muscle soreness may be felt on the loaded side of the jaw. With arthrosis of the middle and advanced stage, the temporomandibular joint hurts when moving. X-ray shows changes in the shape of the head of the joint. Its flattening can be more or less pronounced. In this case, the joint gap in the picture will be narrowed.

Ankylosis

Considering diseases of the temporomandibular joint, a few words should be said about such an ailment as ankylosis. When it occurs, the surfaces of the joints are fused due to fibrous or bone changes.In this case, a partial or complete loss of mobility can be observed in the joint. The cause of the development of ankylosis can be diseases in the joint area of ​​a chronic or acute form. Most often, osteomyelitis, purulent arthritis, and also fractures in this area lead to similar consequences. Children are more susceptible to ankylosis. At this age, the surfaces of the joint, covered by the periosteum without cartilage, quickly grow together. Fibrous ankylosis is more common in adults. One of the main symptoms is persistent difficulty or lack of movement in the painful joint.In most cases, it is determined when moving in a horizontal plane. If the ankylosis is unilateral, the face will be asymmetrical. If the disease develops on both sides, the chin will be pushed back. With the fibrous form of the disease, pain is more common. In this case, the muscles quickly get tired when chewing, it is difficult to open your mouth, especially in the morning. On x-rays, in some areas, the joint space is absent. This is a characteristic symptom of the disease. In this case, the head and neck of the joint thickens.

Muscle dysfunction

Temporomandibular joint dysfunction is a pathology that affects the masseter muscles. Their coordination is disrupted. At the same time, the elements of the joint differ in mutual arrangement. Stress, metabolic disorders, as well as malocclusion or other occlusive disorders can provoke the development of pathology. There is often asymmetry in muscle movement. The position of the heads of the lower jaw also shifts. In this case, the nerve endings in this area are injured.Over time, muscle dysfunction leads to the development of arthrosis. Temporomandibular joint dysfunction can be of two types. In the first case, the disease is painless. In the second case, there is severe discomfort in the masticatory muscles. With this form of the disease, pain appears on one side, which lasts constantly. Its intensity can vary. The pain radiates to the ear, cheek, temple, forehead. Also, discomfort can be given to the teeth and jaw, palate and tongue, pharynx. In some cases, one side of the head hurts.The unpleasant sensations are worse when chewing. Also, when the head is tilted, the soreness becomes stronger. Hypothermia, emotional or physical stress also lead to pain. Unpleasant sensations disappear when taking analgesics. The disease can be accompanied by emotional disturbances. There is a strong feeling of anxiety, fear, nightmares or a person suffers from insomnia. Sometimes the symptoms are mild. There can be several or only one of them. If any abnormalities appear, you need to consult a doctor.

Diagnosis for muscle dysfunction

Treatment of temporomandibular joint dysfunction is prescribed by a doctor after a comprehensive examination. He examines the patient. A survey is also conducted on associated symptoms. Examination can confirm the presence of stiffness. The face also looks asymmetrical. When the dentition is compressed, a creak may appear. The doctor palpates. In this case, pain most often occurs. The muscles become overactive.Sometimes subluxation of the jaw head or its disc occurs. In some cases, the examination reveals hypertrophy of the masticatory muscles. In the process of diagnostics, the functional state of the occlusion in the oral cavity is analyzed. The position of all elements of the joint is also determined using special diagnostic methods. Based on the data obtained, the doctor prescribes a comprehensive treatment. It depends on the degree of neglect of the disease, the characteristics of its course and provoking factors.

Dislocation and subluxation

Another common pathology is the dislocation and subluxation of the temporomandibular joint.These disorders can be caused by injury or certain medical conditions, such as muscle dysfunction. In this case, the elements of the joint are displaced relative to each other. This condition is characterized by pain. The mouth becomes difficult to open. The head and disk change their position relative to each other. With muscle dysfunction, the subluxation or dislocation is directed posteriorly. In case of functional disorders, the capsule and ligaments are stretched. Subluxations occur periodically. In this case, the mobility of the jaw at some point becomes impossible.The patient eliminates this situation on his own. This condition requires timely treatment. If a dislocation occurs, the head assumes a fixed incorrect position. At the same time, the mouth becomes impossible to close.

