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Treatment for Temporomandibular joint disorders - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Dental Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Doctor :   Hi
Doctor :   How can I help you?
User :   hi
User :   the only thing that has been bothering me lately are headaches
Doctor :   Yes
User :   all other symptoms and problems are gone
Doctor :   Ok
Doctor :   Is it still pulsatile headache?
User :   yes
Doctor :   as you were mentioning
Doctor :   on one side?
User :   its only when lying down
Doctor :   IS the MRI done?
User :   no but i actually got a dental x-ray
User :   i had questions about the relationship of the headaches and the finding of the xray
Doctor :   Why is it so?
Doctor :   Ok
Doctor :   Please proceed with the questions?
User :   my wisdom teeth are seeming to cause problems, the lower right one is under the gum and putting pressure on my lower teeth
User :   the upper right one is partially impacted and is putting pressure on my jaw
Doctor :   Ok
User :   and the left upper one is under the gum and putting pressure on my jaw
Doctor :   Yes
User :   the xray also showed that my left tmj has some space in the joint, while the right tmj has almost no padding between bones
Doctor :   Ok
User :   and i grind my teeth at night, and have purchased a mouthguard two days ago to prevent the grinding
User :   how would this affect the pulsatile headaches? do you think there could be any correlation
Doctor :   The pressure on the jaw bones can very much cause the headache
Doctor :   and also the grinding during the night can cause the stress over the TMJ
Doctor :   and thus cause a referred pain too
Doctor :   over the head area
Doctor :   I want to know whether you have headache on both sides now?
User :   yes, but it feels slightly stronger on the right
User :   and its not so much a painful headache as a discomfort in all the neck muscles
User :   and the pulsatile feeling, which scares me
Doctor :   Ok
Doctor :   So you mean to say you have more of discomfort in the neck muscles
User :   yes
Doctor :   What about the pulsatile nature
User :   its not painful, its a pulsing feeling in the upper trapezius muscles, and it only gets worse by lying down or sleeping
User :   and it is synchronized with my heartbeat
Doctor :   Ok did you see a dentist for the xray
User :   yes
Doctor :   and who analysed the Xray
User :   my dentist, and i go to see an oral surgeon tomorrow
Doctor :   What ws the dentist opinion
User :   he said it could add to the headaches, and he said the oral surgeon could probably tell me if there is much of a connection
Doctor :   ok
User :   what is your opinion?
Doctor :   Do you know how long you have this teeth grinding
Doctor :   or bruxism at night
User :   no, it was just discovered monday by my dentist
User :   he could tell by the wear that its pretty intense grinding
Doctor :   If your dentist suspects that you have bruxism, he will try to determine its cause by questions about your stress level, your general dental health, your daily medications, and whether you routinely drink alcohol or caffeinated beverages, especially during the evening.
Doctor :   about your sleep habits,
Doctor :   He also evaluates the extent of it
Doctor :   examine your mouth and jaw, checking for tenderness in your jaw muscles and any obvious dental abnormalities,
User :   right, the jaw was the only abnormality he mentioned
Doctor :   A dental examination may detect other disorders that can cause similar jaw or ear pain, such as temporomandibular joint disorders
Doctor :   so in your case TMJ
User :   yes
Doctor :   If your dentist suspects a significant psychological component to your teeth grinding or a sleep-related disorder, you may be referred to a therapist, counselor or sleep specialist.
Doctor :   So let me put together now.
Doctor :   you were suspected of ear infection previously and put on antibiotics for few days, the infection was cleared and on CT it is normal. But the headache or the neck muscle discomfort remained
Doctor :   The cause of this discomfort is now suspected to be due to the bruxism you have that is detected by your dentist because of the malalligned jaws, dentition and the TMJ problem
Doctor :   now the pain which is increasing on lying down could be contraction of the neck muscles or the jaw muscles
Doctor :   where there is a fair chance to happen because of the grinding habit
Doctor :   having said this if the cause of the pain is only by grinding teeth
Doctor :   which is more commonly due to anxiety, stress, frustration
Doctor :   SO did you understand in whole
User :   yes, but where would the pulsating come into the equation?
Doctor :   Pulsatile component is non specific here
Doctor :   though the subjectively it is important
Doctor :   and it stress, anger, anxiety can also cause the pulsatile headaches
Doctor :   There might be a psychological compoenent too
Doctor :   You can put this across to the oral surgeon next time
Doctor :   yu see him
User :   ok
Doctor :   If he suspects the same
Doctor :   You can again come to me to and I shall give you some very good methods
Doctor :   to destress yourself
Doctor :   are you there
Doctor :   Did I clear your doubts
User :   ok
User :   yes, i would just like to have a proper night of sleep
User :   i wake up twice a night with the pulsing sensation
Doctor :   I understand that
Doctor :   You can start trying the method of relaxation
Doctor :   before yu go to sleep
User :   ok
Doctor :   Meditation is an excellent way
Doctor :   to achieve this
User :   no matter how relaxed i am going to sleep, i wake up a few hours later with the pulsing
Doctor :   Why cant you try this new method
Doctor :   Meditation before bed and Yoga in the morning
Doctor :   with proper respiration
User :   ok
User :   i will
Doctor :   The doctor may suggest you medication like antianxiety medications
Doctor :   which can help you short term
Doctor :   I sincerely suggest you to adopt this lifestyle
User :   do you think it could help the pulsing?
Doctor :   It takes some time but it is really worth the doing
Doctor :   Yes
Doctor :   Is there any thing else that I could help you with?
Doctor :   Please fill the feedback form say done when done
User :   no thanks for your help
Doctor :   Thanks for consulting Healthcaremagic. Bye for now. Please refer your friends to our service.
User :   done

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