Sudden onset closed lock Treatment? in TMJ SUPPORT Forum

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Sudden onset closed lock Treatment?

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violet	Sudden onset closed lock Treatment?	Lead	[-]
Member Posts: 9 (03/09/09 02:35:52) Reply Quote More My Recent Posts	Tags : None Remove this ad Hi I am new to these boards. About 7 weeks ago, just in the middle of the day out of nowhere, my mouth wouldn't open up properly. It opened about 1.5 to 2 cm only & wouldn't open normally again. While brushing my teeth the next morning, I went to try and brush my tongue a bit & my mouth suddenly slid open fully without any force, but once I shut my mouth it wouldn't open wide again. The next day, my mouth slid fully open again, but then ever since, it has been locked permanently to only a 2cm maximum opening. It won't open fully and therefore I have had to be very careful to eat soft food. I haven't had any pain at this stage. I went to a dentist within 5 days of the lock & he put me on valium for 7 days, made me a temporary device to fit over my front teeth to keep my back teeth from touching (worn 2 weeks) & did on 3 occassions some gentle muscle stretches. None of this worked- this treatment was done for a period of 2 weeks. I was then referred to an oral & maxillofacial surgeon who recommended an arthroscopy on the right side. This was diagnosed by a closed mouth ordinary x ray- I have not had any tests or MRIs done. I think surgery is a bit too soon at this stage. All I have been told is that the closed lock has been caused by my clenching and grinding. I have never had jaw popping/clicking or any jaw pain or dysfunction.I have never had an injury to my jaw. The only thing I have had done to my jaw area are steroid injections on the side of my face/jaw for acne scarring by a dematologist about 5 months prior- but I doubt this would have caused my jaw lock???? My dentist had no suggestions for me apart from the arthroscopy. He thinks that chiro, physio, massage wont work for a joint issue- only a muscular issue. But to be honest, I really don't know what's wrong with me. From looking at the internet and these forums it does look like its a joint issue (internal derangement without reduction- that's my own self diagnosis by the way). The doctors i have been to havent really told me exactly what's wrong, that's why I'm hesitant to proceed. But perhaps its partially a muscle issue & maybe massage therapy would help. I'm really having trouble finding others that have sudden onset closed lock- I'd really appreciate hearing from anyone who has experience with this. Thanks!
Cymy Sue		#1	[-]
Posts: 7276 (03/09/09 09:14:28) Senior Member * Moderator * Reply Quote More My Recent Posts	Hello Violet & Welcome. I'm sorry you've had to search for help for this problem. I had never experienced what you describe until "AFTER" I began having surgeries and there could have been any number of reasons for it then. From my personal experience, I do believe the muscles could be responsible, but most of us have found that doctors tend to overlook this possibility. "All I have been told is that the closed lock has been caused by my clenching and grinding." It seems from what you've been told that the muscles could be in a constant spasm or super tense condition and the result from the overload might be these sudden onset locks. Attention to the muscles could be all you need. This would include Massage Therapy and possibly, a passive muscle relaxing splint.The splint you had is not this type. Keeping the back teeth apart is not always the best thing to do. In many cases, it seems to make the muscles tighten up more. Not all doctors believe in "passive muscle relaxing" with splints, but it may be the single best treatment for many cases of TMJ. "I was then referred to an oral & maxillofacial surgeon who recommended an arthroscopy on the right side. This was diagnosed by a closed mouth ordinary x ray- I have not had any tests or MRIs done. I think surgery is a bit too soon at this stage." I think you are absolutely right and this is all too common. No one should suggest surgery without seeing what you have going on with an MRI and other tests. Doctors who understand TMJ problems and have the best results treating patients DO NOT suggest surgery as a first course of treatment. It should be the last resort if at all. The best doctors understand, the least that can be done to correct the problem is the best for the patient. Non-invasive and passive treatments are suggested by all of the TMJ Organizations and Patient Advocacy Groups. These suggestions result from years of research and patient histories. Surgeons do surgery. Sometimes they will tell you that a preliminary arthro-procedure to see what's going on is needed and it's "mostly" a non-invasive procedure. It is not. There are no non-invasive surgeries. In many cases, the trauma caused by grinding and clenching can be treated and resolved. In many cases, actual damage to the joint or joints can be treated with splints, hands on therapies and sometimes, medication. I would do what you're doing. Eat soft and let the muscles rest. Moist heat is helpful for most everyone. If you can, try and rest your face/jaws completely by talking as little as possible. Just a thought. Try and see if you can pinpoint anything that happened prior to the locks. I know you said it came out of the blue, but there could have been something ...... were you sitting with your chin on your hand, sitting in the same position for a long time, talking a long time.......anything that could be a trigger. This information would tell a massage therapist, physical therapist and a lot of doctors more about what's going on. I'm sorry I don't have more information about what's happening. TMJD has so many variables and everyone seems to have something a little different. I do know the muscles can cause problems and do things that I would not believe had I not experienced them. I personally would get opinions from someone other than you have at this point. Their treatment options are quite limited and there is so much more that can be done.....the first being appropriate & comprehensive diagnostics. Hopefully some of our other members will drop in & have some other information for you. Take care, Cymy Sue Last Edited By: Cymy 03/09/09 09:17:06. Edited 1 times.