Treatment

Treatment of the temporomandibular joint is prescribed by a doctor after a thorough diagnosis. The symptoms of many diseases are similar. Therefore, self-medication can be hazardous to health. Having gone to the hospital and undergoing examination, the patient is prescribed a complex treatment.The process includes a number of general and special effects. The first category of methods for treating the temporomandibular joint includes providing the patient with a rest regime. He should only eat soft, liquid food that does not need to be chewed. Also, you can not open your mouth wide, talk a lot. In accordance with the type and characteristics of the disease, the doctor prescribes a set of medications that have a certain mechanism of influence on the pathology. If necessary, the bite is corrected, the strong compression of the teeth is eliminated.Physiotherapy is prescribed. Therapy is carried out aimed at relieving muscle tension. In some cases, only surgery can help the patient. This is required if conservative treatment has failed. Having considered the features and types of diseases of the temporomandibular joint, it is possible to identify the main symptoms that most often accompany this ailment. Knowing them, each person will be able to consult a doctor when early signs of the disease appear.

90,000 Which doctor should I contact for pain in the jaw joint

Dentists in Moscow – latest reviews

Overall a kind and good doctor.It seems to me that everyone who needs money will behave this way. During the appointment, the doctor performed a full examination, we took pictures of the teeth and made a treatment plan. But, most likely, I will not follow it because the prices are very high even for Moscow. I already have a system of braces, but Irina Feliksovna for some reason suggested putting it all over again.

Amal,

September 21, 2021

The reception went well.The doctor took action. Mikhail Alekseevich placed a filling and grinded another tooth. The specialist advised me. Which is rare now. An attentive, qualified, neat specialist. I will apply again if necessary.

Olga,

September 23, 2021

Good pediatric dentist.It is difficult for a son to get along with people, and especially with doctors. The doctor was able to pick up the key to his heart, and the son opened. At the reception, he wonders if it hurts him comfortably or not. The treatment itself was not painful, and no pain relief was given. We were satisfied with the quality of service, and the result of the treatment, we will come again for a preventive examination

Tatiana,

September 20, 2021

A neat doctor.I liked the way it works. Old roots began to bother me very much, the dentist said that everything should be removed urgently, otherwise there was no way. I obeyed. The anesthesia took effect in almost a couple of minutes. The doctor performed the manipulation painlessly. I am very glad that everything went quickly and painlessly. I advise!

Love,

September 21, 2021

Liked at the appointment with Dr. Medzhidova.Correct specialist, carefully carried out all the manipulations. She spoke in detail about my problems and about possible ways to eliminate them. We have arranged the prices, we will meet more often.

Catherine,

September 23, 2021

I really liked Dana Ruslanovna.Tactful, attentive, experienced and professional specialist. The doctor performed an examination and an X-ray. The doctor told me everything only on the case. And she did not impose unnecessary procedures, only what was needed. As a result, the specialist prescribed a treatment plan for me. Now I will undergo treatment with her. I recommend it to my friends.

Diana,

September 20, 2021

I will contact you again.Dmitry Ivanovich is a very attentive and caring doctor. Helped me to overcome my fear of impending manipulation. Nothing else bothers you anymore. Recomend for everybody!

Olga,

September 23, 2021

I got an appointment with a doctor after an unsuccessful tooth extraction in another clinic.On the third day, the temperature and unbearable pain rose. The doctor removed the inflammation and explained why this could happen. In addition, he recommended using an irrigator to cleanse the oral cavity. I didn’t know about this device before, thanks to Ramazan Indrisovich for instructions. I liked the reception. The doctor is attentive and hearing. All actions were accompanied by explanations, so it was much calmer.

Alina,

September 20, 2021

The doctor is kind, polite, benevolent, empathetic.Everything went great. At the reception, Olga Valerievna examined very carefully, nothing hurt, she described in great detail the course of action in the future, what needs to be treated, what not. She answered any questions. As a result, I selected a treatment plan. She explained everything clearly, in an accessible language.

Moderation,

September 29, 2021

Ziyautdin Gammadaevich looked up and told him what to do.As a result, he prescribed physiotherapy. I took pictures. I didn’t like a little that I started to cheat for money. Communicated normally, energetically. I was satisfied with the quality of the reception.

Irina,

September 22, 2021

Show 10 reviews of 4,692 90,000 Joint pain.Doctor can’t open my mouth, what should I do?

So, temporomandibular joint dysfunction
The TMJ is the most difficult joint in the human body. It is paired (right / left) and has a degree of freedom of movement 360 *

The upper jaw is “screwed” to the skull, but the lower jaw is suspended with the help of muscles and fasciae and the joint of the lower jaw with the upper is our temporomandibular joint joint. In it, a very important element is the cartilage-shaped disc.

