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Posts for tag: jaw pain

By Paul David Epstein, D.M.D. & Associates, P.C.
April 12, 2020
Category: Dental Procedures
Tags: jaw pain   tmj disorders  
ThinkTwiceBeforeConsideringBotoxforChronicJawPainRelief

Chronic jaw pain can be an unnerving experience that drains the joy out of life. And because of the difficulty in controlling it patients desperate for relief may tread into less-tested treatment waters.

Temporomandibular disorders (TMDs) are a group of conditions affecting the joints connecting the lower jaw to the skull and their associated muscles and tendons. The exact causes are difficult to pinpoint, but stress, hormones or teeth grinding habits all seem to be critical factors for TMD.

The most common way to treat TMD is with therapies used for other joint-related problems, like exercise, thermal (hot and cold) applications, physical therapy or medication. Patients can also make diet changes to ease jaw function or, if appropriate, wear a night guard to reduce teeth grinding.

These conservative, non-invasive therapies seem to provide the widest relief for the most people. But this approach may have limited success with some patients, causing them to consider a more radical treatment path like jaw surgery. Unfortunately, surgical results haven't been as impressive as the traditional approach.

In recent years, another treatment candidate has emerged outside of traditional physical therapy, but also not as invasive as surgery: Botox injections. Botox is a drug containing botulinum toxin type A, which can cause muscle paralysis. Mostly used in tiny doses to cosmetically soften wrinkles, Botox injections have been proposed to paralyze certain jaw muscles to ease TMD symptoms.

Although this sounds like a plausible approach, Botox injections have some issues that should give prospective patients pause. First, Botox can only relieve symptoms temporarily, requiring repeated injections with increasingly stronger doses. Injection sites can become painful, bruised or swollen, and patients can suffer headaches. At worst, muscles that are repeatedly paralyzed may atrophy, causing among other things facial deformity.

The most troubling issue, though, is a lack of strong evidence (outside of a few anecdotal accounts) that Botox injections can effectively relieve TMD symptoms. As such, the federal Food and Drug Administration (FDA) has yet to approve its use for TMD treatment.

The treatment route most promising for managing TMD remains traditional physical and drug therapies, coupled with diet and lifestyle changes. It can be a long process of trial and error, but your chances for true jaw pain relief are most likely down this well-attested road.

If you would like more information on treating jaw disorders, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Botox Treatment for TMJ Pain.”

By Paul David Epstein, D.M.D. & Associates, P.C.
January 13, 2020
Category: Oral Health
Tags: jaw pain  
ChronicJawPainCouldbeRelatedtoOtherInflammatoryConditions

If you're suffering from jaw pain or impaired function, it may not be the only source of chronic pain in your body. Of the millions of adults with temporomandibular joint disorders (TMD), many have also been diagnosed — among other conditions — with fibromyalgia, rheumatoid arthritis or sleep problems.

TMD is actually a group of painful disorders that affect the jaw joints, muscles and surrounding tissues. Besides pain, other symptoms include popping, clicking or grating sounds during jaw movement and a restricted range of motion for the lower jaw. Although we can't yet pinpoint a definite cause, TMD is closely associated with stress, grinding and clenching habits or injury.

It's not yet clear about the possible connections between TMD and other systemic conditions. But roughly two-thirds of those diagnosed with TMD also report three or more related health conditions. Debilitating pain and joint impairment seem to be the common thread among them all. The similarities warrant further research in hopes of new treatment options for each of them.

As for TMD, current treatment options break down into two basic categories: a traditional, conservative approach and a more interventional one. Of the first category, at least 90% of individuals find relief from treatments like thermal therapy (like alternating hot and cold compresses to the jaw), physical therapy, medication or mouth guards to reduce teeth clenching.

The alternative approach, surgery, seeks to correct problems with the jaw joints and supporting muscles. The results, however, have been mixed: in one recent survey a little more than a third of TMD patients who underwent surgery saw any improvement; what's more alarming, just under half believed their condition worsened after surgery.

With that in mind, most dentists recommend the first approach initially for TMD. Only if those therapies don't provide satisfactory relief or the case is extreme, would we then consider surgery. It's also advisable for you to seek a second opinion if you're presented with a surgical option.

Hopefully, further research into the connections between TMD and other inflammatory diseases may yield future therapies. The results could help you enjoy a more pain-free life as well as a healthy mouth.

If you would like more information on TMD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Chronic Jaw Pain and Associated Conditions.”

By Paul David Epstein, D.M.D. & Associates, P.C.
June 01, 2018
Category: Oral Health
Tags: jaw pain  
TheresNewHopeforaBetterUnderstandingofChronicJawPain

Chronic jaw pain and limited jaw mobility are two common symptoms of a group of conditions known as temporomandibular joint disorders (TMJD or TMD). Several effective treatments have developed over the years, despite the fact that the underlying causes for TMD remain an elusive quarry for medical researchers.

But we may now have a promising new lead in understanding TMD: a possible link between it and other systemic inflammatory diseases. In recent study researchers interviewed over 1,500 people with TMD about various aspects of their lives. Nearly two-thirds reported at least three or more other inflammatory health conditions like fibromyalgia, chronic headaches or rheumatoid arthritis.

These statistics suggest a relationship between TMD and these other conditions. Further exploration of these possible links could result not only in a greater understanding of TMD but better treatment strategies for it and the other related conditions.

In the meantime, though, what can you do if you're currently dealing with TMD?

