Dr.Crapo: A year ago I sat in my dentist’s office for two large fillings. My mouth was open for more than an hour. After that appointment, my teeth didn’t seem to fit real well, even though my dentist spent a lot of time adjusting my bite. The day after, I experienced the most severe pain of my life. I’m a forty something guy who played rugby from junior high until a few years ago and I know pain – but this jaw pain topped anything I’d ever experienced. It started at my lower jaw, went up the side of my face, over the top of my head, down the back of my head to my neck and all the way out to my shoulders. I went back to my dentist and he thought my jaw must be dislocated, but he couldn’t put it back in. I saw two other dentists and they couldn’t budge my jaw or relieve the pain. Finally, I saw my MD and he gave me some very powerful painkillers. I took two and went to bed. It was the only thing that helped. It’s been a full year and about once a week I’m down for the count with this unbearable pain. Oh, I must say that when they tried to put my jaw back they all said my muscle and bone size were enormous and stronger than anything they’d seen – one of the dentists must have been a farm boy because he said my jaw and associated muscles reminded him of his dad’s Black Angus bull. Is my jaw “out”? What’s causing this massive pain? I can’t imagine taking these strong painkillers and being sidelined once every five to seven days for the rest of my life. Have you got any ideas?
The problem you describe falls under a very broad category of TMD or temporomandibular disorder/disease. From your description of the pain and the Black Angus bull reference, my best guess is that you’re experiencing muscle pain and not joint pain. In my experience, people who are powerfully built in their bone and ligament structure usually see problems in other parts of the oral masticatory system (teeth, bone, gums).
I have seen individuals built as you describe yourself, with tremendous wear and destruction to their teeth – frequently breaking new fillings and even crowns. You must see someone who deals with force of bite, bite alignment and bite balancing. When these things are not in harmony, tremendous pain can be generated. The last time I treated a similar situation, all the teeth, their guidance system and alignment had to be rebuilt and then safe guarded. It will not be cheap to fix the problem, but my best prognostication is that it is fixable – meaning your pain has a good chance of being eliminated.
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Based on actual patient cases.