The correct position of the joint depends on what kind of bite the person has and on which tracks the lower jaw moves.
For most people, the bite is not ideal due to various reasons from untimely extraction of milk teeth to destruction and loss of permanent ones.
But often most people do not bother with the joint, because it is in the compensation phase.
Please note that most of you have clicks and noises in the joint (open your mouth and listen), but this does not bother you in any way and does not interfere with your life. However, the phase of decompensation may come .. It becomes painful or impossible to chew, it hurts to talk, etc.e. I always sympathize with people in such a situation, because not every doctor can help them! Doctors dealing with the problems of dysfunctions of the VNS are called dentists – gnathologists.

They use expensive equipment for joint diagnostics, axiographs, condylographs, myographs, etc.
Based on the diagnostic result, the scope of treatment is determined and often it involves a total reconstruction of the teeth with the help of ceramic restorations to set the lower jaw in the correct position.

Anything from an incorrectly installed filling to a tooth extraction can affect dysfunction! The correct contacts between the teeth are lost and the jaw moves.
What is the conclusion of all this: “Pay attention to prevention !!!” Come for a regular check-up to your dentist, do not eat sweets, brush your teeth twice a day, changing the brush every three months, and if you have an extracted tooth, install an implant as soon as possible! Good luck dear friends and trust only the best!

Ringing or squeaking in the ears or temporomandibular joint (TMJ) dysfunction?

Ringing (squeaking) in the ears can range from simply unpleasant to seriously disturbing and intrusive.Since tinitus itself is often a symptom of many other diseases, it is sometimes difficult to determine what exactly is bothering a patient with TMJ or just tinitus.

In moments of silence, all you want to hear is silence. However, many people get the opposite. They may have high-pitched ringing, constant noise, or even roaring. This sound is constant and makes it difficult for them to focus or relax. Tinnitus, a condition that causes distracting sounds when a person is not speaking or listening to something.

However, it can also be a symptom of TMJ or temporomandibular joint disorder. Because jaw lesions can affect hearing, TMJ can cause tinnitus in some people. In fact, almost half of those suffering from TMJ report some form of tinnitus.

Tinitus and TMJ

A squeak often appears, it becomes intrusive and distracting. Its appearance can be caused by many factors, including hearing loss, the presence of a wax plug in the ear canal, and the result of sudden exposure to excessive noise.

Tinitus may be a temporary manifestation, or it may have more serious causes, in which case the usual disguise cannot be done. Any treatment for tinnitus begins with identifying the causes.

Meanwhile, TMJ refers to a condition that affects the temporomandibular joint. The disc in this joint is responsible for connecting the jaw bones, allowing you to speak, chew, and open your mouth. When this joint is damaged, it can cause tinnitus, among other symptoms.

This obsessive, sounding condition can also be a manifestation of TMJ, and this often confuses the specialist in the diagnosis and treatment of symptoms. Someone with dysfunction may accept ringing as a concomitant condition, and this may be a condition of tinnitus, independent of the diagnosis. And to eliminate intrusive sound sensations, it is necessary to correctly determine the diagnosis and the root cause.

How to Distinguish

1) Identifying TMJ is easy, especially if you regularly experience pain in your face or jaw.

2) Those with TMJ may also have trouble chewing or opening their mouth, and the joint may pinch or snap. This can make it difficult for them to open their mouths, and opening the jaw can lead to pain.

3) TMJ is common in people with arthritis or facial injuries.

Because the temporomandibular joint is very close to the ear, damage to this disc can lead to tinnitus. The best way to determine if TMJ tinnitus is caused is to see your dentist for an appropriate examination and diagnosis.

If your TMJ is diagnosed and treated correctly, your tinnitus is likely to decrease. If you do not regularly feel pain in your jaws, it is unlikely that you have TMJ, which means that you are simply concerned about tinitus. Your ENT doctor can give you the advice and help you need.

Neck and jaw hurts: what to do

If something hurts somewhere, you should not endure the pain, but go to the doctor. If the neck hurts, gives under the jaw, and in general the pain causes serious discomfort, then you can contact one of these specialists – surgeon, neurologist , dentist, otolaryngologist – or make an appointment with therapist , who will direct you to the right doctor.It is not possible to make an accurate diagnosis based on the location and nature of the pain alone. Additional examinations may be required to help find the right solution and relieve you of the excruciating discomfort. Pain in the neck and jaw occurs for a number of reasons, which can be conditionally divided into mechanical effects and acquired diseases and pathologies. If such pain accompanies you constantly, then it cannot be ignored. The lack of a well-chosen treatment results in a whole list of unpleasant consequences.