As of now the approaches with the best results continue to be conservative, non-invasive techniques we've used for several years. Thermal therapies like hot or cold compresses to the jaw area, for example, are quite effective in providing pain relief, and muscle relaxant drugs have proven beneficial for improving jaw mobility.

More radical approaches like jaw surgery have also come into prominence. But there's a caveat here: a significant number of people find their conditions don't improve or may even worsen. In the study previously mentioned, only 38% of respondents who had undergone jaw surgery saw any range of improvement (from slight to significant); by contrast, 28% indicated no change in symptoms and 46% said they were worse off.

It's important, then, that you thoroughly discuss your condition with your dentist, verifying first that you have TMD.  Together you can develop a treatment plan to relieve pain and restore jaw function. If your dentist or surgeon suggests surgery, consider seeking a second opinion before choosing this more radical approach.

Hopefully, further research into the causes and relationships of TMD with other health conditions will yield still better treatments. In the meantime, you may still find relief and improve your quality of life with the proven techniques available now.

If you would like more information on treatments for chronic jaw pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Chronic Jaw Pain and Associated Conditions.”

By Paul David Epstein, D.M.D. & Associates, P.C.
April 10, 2018
Category: Oral Health
Tags: jaw pain   tmj   tmd  

Your jaw moves constantly. You eat, speak, breathe, and change facial expressions with your mandibles and the two joints on either side ofjaw pain your head. Called the temporomandibular joints, these hinge-like mechanisms operate the bone, muscles and connective tissues of your jaw in three dimensions. If something malfunctions, jaw pain often results. Dr. Paul David Epstein expertly evaluates and treats jaw pain in Burlington, MA. Sufferers of TMJ, or TMJ/TMD, as it is called, can feel well again.

Symptoms of TMJ/TMD in Burlington, MA

Commonly, your jaw hurts if you suffer from temporomandibular joint dysfunction. It may feel warm to the touch, stiff and swollen. You may hear weird popping, grinding or clicking sounds as you eat or simply open and close your mouth. In extreme cases, you may not be able to open or close your mouth. Ear aches, tinnitus (a buzzing or high-pitched squealing noise) and headaches often accompany TMJ/TMD.

Causes of TMJ/TMD

Women between the ages of 18 and 44 seem most prone to jaw pain. However, besides age and gender, heredity poses risk for TMJ/TMD, as the condition appears to run in families.

Other causes of jaw pain include:

  • Stress
  • Uneven dental bite
  • Chronic teeth clenching or grinding (bruxism)
  • Arthritis
  • Trauma (a blow to the head)
  • Osteoporosis

How Dr. Epstein can help

If you have jaw pain, contact Paul David Epstein DMD & Associates. During a one-on-one consultation, Dr. Epstein will review your symptoms, take digital X-rays and other kinds of imaging as needed and do a complete oral examination. Based on his findings, he'll present a care plan aimed at the root causes of your jaw pain.

Relief often comes with a combination of treatment modalities, and most of them are very simple. Surgery, orthodontic correction or bite alteration with dental crowns are good options but only when more conservative measures don't work. As such, Dr. Epstein likely will recommend:

  • A soft diet to reduce the pressures associated with biting and chewing
  • Stretching exercises
  • Ice or heat to relieve pain
  • Muscle relaxants
  • Over-the-counter ibuprofen to reduce inflammation
  • A customized acrylic bite guard to cushion teeth

End your jaw pain

Yes, you can. For more information, or to arrange your TMJ/TMD consultation with Dr. Epstein, call his office at in Burlington, MA, (781) 273-1152.

By Paul David Epstein, D.M.D. & Associates, P.C.
March 11, 2016
Category: Oral Health
Tags: jaw pain  
PersistentJawPainAfteranInjuryNeedsImmediateAttention

Accidents happen. And if an accident causes an injury to your jaws or surrounding facial area, it could result in serious damage. Without prompt treatment, that damage could be permanent.

You’ll usually know, of course, if something is wrong from the extreme pain near or around a jaw joint that won’t subside. If you have such symptoms, we need to see you as soon as possible to specifically diagnose the injury, which will in turn determine how we’ll treat it.

This is important because there are a number of injury possibilities behind the pain. It could mean you’ve loosened or displaced one or more teeth. The joint and its connective muscle may also have been bruised resulting in swelling within the joint space or a dislocation of the condyle (the bone ball at the end of the jaw), either of which can be extremely painful.

These injuries also cause muscle spasms, the body’s response for keeping the jaw from moving and incurring more damage (a natural splint, if you will). After examining to see that everything is functioning normally, we can usually treat it with mild to moderate anti-inflammatory drugs to reduce swelling and pain and muscle relaxers to ease the spasms. We may also need to gently manipulate and ease a dislocated jaw into its proper position.

In the worst case, though, you may actually have fractured the jaw bone. The most common break is known as a sub-condylar fracture that occurs just below the head of the joint with pain and discomfort usually more severe than what’s experienced from tissue bruising or dislocation. As with other fractures, we’ll need to reposition the broken bone and immobilize it until it’s healed. This can be done by temporarily joining the upper and lower teeth together for several weeks to keep the jaw from moving, or with a surgical procedure for more severe breaks that stabilizes the jawbone independently.

It’s important with any persistent jaw or mouth pain after an accident that you see us as soon as possible — you may have an injury that needs immediate attention for proper healing. At the very least, we can help alleviate the pain and discomfort until you’re back to normal.

If you would like more information on treating jaw injuries, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Jaw Pain — What’s the Cause?