Why does my mouth hurt when I open or close?


Although many dental patients complaints  are somewhat "tooth centric"( caused by tooth problems) , there are other causes of dental pain that are unrelated to the teeth per se.  The temporomandibular joint is a complicated structure that has multiple moving parts that when injured can cause pain on opening and closing motions. Sometimes the symptoms can stem from inflamed muscles involved with opening and closing , while others may have sustained injuries to the joint as well. Patients with damaged joints can experience many symptoms including clicking, crepidus( sound of loose particles grinding) tenderness in the soft tissue adjacent to the joint, locking of the jaw and asymmetric movement of the jaw to the side on opening and closing.

The diagnosis of the exact nature of tmj injuries can be somewhat complicated. Dentists with proper training can conduct a hands on physical examination that can infer the nature of a patients injury, but  many dentists are not expert in performing this type of comprehensive tmj exam.

The good news is that many patients experiencing pain are in an acute stage and given enough time will have a diminution of their pain. Wearing an appropriately design night guard often helps as well ( or at least can't hurt). and I believe it may keep injured joints from getting worse, especially if a patients is a night time bruxer.

Most of my patients with tooth wear, know that   would suggest a full arch maxillary hard night guard. This guard when inserted takes their excursions into account and is usually adjusted to have anterior occlusion in all excursions. This tends to shut off some of the more powerful muscles of mastication and may help alleviate some jaw tenderness.

If a patients symptoms do not get better, there is always the possibility of a consult with a maxillo facial surgeon or a specialist in treating TMJ problems. That being said, most of my patients seem to improve after they start wearing their night guards.

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2019/11/why-does-my-mouth-hurt-when-i-open-or.html - http://lspindelnycdds.blogspot.com/

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