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01 March 2007

My Jaw's Faulty! I gots the TMJ please help! [More:]dear wise internet-folk, my dentist says I have TMJ and I am betting at least one or two or a few of you have the same thing! My jaw hasn't locked up in a while but it IS really painful and sore. I go back Monday (when I can open my mouth wider) and I assume get fitted for one of those bite guard things. Till then I am supposed to take advil 3 times a day, apply moist heat (what qualifies as moist heat? why must it be moist?) and eat soft foods (does this literally mean purees?! she said no uncooked vegetables, not even celery so does this mean no lettuce? tomatoes? what?!)

Anyhow I am confused and I just wanted someone to say they had this shit too and give me a little horse's mouth advice. And that advil/heat thing isn't doing dirt, but i was eating carrot sticks earlier like an idiot.
I have this too, unfortunately, so I know what you're going through. I only had "atypical face pain" which I assumed was sinus-related, my jaw didn't lock up. I was truly at my wit's end before my ENT sent me to my dentist (she suspected TMJ after hearing my jaw pop and a CT scan showed my sinuses weren't the cause). I was sleeping so poorly I could barely function during the day.

I use one of those "heat it in a microwave" heating packs when mine is bad, I'm not sure that qualifies as "moist" heat but it's better than a heating pad. My dentist told me that anti-inflammatories (like Advil) have very limited use for TMJ. Muscle relaxers work, but they don't just relax your jaw. Maybe you should leave the heat on longer? It isn't something that goes away very quickly, at least in my case. And don't overlook stress as a contributor. I tend to bite down and grind my teeth when I'm stressed, it doesn't help.

When I was first diagnosed, my dentist made me a soft appliance right then and there. I got a hard one a little later. I had almost immediate relief and I was sleeping normally in about 3 days or so. My jaw doesn't pop as much as it used to, especially when I eat.

The raw vegetables thing is because they're crunchy and you end up gritting your teeth. I would imagine anything that doesn't crunch too much should be fine.

Oh, and one other thing. After a week or so with the appliance I felt like my bite was off and my lower jaw "didn't know where to go" (can't describe it better than that). My dentist said that's common since most people have TMJ more or only on one side and your jaw moves to try to compensate. In my case it went away over time but he said some people need physical therapy to deal with it. He sometimes does bite corrections if the final result still is off.
posted by tommasz 01 March | 15:50
Yep, I've had TMJ damage since high school. Don't take Advil 3 times daily for more than 2 weeks; you can give yourself an ulcer that way.

Don't eat anything that causes your jaw to pop (like carrot sticks or lightly cooked, crispy vegetables) is what your doctor means. Stuff has to be the consistency of a 3 Musketeers bar. Your jaw can't take the snap of pressure being suddenly released, like biting through the skin of a vegetable or fruit (or a particularly snappy hot dog, even).

Also be careful about eating thin flat things (like fruit roll-ups) or biting down on paper (holding your mail in your mouth while you find your keys). Stuff like that can hurt without you realizing it.

Also if you're too hot or dehydrated while you sleep you may grind your teeth. If you have dry heat use a humidifier, and get used to fewer blankets until the TMJ pain eases up. Sounds crazy but it's true.
posted by Hugh Janus 01 March | 15:53
Also mind you don't open your mouth too wide. Not just when eating, but also if you have to shout really loud or something.
posted by Hugh Janus 01 March | 15:56
I had major jaw surgery 2 years ago (not for TMJ but for a totally screwed up bite) so between having my mouth wired shut for a month, having to relearn how to chew for another 2 months, and being in braces for nearly 3 years, I am the maven of soft foods! This is a great resource for suggestions by food type, meal, etc. Purees figure into it, but there are also plenty of other things -- casseroles, mac & cheese, chili, scrambled eggs/omelettes, soups, pasta, fish, etc. Plus, you now have an excuse to drink all the milkshakes you want! ;)

For veggies, it really is important that you NOT crunch on stuff. Yes, that means cooked carrots, yams/sweet potatoes, etc. About the only uncooked veggie I can think of that you can eat is avocado, and perhaps very soft tomatoes. Otherwise they've got to be cooked. (Try roasting some peppers! They're heavenly.)

Moist heat is, the best for reducing inflammation of this type. A damp washcloth that you heat up in the microwave (be careful! Try it in 20 or 30 second increments so that you don't burn yourself) is the easiest way to do it.
posted by scody 01 March | 16:03
thanks for the advice! and I have one of those pop into the microwave heat packs and it did help a bit, maybe I will wrap it in a damn washcloth and see if that supercharges it!

And even tho I do enjoy some foods which are soft, I really get a squick feeling when I think of the term "soft foods".

what about a simple green salad with nothing crunchy in it? is that okay? It's the winter thing, you want things to be fresh and crunchy! or at least crisp.
posted by Mrs.Pants 01 March | 16:39
what about a simple green salad with nothing crunchy in it? is that okay?

I wouldn't, especially since it's just till Monday. The point is to rest your jaw, and you can't do that if you're chewing/grinding your teeth (even on lettuce), but it's up to you how serious you want to be about following your doc's orders to heal your jaw.

If you need some consolation, consider that at least you're not restricted to eating through a straw for a month, which I can tell you from experience is really horrible.
posted by scody 01 March | 16:52
I have this too, although it hasn't bothered me for a few years. A maxilla-facial surgeon told me to do the following, and it helped (although it only works, apparently, if the jaw 'slips' on one side only):

Open your mouth about halfway, bend your tongue back as far as you can so it touches the back of the roof of your mouth and then, without closing your mouth fully, open and close your jaw, using the 'good' side as far as you can. Think of how you would pretend to make a skull talk, that kind of movement.

I empathise. I used to get the most evil headaches all up the left side of my head, as if someone had buried an axe in it, and it was all due to jaw pain.

posted by essexjan 01 March | 17:12
Get used to the idea that you can never eat another bagel so long as you live.
posted by mudpuppie 01 March | 18:10
I have TMJ, and it was amazing to me to learn how much of my other physical symptoms were caused by it. Sure, I knew the headaches, but it was also causing all of my sinus trouble, some back and neck pain, and some really sharp pains in my ears that I had preiously been told were the result of allergies. I was completely skeptical about my nightguard at first (and I think I answered an AskMe somewhere saying it was worthless; I wish I could delete that), but it turns out to be great! Near total relief from all the aches and pains most of the time. There are still occasional mornings where it seems like it just didn't do the job, but it's such a change from the years I would wake up 20 minutes early just to take Advil, and had a headache all the freaking time. But yeah, foodwise: you may never be able to eat foods that require a lot of chewing without having pain, I know I can't. I have a headache now from the turkey sandwich I just ate, although it's not too bad. Good luck!
posted by amro 01 March | 18:11
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