Causes of pain under the jaw

There are many reasons for the appearance of pain in the neck and / or jaw, and they can indicate various health problems. There are many structures in the neck area, the pathologies of which cause painful sensations and create serious discomfort.

Pathological changes in lymph nodes

Behind our ears, on the neck, in the lower part of the jaw, there are many lymph nodes. And one of the diseases that leads to painful discomfort is called lymphadenitis.This is inflammation of the lymph nodes due to bacterial or other infections. It is accompanied by severe sharp pain in the neck, which will radiate to the jaw, and also cause an increase in body temperature. Without treatment, lymphadenitis becomes chronic, and then constant fatigue, weight loss and general malaise are added to the elevated temperature. Another pathology may lie in neoplasms that appear on the lymph nodes. These are, as a rule, metastases that have penetrated from any organs affected by oncology.The nature of the pain varies, but weakness and weight loss also accompany this condition.

Glossitis

Another disease that is associated with the inflammatory process, but does not affect the lymph nodes, but the tongue. Signs of glossitis are a bright red tongue, severe swelling of the tongue and lower jaw. There may also be purulent discharge from the glands in the mouth, soreness radiating to the ear, jaw and neck.

Pharyngitis, tonsillitis, tonsillitis

These diseases can also cause pain.But at the same time, if the neck hurts, then the pain does not give under the jaw, but into the throat. With angina, the pain intensifies at the time of swallowing, and a person also has all the signs of acute respiratory infections or flu (pain in the ear, fever, weakness, lack of appetite, etc.). With acute pharyngitis , inflammation of the lymph nodes is possible.

Jaw fractures

A fracture in the lower jaw occurs due to a strong blow, head injury, or an accident. Fractures can be direct and reflected, multiple, splinter, with displacement, open and closed, but in any case, the person experiences severe pain, which is accompanied by edema, hemorrhage and impaired chewing function.In the event of a fracture, you should immediately consult a doctor.

Types of pain in the neck and jaw

The neck may hurt on the left side under the jaw, or the pain arises on the right or in the front and radiates from the back. The nature of pain is very different, due to various reasons for its occurrence. The nature of the pain is very important for the diagnosis, so it is necessary to describe it as accurately as possible to the doctor.

Intense pain on the sides in the neck under the jaw

Most often, such pain occurs due to inflammation of the lymph nodes and with angina.Both diseases are the result of infection entering the body. Migraines and dental infections can also cause severe soreness under the jaw.

Aching pain

If the pain is aching in nature, then it could be caused by a migraine, which, in bright light, changes in lighting or loud sounds, intensifies and concentrates in one place. Additionally, symptoms such as vomiting, nausea, vision problems and constant thirst may appear.Aching pain can also be associated with dental infections.

Pain under the jaw on the left

If your neck hurts on the left side under the jaw, then this can indicate almost any disease that was listed above; also pain is associated with problems in the work of the cardiovascular system. For example, pain on the left under the jaw occurs with a heart attack or angina pectoris, which usually comes from soreness in the chest area and is accompanied by acute pain in the teeth.

Pressure pain

If your neck under the jaw starts to hurt when pressed or pressed, then this may indicate inflammation of the lymph nodes, as well as diseases such as neuralgia of the ear node, osteosarcoma, or the presence of sialoliths. Any painful sensations cannot be ignored. Even if discomfort in the neck and jaw does not cause any particular problems, this is not a reason to ignore it. Seeing a doctor on time is a decision that needs to be made right away.Only a doctor will be able to tell why your neck hurts under the jaw and what to do about it.

What to do if the jaw and neck hurts

The most sure and correct step is to consult a specialist. You can start with a therapist who will examine you, collect anamnesis, make a preliminary diagnosis and give you a referral to a narrow specialist. For diagnosis, you may need to do an x-ray, ECG , blood tests, MRI, CT, etc., depending on what is the possible cause of your illness.If cancer is suspected, diagnosis and treatment is more difficult.

