Q: I have prided myself on reaching my fifties with all my teeth except one wisdom tooth. I’ll explain in a minute. Up through my forties, I didn’t give my teeth much thought.
I saw the hygienist kind of regularly but not religiously. My family has good teeth and every time I went, though I wasn’t diligent, I got a “good check-up, no cavities.” I thought, “Great,” then I’d let a year and a half go by, then two years, before going back.
A number of years after doing this, I did have a couple of cavities – big ones, so I got root canals. Then a year or so later, I began to have pain on the opposite side that ran over the side of my face, back of my head, and into my upper back.
I saw a dentist and because my wisdom tooth seemed a bit tender, we put it down to that so I had that wisdom tooth pulled. I expected relief but it didn’t come and that has been several years. The pain is not debilitating but it really gets my attention and takes my focus from more important things.
I’ve looked into it but can’t seem to find answers. Recently, I saw a dentist who asked a bunch of questions and took a lot of x-rays and moulds of my teeth. After all the information gathering, I’m to go back and get a diagnosis but something interesting happened as I was about to leave.
He said, “You have a deep overbite,” (something I knew). He said, “Because the pain is regional, over a large area, that is a good thing; proper treatment will relieve the pain.” That made me feel hopeful. What did he mean?
A: TMJ, or temporomandibular joint, is a shortened, almost acronym, of non-dental personnel to describe a painful aching or sharp pain that can affect the head, neck, back, and sometimes centres itself over the joint.
This is a big topic so let’s keep it to your symptoms. When pain is regional, it most often is a muscular response – lactic acid build-up and over exertion. Though the root causes are multifaceted, clenching and retro pressure on the joint structure can set this off. It is exacerbated every time you swallow.
A deep overbite can often be found to be the mechanical cause. In other words, when you bring your teeth together, your lower jaw is forced backward because as the front teeth and bite come together, the final squeezing together of the teeth “levers” the jaw and joints rearward.
This backward force stimulates muscle reactivity, meaning muscles that close the mouth and muscles that open the mouth are activated at the same time. Muscles that are supposed to be complementary become antagonistic as a result. This hyperactivity leads to muscle fatigue, lactic acid build-up, and pain.
Palliative and definitive treatment of muscular facial pain is available. It sounds like you are on the right track.