Jaw Issues After Ankle Injury: A Patient's Journey

Q: Jaw Issues After Ankle Injury: A Patient's Journey

Hello Ms. <br>Caroline： If the discomfort in your temporomandibular joint persists, it is recommended to return to the oral surgeon for further evaluation. <br>If you are experiencing pain in your temples, it could also be a migraine issue, so it is advisable to consult a neurolo

Swallowing saliva, wisdom tooth issues?

Hello Doctor,
On September 11th of this year, I sprained my left ankle while carrying four large bags of trash at my rental place in Banqiao.
I missed the last two steps and fell.
I went to an orthopedic doctor and had two X-rays, which confirmed that there was no fracture in my left ankle.
On September 18th, I had a cast applied, and it was removed on September 26th.
It has been two months, and I have been undergoing continuous rehabilitation, including shockwave therapy and other treatments covered by health insurance.

This part is not concerning, but starting around September 20th or 21st, after returning to the south on September 19th, my temporomandibular joint (TMJ) began to feel very strange.
Speaking became difficult, and swallowing felt awkward.
My bite has changed completely compared to before.
When I went to have the cast removed at the end of September, the orthopedic doctor only arranged for X-rays of my neck and left ankle, which showed no issues.
He prescribed muscle relaxants, but the awkward swallowing sensation has not disappeared even after two months.
Now, I can only chew food using my front teeth; the sides are completely unusable.
I was still able to order takeout on September 17th, so this change is puzzling.

I want to clarify that I did not hit my head during the fall, and I mentioned this to the doctors I consulted.
In October, I visited an ENT specialist, who recommended a referral to a dentist.
After being referred to a dental clinic, the dentist assessed that my condition could not be treated there and referred me to an oral and maxillofacial surgeon at a large hospital.
I saw two doctors there.
The first female doctor arranged for oral X-rays and determined that the issue was due to the impact from my fall.
She prescribed muscle relaxants and a variety of patches.
The second male doctor, who examined me last Friday, also concluded that there was no significant problem with my bite.
He reviewed my oral X-rays and suggested that I continue rehabilitation and apply heat to my neck, also prescribing muscle relaxants, with a follow-up if necessary.

However, two months have passed, and sometimes when I get too excited, I feel something strange in the bone inside my nose (I’m not sure what it’s called).
My upper left wisdom tooth also feels odd.
Occasionally, I feel movement near my temple on the right side of my skull (I wonder if this is related to my mental state?).
I am unsure which specialty to consult for a more detailed examination, as I fear that continuing to see oral and maxillofacial surgeons will lead to the same conclusion that my condition is not serious.
I am very concerned about my symptoms, so I urgently need a brief online consultation with a doctor.
Thank you for your response!

Caroline, 20~29 year old female. Ask Date: 2023/11/16

Dr. Zeng Guanghui reply Dentistry

Hello Ms.
Caroline: If the discomfort in your temporomandibular joint persists, it is recommended to return to the oral surgeon for further evaluation.
If you are experiencing pain in your temples, it could also be a migraine issue, so it is advisable to consult a neurologist for further diagnosis and treatment.
Director Tseng Guang-Hui, Dental Department, Nantou Hospital.

Reply Date: 2023/11/16

More Info

Dear Patient,
Thank you for sharing your detailed experience regarding your ankle injury and the subsequent jaw issues you have been facing. It sounds like you have been through a lot, and I appreciate your patience as you navigate these health concerns.

From your description, it seems that your initial injury to the left ankle did not involve any fractures, which is a positive sign. However, the onset of jaw issues following your ankle injury is indeed concerning and warrants further exploration.
The temporomandibular joint (TMJ), which connects your jawbone to your skull, can sometimes be affected by injuries or stress in other areas of the body, including the neck and jaw. The symptoms you describe, such as difficulty speaking, swallowing, and changes in your bite, could be indicative of TMJ dysfunction. This condition can arise from muscle tension, misalignment, or even stress, which may have been exacerbated by your recent injury and the physical strain of using crutches or adjusting your posture to accommodate your ankle.

It is important to note that while your ankle injury may seem unrelated, the body often compensates for injuries in ways that can lead to additional strain on other areas, including the jaw. The muscle relaxants you have been prescribed may help alleviate some of the tension in the jaw muscles, but if the symptoms persist, further evaluation is necessary.

Here are some recommendations for your situation:
1. Follow-Up with a Specialist: Since you have already seen an oral and maxillofacial surgeon, consider following up with a specialist in TMJ disorders or a dentist who specializes in occlusion (bite alignment). They can provide a more focused evaluation of your jaw and recommend specific treatments.

2. Physical Therapy: Continuing physical therapy, particularly with a focus on the neck and jaw, may help. A physical therapist can provide exercises to improve jaw mobility and reduce muscle tension.

3. Heat and Cold Therapy: Applying heat to the jaw area can help relax tight muscles, while cold packs can reduce inflammation if there is any swelling. Alternating between the two may provide relief.

4. Stress Management: Since stress can exacerbate TMJ issues, consider incorporating stress management techniques such as mindfulness, meditation, or gentle yoga into your routine.

5. Dietary Adjustments: Soft foods may be easier to manage while you are experiencing discomfort. Avoiding hard or chewy foods can help reduce strain on the jaw.

6. Monitor Symptoms: Keep a journal of your symptoms, noting any triggers or patterns. This information can be valuable for your healthcare providers in determining the best course of action.

7. Consider Imaging: If symptoms persist, further imaging studies, such as an MRI of the TMJ, may be warranted to assess the joint's condition more thoroughly.

8. Seek Psychological Support: If you feel that anxiety or stress is contributing to your symptoms, consider speaking with a mental health professional. They can provide strategies to help manage any psychological factors that may be affecting your physical health.

In conclusion, while your ankle injury may not directly cause your jaw issues, the interconnectedness of the body means that one injury can lead to complications elsewhere. It is essential to continue seeking care and advocating for your health. If you feel that your concerns are not being adequately addressed, do not hesitate to seek a second opinion or further evaluation from a specialist.

I hope this information helps you on your journey to recovery. Please take care and continue to monitor your symptoms closely.

Best regards.

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