Massage procedures

Massage makes it possible to relax the muscles in the neck, but it should only be prescribed and performed by specialists. Also, massage is often prescribed as a restorative procedure after a course of treatment has already been completed. Certain types of therapeutic and simple massage can strengthen the muscle corset and relieve tightness in different parts of the spine. Self-massage can also be prescribed to work out the muscles of the neck.But before that, the specialist must teach you how to properly perform all massage exercises (stroking, kneading, rubbing, etc.), and also track the result.

Drug treatment

If the cause of the pain is an inflammatory process, such as otitis media or tonsillitis, then a whole complex of medicines is prescribed, the action of which is aimed at removing the signs of a cold and getting rid of the virus, bacteria or infection that led to the onset of the disease.It is not safe to prescribe medication yourself. Depending on your condition and problem, taking medication can only make the situation worse. For example, a number of medications, under certain conditions, cause swollen lymph nodes, and this, in turn, is likely to lead to increased pain in the neck and jaw. Medication and other methods of treatment are selected based on the problem. For the treatment of the same sore throat, antiviral and antipyretic drugs are prescribed. If a patient is diagnosed with a violation of the temporomandibular joint, then surgery and physiotherapy are suggested.

Folk remedies

Folk remedies are far from the best option for getting rid of pain in the neck and jaw, especially when these folk methods are prescribed independently. Tea with honey and an abundant warm drink for colds and sore throats help to quickly overcome the disease, but do not cure. Only the methods of official medicine can cure a sore throat or other disease. If the problem lies in inflammation of the lymph nodes, then it is highly discouraged to use such a folk remedy as warming up.This can lead to increased inflammation and its serious spread. If you experience neck pain, do not try to solve the problem on your own, only the doctor, after a comprehensive diagnosis, will draw up a treatment plan and will correct it during your recovery.

Wisdom tooth hurts | why the gums ache and how to relieve pain

The wisdom tooth is the third molar tooth, which appears later than the others, and sometimes does not erupt at all. A person cannot have more than 4 wisdom teeth.The approximate time when teething begins is 18 – 27 years old.

Modern experts classify wisdom teeth as rudiments – elements that have lost their role for humans in the course of evolution. The specific location of the third molars causes a number of difficulties in terms of caring for them.

Eights are not loaded like the rest of the teeth. In addition, they almost always have a tendency to cut through painfully. Not surprisingly, they are called the most problematic, and most dentists recommend removing wisdom teeth at the earliest opportunity.

Why wisdom tooth hurts

Wisdom teeth almost always grow crooked. Teething problems are dictated by the following anatomical features:

• “Eights” appear later than all other teeth. As a rule, the jaw bones are fully formed, the dentition is stable, and the “beginner” simply does not have enough space;
• Third molars do not have milk “predecessors”, and the rudiments of wisdom teeth have been developing for too long and in not very favorable conditions.Because of this, they erupt chaotically, while damaging the adjacent tooth or causing inflammation of the gums.

When talking about the causes of pain associated with one or more molars, it is worth distinguishing between some concepts. Toothache can occur against the background of abnormal eruption, due to deformations of soft tissues, adjacent teeth. Such a clinical picture is inherent only in the “eights”, the rest of the teeth are cut much more easily.

Reasons

However, the cause of toothache can also lie in rather classic reasons associated with common dental pathologies: caries, periodontal disease or periodontitis.If you systematize all the reasons due to which there is pain in the tooth, you get the following list:

• The wisdom tooth rests too much on the tissues of the oral cavity, squeezing and injuring them;
• The tooth is rotated around its axis. The greater the angle of rotation, the more tense the dental nerve, which provokes pain;
• Carious cavities have formed on the surface of the wisdom teeth, if they have reached the dental tissues, the pain will intensify;
• Tartar deposits have formed, rubbing the gums and causing inflammation;
• Due to the fact that the rapid growth of the figure eight and the crooked eruption damaged the root system of the adjacent molar, it is this neighboring tooth that hurts;
• If a wisdom tooth, due to an incorrect position, began to clamp the jaw nerve, pain occurs in the lower jaw.In this case, neuritis manifests itself in this way;
• A follicular cyst has formed at the neck of the tooth. It often occurs against the background of permanent damage to the tissues of the gums and the tooth itself.

It is worth noting that the follicular cyst near the wisdom teeth is often accompanied by all sorts of complications. For example, an abscess may occur that can deform even the jaw when it is neglected. Also, the periodontal tissues can become inflamed and pericoronitis can develop.

