Jaw Pain: Causes and Solutions for Teeth Grinding Issues

Temporomandibular joint pain?

Hello Doctor,
I have a problem with nighttime bruxism, so I started wearing an occlusal splint about a year ago.
After wearing it for about six to seven months, I began to experience a clicking sensation in one of my temporomandibular joints (TMJ).
Initially, I would have difficulty opening my mouth in the morning, but it would gradually improve by the afternoon.
Eventually, I was unable to open my right joint at all, accompanied by a dull pain, and occasionally I would feel a slight sharp pain while eating.
I noticed the inability to open my mouth early on and returned for a follow-up.
The dentist who made my occlusal splint prescribed muscle relaxants and adjusted the splint, but my condition continued to worsen.

Dr.
Huang, could it be possible that the occlusal splint is ill-fitting, causing joint displacement and locking? Or could it also be due to long-term bruxism leading to gradual joint degeneration?
Additionally, my bruxism has caused my back teeth to become very short, and they continue to wear down.
What solutions are available for my teeth? Thank you, Doctor.

Ayeh, 20~29 year old female. Ask Date: 2018/03/08

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Aye,
Hello! As mentioned, although you are very young, you are experiencing severe teeth grinding, and the vertical dimension of your occlusion is too low, resulting in increased bite force.
You will need occlusal reconstruction, and the occlusal splint for treatment needs to be adjusted.

Additionally, it is crucial to maintain a very regular lifestyle, engage in more physical activity to reduce stress, and reassess your daily habits.
The pain in your joints can be caused by many factors.
Please communicate frequently with your physician.
Thank you! Wishing you safety and health!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2018/03/08

More Info

Jaw pain, particularly related to teeth grinding (bruxism), can be a complex issue that often involves multiple factors, including dental alignment, muscle tension, and joint health. Your experience with the use of a bite guard (occlusal splint) is common among individuals who grind their teeth, as it is intended to protect the teeth and alleviate pressure on the jaw joints. However, it seems that your situation has become more complicated over time, leading to significant discomfort and limited jaw mobility.

Causes of Jaw Pain and Teeth Grinding
1. Bruxism: This is the primary cause of your symptoms. It can occur during the day or night and often leads to excessive wear on the teeth, muscle fatigue, and joint strain. The grinding action can cause inflammation in the temporomandibular joint (TMJ), leading to pain and dysfunction.

2. TMJ Disorders: The TMJ connects your jawbone to your skull and is responsible for the movement of your jaw. If the bite guard is not properly fitted, it may not provide the necessary support, potentially leading to misalignment of the jaw and further aggravation of TMJ disorders. Symptoms can include clicking or popping sounds, pain, and limited movement.

3. Muscle Tension: Chronic grinding can lead to muscle fatigue and tension in the jaw muscles, which can contribute to pain and discomfort. This tension may also affect the surrounding muscles in the neck and shoulders.

4. Dental Issues: The wear and tear on your teeth from grinding can lead to shortened teeth, sensitivity, and even fractures. This can create a cycle of discomfort, as the altered bite may lead to further grinding.

Solutions and Recommendations
1. Re-evaluation of the Bite Guard: Since you have experienced worsening symptoms, it is crucial to have your bite guard re-evaluated by your dentist. An ill-fitting guard can exacerbate TMJ issues. Your dentist may need to adjust the guard or create a new one that better accommodates your bite.

2. Physical Therapy: Engaging in physical therapy focused on the jaw and neck can help alleviate muscle tension and improve joint function. Techniques may include stretching exercises, heat therapy, and ultrasound treatment.

3. Medication: Muscle relaxants, anti-inflammatory medications (like ibuprofen), or even low-dose antidepressants (which can help with bruxism) may be prescribed by your healthcare provider. These can help manage pain and reduce muscle tension.

4. Stress Management: Since stress is a significant contributor to bruxism, incorporating stress-reduction techniques such as mindfulness, meditation, or yoga can be beneficial. Behavioral therapy may also help address the underlying causes of teeth grinding.

5. Dental Restoration: For the wear on your teeth, consult your dentist about restorative options. This may include crowns, veneers, or other treatments to protect the remaining tooth structure and improve function.

6. Regular Follow-ups: Regular dental check-ups are essential to monitor the condition of your teeth and jaw. Your dentist can track any changes and adjust your treatment plan accordingly.

Conclusion
Your symptoms of jaw pain and limited mobility are likely multifactorial, stemming from bruxism and possibly exacerbated by an ill-fitting bite guard. It is essential to address both the dental and muscular aspects of your condition. A comprehensive approach that includes re-evaluation of your bite guard, physical therapy, stress management, and possibly medication will be crucial in alleviating your symptoms and preventing further damage to your teeth and jaw. Always consult with your healthcare provider or dentist for personalized advice and treatment options tailored to your specific needs.

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