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Dr. Hegland
Dr. Hegland, Dentist
Category: Dental
Satisfied Customers: 322
Experience:  Dentist at Dental Care on Demand
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I have recently been diagnosed with a TMD problem after

Customer Question

I have recently been diagnosed with a TMD problem after nearly a year of on-again, off-again facial/jaw pain, clicking, ringing in my left ear, headaches and (overnight) clenching. At worst, it's 3-4 days/week. At best, ***** ***** be only slightly aggrieved and no bad headaches for weeks. I have no other health problems, take no medications other than an oral contraceptive. From a dental standpoint, I have a few missing teeth (opposite to the more painful side), am class two type 1 with a noticeable deviation to the left. I've began to receive ultrasound treatments and use hot packs daily and the pain has never been so bad. I'm nauseous, can't eat, jaws on fire, feels honestly like one of my eyeballs is being torn out. I had to stay home today but have an appointment with my dentist tomorrow - where do I go from here? What can help me? This is awful and I don't know how people live like this.
Submitted: 1 year ago.
Category: Dental
Expert:  Dr. Hegland replied 1 year ago.

I'm sorry to hear that you are suffer from TMD related problem. May I ask what type of dentist you are going to tomorrow? Have you over the last year been able to identify any triggers that exacerbate the pain? What type of imaging/xrays have you had? Also, do you know what type of night guard you are using (soft guard or hard splint)?

Customer: replied 1 year ago.
It just has never been like this...this is really scary! I am seeing a dentist in the orofacial pain / TMD department of the local dental school. I was recommended there by a general dentist after describing some of the symptoms and having a check-up (new bitewings, exam) to make sure it wasn't a bad tooth causing the radiating pain/headaches. They've taken a pan and new bitewings of their own. I had an eval by ortho as well - they took cephalic (?) X-ray and measurements for face bow; they think ortho can help, though TMD said my symptoms are too severe right now to get ortho treatment without more pain. I also saw my regular MD - was sent for MRI, which was normal, just to make sure. I've kept a journal since the summer trying to identify if there are triggers; beyond eating something hard/chewy, I haven't found much in way of sleep, stress, diet or activity that seems to set them off. I was given a soft guard temporarily a few weeks ago and have been using it with some relief. It makes sense that the clenching at night is what probably causes me to wake up with the headaches/pain. Oddly, when this all started the other day, I found I couldn't use it at night - have been drooling excessively for some reason and unable to keep it in. So weird. They told me they'll take impressions and make me a custom one this week but I'm wondering how much worse this is going to get and how I'll be treated? I can't work or do much of anything like this!
Expert:  Dr. Hegland replied 1 year ago.

Well I'm glad that you are going to a Specialist, because your symptoms seem to be very severe. I'm sure that dr will run plenty of diagnostic tests to try to gauge your limitations. Are any of your teeth sore or does it seem more muscular? I ask because maybe if a particular area or tooth was identified some occlusal adjustment/equilibration coukd help settle things down for a few months. Then maybe ortho can be a possibility. Myofascial pain often can start from trigger points located elsewhere in the head and neck. What do you do for work? Are you sitting in front of a computer a lot? As far as meds, has a muscle relaxant at night been prescribed? One tip as far as sleep is Do NOT sleep on stomach. That puts excess pressure on the tempromandibular joint.

Expert:  Dr. Hegland replied 1 year ago.

Did you have you appointment today with the orofacial pain dentist? How'd that go?

Customer: replied 1 year ago.
The appointment didn't go so great but I'm happy to report the pain started to die down yesterday and is only a dull roar today. I showed up and told them everything that happened; from the places I'm having the pain, she told me that she believed it may be a sinus attack and that they couldn't help with that. She did offer some stretch and spray with the ethyl chloride and I think it helped a little - too sore and ouchy to tell much at the time. That was all. They scheduled me to come back in a week and stated we will continue with the stretch and spray, PT exercises at home and the mouth guard at night. *sigh.I went to the MD after that and told them I'm freaked out, not sure what the source of all these symptoms - pain, nausea, etc - is or how to treat. They drew blood and are sending me to neurology and ENT for eval next week. I'm disappointed and a little scared, really because I'm not sure what I should be asking for or expecting to be done. Thank you for asking on about me!
Expert:  Dr. Hegland replied 1 year ago.

Treating TMD really can take a lot of time and patience. Pt for your jaw is import and especially after a situation has been aggravated for long time. So keep with it, I know sometimes these exercises seem stupid. I believe that the specialist wants to rule out any sinus related contributions, and Ent will be helpful with that. I wouldn't be too concerned in that arena. As far as the neurologist goes, they will be looking into nerve conditions that you could be suffering from that are in facial region but aren't tooth related such as Trigeminal neuralgia. Hopefully that make sense that your doctor team just wants to hone in on your treatment and to do so must rule out other factors. Is there anything more I can help you with?

Expert:  Dr. Hegland replied 1 year ago.

Is there anything else I can clarify for you?

Expert:  Dr. Hegland replied 1 year ago.

If there is nothing else I can assist you with in regards ***** ***** question, if you'd please rate your experience so to keep proper quality assurance. Thank you!

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