Inflammatory processes of the tissue covering the wisdom tooth

Hood inflammation is common. If a wisdom tooth erupts at once with several tubercles of the crown, phenomena may occur when the chewing surface of the crown is partially covered with tissues. The part of the gum and mucous membrane that hangs over the molar is called the hood. He is constantly prone to injury and inflammation.

Particularly favorable conditions for the accumulation of various biological “debris” and the reproduction of pathogenic bacteria are formed under the surface of the hood.Often, even the slightest damage is irritating. The gums around the “eight” may not hurt much, so they do not always turn to such a problem.

However, if the inflammatory process is strongly pronounced, the tissues not only swell, but also irritate. The patient complains of painful swallowing, sometimes it is difficult even to open his mouth. On the gum near the wisdom tooth, there may be pus, severe hyperemia. Only a doctor can save from such an intrusive and severe dental inflammation by excising the hood.

Space deficit during teething

If the wisdom tooth does not have enough space in the dentition, adjacent tissues are injured during eruption. The pains are total. It hurts not only the place where the molar erupts, but also the adjacent teeth. There may also be swelling, hyperemia, severe painful sensations that are permanent. It is difficult for the patient to open his mouth, especially if the “eights” grow in the direction opposite to the jaw.Such teeth must be removed. This is due to the fact that a crooked tooth can damage the entire dentition, up to its noticeable curvature.

Caries

If a wisdom tooth is affected by caries, the first symptom indicating a disease will be pathological hypersensitivity of the teeth. They will react painfully to any irritants – sour, spicy, salty foods, sweets, cold irritants.

Often there are situations when the curvature of the wisdom tooth injures the adjacent tooth, which causes caries in him.The most dangerous situation is when the G8 damages the root of the neighboring G7. Caries develops just below the gums, and the doctor does not always manage to visually identify the carious focus. At the same time, a severely neglected form of “root” caries is difficult to treat and the tooth is almost never saved.

Pulpitis

In acute pulpitis, which has affected the wisdom tooth, patients complain of acute pain arising from attacks. The disease and its main manifestations are characterized by a spontaneous nature.Unpleasant sensations can occur spontaneously, lasting up to 15 – 30 minutes. The pain increases at night.

In the chronic form of pulpitis of the wisdom tooth, the pain is not so pronounced. Unpleasant sensations of a whining character arise against the background of exposure to cold or heat. If the irritant is removed, the pain continues for some time.

Periodontitis

Periodontitis is characterized by aching pains that constantly disturb the patient.At the same time, a sick tooth will react to any stimulus with an acute pulsating, shooting pain. There is also a slight mobility of the affected tooth, in addition, swelling and soreness of the gums is often observed.

Interestingly, with chronic periodontitis, pain is almost not disturbing. Very minor unpleasant sensations can appear only when tapping on the tissues of the sick “eight”.

Diagnostics

Any pathology associated with problematic eruption of one or more wisdom teeth should always be investigated by means of X-ray diagnostics.To determine the position of the tooth in the jaw (inclination, shape, configuration, structure, how it grows), an orthopantomogram is used.

OPTG is a high-quality panoramic image of all teeth on both jaws. Another diagnostic method that will help you understand why a wisdom tooth hurts is visiography.

Treatment methods

Removal of a wisdom tooth in case of carious lesions or in the event that an extremely problematic eruption is observed, experts practice in people of any age.Pain and inflammation signal a serious problem. If it is not resolved in a timely manner, complications cannot be avoided.

Simple delete

The doctor decides what to do in each specific situation, based on the results of the research. This can be either a simple removal or a rather complex multi-stage operation.

Before the procedure, the specialist must make sure that the patient is not allergic to the drugs that will be used during the manipulation.First, the soft tissue around the tooth and the nerves are numbed. After the anesthesia has worked, the tooth is extracted with forceps. The duration of the entire procedure does not exceed 10 minutes.

Complex removal

If the crown of a tooth is destroyed, it has large branched roots, and also, if the “figure eight” has not erupted at all, and the whole jaw is involved in the inflammatory process, complex removal is practiced. During the intervention, the dental surgeon makes one or more incisions, removes the tooth, rinses the wound surface, and then sutures.

It is also worth mentioning the procedure for excising the hood. If it is the wisdom tooth that hurts at the time of eruption due to inflammatory processes of the mucous membrane, the doctor removes fragments of “excess” tissue. Situations are possible when the wisdom tooth is not removed, but only soft tissues are corrected. This is true if the tooth itself does not hurt and is positioned correctly in the hole.