Ruby: Headache in right temple. Throbbing in teeth and tm joint. Neck pain. Had a splint put in 10 days ago. Went for Pt, massage, chiro and today pain management dr who I didn't like much and jumped to wanting to do a nerve block. Just trying to find the right person to treat me. Chronic grinder, had crowns put on all uppers and didn't make night guard fast enough. Tmj dentist only does splints and says jaw position is 80% better. Help! Haven't been able to work in almost 2 weeks.
Dr Shapira Reponse: Dear Ruby,
I am sorry to learn of your ordeal.
Normally it is relatively easy to decrease pain rapidly but it does not sound like you were dealing with a neuromuscular dentist. Blocks can be very effective but they are rarely a first line of treatment. MASSAGE THERAPY, CHIROPRACTIC OR OSTEOPATHIC ADJUSTMENTS CAN BE HELPFUL BUT THEY DO NOT ADDRESS THE UNDERLYING CAUSES OF THE PROBLEM ABD ARE MERELY PALLIATIVE IN NATURE. Frequently, you may also have long-standing underlying postural problems that these therapies will correct.
To say your jaw position is 80% better when you are in the pain you describe is ludicrous. Quality of life is always a primary concern and it does not appear that you are doing well from the little information you have given me. I normally hold off on permanent dental work until the pain is under control but I do not know if the pain was there prior to your dental work.
The use of spray and stretch with vapocoolant and trigger point injections can speed results but the utilization of the Low Frequency TENS to reduce spasm and pain is very important.
The headache in the temple area and throbbing pain in the teeth following dental work indicates that this probably is myofascial pain or TMD that should respond well to Neuromuscular Dental Treatment. A Diagnostic neuromuscular orthotic will be made to allow your muscles to function in a physiologic zone. An orthotic is designed to correct orthopedic and physiologic funtion rather than just protect the teeth like a "splint:.
Good Luck with your treatment.
I am forwarding your information to Dr **** ******. I hope that he will be able to help you improve your quality of life quickly.. I am available in Chicago if you do not find answers but Dr **** is an excellent practitioner. If for any reason it does not work out I can help you find another doctor but I know Dr **** and he can consult with me if there are any questions.
I am willing to see long distance patients but to be effective I try to schedule you so that we can initiate treatment and control your pain and correct orthopedics as quickly as possible. This requires a significant amount of time being scheduled in advance.
Dr Ira L Shapira
