tmj?

This morning I called the dentist because my jaw has been hurting when I open it and you hear a clicking/popping sound. It's been this way for a couple of weeks. Unfortunately, my student insurance is so basic that I only get one free visit/cleaning a year. Everything else is paid out of pocket at slightly better than average rates. Also unfortunately, the clinic I usually go to is closed until July 18th (these are Columbia dental school post-docs).

I called the health clinic where I typically go on campus. Because I apparently didn't extend my health services fee I would have to pay $60 per visit or $175 for the summer.

I called the Columbia Dental School clinic. Here I would need to go in for a primary evaluation, $75. Then get referred to a dentist who I wouldn't see until visit #2, another $75. Then if either my primary doctor or this dentist refers me, I can go to the TMJ clinic where a diagnostic evaluation costs at least $125.

Ahhhh! This is crazy. I looked up info on www.tmj.org.

Some info from the website:

Basics - Overview
The TMJ:
"TMJ" stands for TemporoMandibular Joint, or the jaw joint. You have two TMJs, one in front of each ear, connecting the lower jaw bone (the mandible) to the skull. The joints allow movement up and down, side to side, and forward and back—all the mobility necessary for biting, chewing and swallowing food, for speaking and for making facial expressions.

TMJ Diseases/Disorders:
Temporomandibular joint diseases and disorders, commonly called TMJ, are a collection of poorly understood conditions characterized by pain in the jaw and surrounding tissues and limitations in jaw movements. Injury and conditions that routinely affect other joints in the body, such as Arthritis, also affect the temporomandibular joint.

Who is Affected by TMJ Diseases/Disorders:
The National Institute of Dental and Craniofacial Research (NIDCR) of the National Institutes of Health (NIH) states that over 10 million people in the United States suffer from TMJ problems at any given time. While both men and women experience TMJ problems,
the majority of those seeking treatment are women in their childbearing years.

*How strange is that?!

Causes:
Not all causes are known. Some possible causes or contributing factors are injuries to the jaw area, various forms of Arthritis, dental procedures, genetics, hormones, low-level infections, auto-immune diseases, stretching of the jaw as occurs with inserting a breathing tube before surgery, and clenching or grinding of the teeth.

*I think this is typically my problem.

Diagnosis:
Diagnosing TMJ diseases and disorders can be difficult and confusing. For example, facial pain can be a symptom of many conditions, such as sinus or ear infections, decayed or abscessed teeth, various types of headache, and facial neuralgia (nerve-related facial pain).

At present, there is no widely accepted, standard test to correctly identify all TMJ conditions. In most cases, however, a complete evaluation, including a detailed medical history, the patient’s description of symptoms, and physical examination of the head, neck, face and jaw provide information useful for making a diagnosis.

Tests that are recommended are often intended to rule out other possible medical conditions. A diagnosis of TMJ diseases and disorders may be made only after every other possibility has been considered and eliminated. Many TMJ patients see multiple healthcare providers, such as primary care physicians, dentists, sleep specialists, ear, nose and throat specialists, neurologists, endocrinologists, rheumatologists, pain specialists, chiropractors, etc., in their search for answers.

Before undergoing any costly diagnostic test, it is always wise to get an independent opinion from another healthcare provider of your choice and one not associated with your current provider.

*Yeah, costly!

Progression of TMJ Diseases and Disorders:
Some TMJ problems improve on their own, without treatment, within weeks or months with simple home therapy. For others, symptoms worsen over time and develop into long-term, persistent and debilitating pain. Most people with TMJ problems have relatively mild or periodic symptoms.

Symptoms:
Pain is the most common symptom. TMJ pain is often described as a dull aching pain in the jaw joint and nearby areas, including the ear, which comes and goes. Some people, however, report no pain, but still have problems using their jaws. Other symptoms can include:
Being unable to open the mouth comfortably
Clicking, popping or grating sounds in the jaw joint
Locking of the jaw when attempting to open the mouth
Headaches
A bite that feels uncomfortable or “off”
Neck, shoulder and back pain
Swelling on the side of the face

Additional symptoms may include: ringing in the ears, ear pain, decreased hearing, dizziness and vision problems.

Keep in mind that occasional discomfort in the jaw joint or chewing muscles is common, and is not always a cause for concern. Many people with certain TMJ problems get better without treatment. Often the problem goes away on its own in several weeks to months. However, if the pain is severe and lasts more than a few weeks, see your healthcare provider.

Treatment:
Because most common jaw joint and muscle problems are temporary, lasting only weeks or months, simple care is all that is usually needed to relieve the discomfort. Self-care practices, for example, eating soft foods, applying ice or moist heat, and avoiding extreme jaw movements (such as wide yawning, loud singing, and gum chewing) are useful in easing symptoms.

Unfortunately, treatments are based largely on beliefs that are not grounded in thorough scientific research. As a result, some patients are made worse by these treatments.

*Thus, I think my end conclusion is that I will try home treatment and see if it goes away by itself. I'm not in excruciating pain...I'll just not open my mouth too wide and keep chewing soft foods on the side that doesn't hurt.