lu jones		#2	[-]
Posts: 3163 (03/09/09 10:37:17) Senior Member Reply Quote More My Recent Posts	Welcome Violet. Sorry you had to find us. I haven't had that problem. My mouth always has been able to open wide. I am thankful for that. Cymy has some good ideas for you. Keep in touch.Lu
feelines		#3	[-]
Posts: 1878 (03/09/09 13:36:15) Senior Member Reply Quote More My Recent Posts	Violet, sorry you had to find us. Good thing this locking hasn't been going on longer than 7 weeks. You do need to get unlocked to avoid further damage to your joint(s). Did you say which side it was on? Cymy was right on about muscular involvement and a conservative approach. Have you tried a muscle relaxer such as flexeril to see if relaxation of the muscles alleviates symptoms. I don't like taking meds but did take flexeril once with some relief. I could then reasonably deduce my muscles were involved. It's not always that simple though. One has to then look at what is making the muscles spasm, and so forth, and consider the whole picture.... Last Edited By: feelines 03/10/09 01:03:43. Edited 1 times.
Michelle Denise	Welcome Violet	#4	[-]
Posts: 6585 (03/09/09 20:28:43) Senior Member * Moderator * Reply Quote More My Recent Posts	Hello Violet, You have been given some really good information by Cymy and Feelines. I hope we hear back from you as to what treatment you decided on and if it worked. My thinking was that after you got a correct diagnosis that possibly physical therapy might be an option to help you regain your opening along with massage therapy. You would indeed need someone that has been trained in TMJ and not all physical therapist have been trained in treating the TMJ. It is really important that the physical therapist has training in treating the TMJ. A lot of times TMJ also resolves without advanced treatment as suddenly as it came on. I hope this is what happens in your case. Best wishes, Michelle
violet		#5	[-]
Member Posts: 9 (03/10/09 07:13:57) Reply Quote More My Recent Posts	Remove this ad Hi everyone, Thanks for the welcome and your advice I probably missed a few bits of background information on my initial post- I had braces taken off 6 years ago (which I got as a teenager to straighten my teeth) & ever since I have worn plastic retainers on my teeth which I thought helped prevent wear on my teeth from the grinding. It never occurred to me that I was doing damage to my jaw. I also clench, but before my lock happened, I think it was an unconcious habit (I didn't realise how much I did clench). 3 years of uni and 4 years of work have had a lot of stressful times for me, so it was not unusual for me to wake up with sore molars or a headache over the years. I have had problems with managing stress & I'm pretty highly strung. Occassionally I didn't wear my retainers & THE NIGHT before the lock happened I DIDN'T wear it & I was going through a stressful time at work. The next day my molars hurt & that afternoon I bit into some chocolate and felt a bit stiff, then a few hrs later my mouth locked & has basically been that way for weeks.Maybe it was just too much pressure for my jaw to handle? The initial splint the dentist made was just a temporary device- he just got some plasticine stuff that hardened & moulded a 'deprogramming jig' which was just for short term use to try & help stop my teeth touching. It wasn't designed as a longterm proper splint. Another thing I forgot to tell you was that after 2 weeks the dentist made me a full arch splint, which I just rushed into because I was desperate to get better. It was made from a mould from my teeth, is hard & fits over all my upper teeth. But once I wore it I realised that it just protects my tooth from wear. I questioned the dentist & he said that it just offers even support & protects my teeth from grinding. He said no device will stop me clenching/grinding he was against NTI splints, especially long term use. He said that's why I used the 'deprogramming jig' for such a short time as it can ruin your bite.I've been wearing the full arch splint, but really don't see it doing anything- my teeth don't hurt as much, but I still get headaches. Cymy Sue, what sort of splint is a muscle relaxing splint? I have an appointment with a supposed jaw specialist in a few weeks, until then I will look up physio etc. I just don't know any that are knowledgable with TMJ- I'm going to a medical doctor in 2 days time to see if I can get any recommendations of physio therapists I can see. Thanks so much for all your help, I look forward to hearing everyone's suggestions. I really appreciate your responses, it gives me hope...
Michelle Denise	Additional information	#6	[-]
Posts: 6585 (03/10/09 09:24:01) Senior Member * Moderator * Reply Quote More My Recent Posts	Thank you Violet for the additional information I am sure it will help all of us have a clearer view of what is going on. I also had braces and I wear a full upper splint as a retainer and to help protect my teeth when I grind at night. I wear a regular retainer on the bottom, but not every night. The splint is like Cymy's but maybe a bit thicker. I have been out of braces for several years. Many times medical doctors can offer things such as trigger injections into the jaw to relax the muscle. Also, they can prescribe muscle relaxers such as Flexeril or Soma, which will also help relax you. Hopefully they will and your jaw will unlock. Some of these medications can make you sleepy so be very careful. Try to be conscious of your bite and try not too clench. I always keep my lips together, teeth a part and rest my tongue on the top of the roof of my mouth. I had to wear my splint during the day for awhile to deprogram myself from clenching. I disliked wearing it during the day, but it did break my clenching habit. You dentist is correct about the NTI and any splint other than a passive/permissive splint changing your bite. Many people post that NTI splints have given them an open bite. I am hoping that your medical doctor will be of some assistance to you when you see him in a couple of days. It would seem likely that he will order a MRI to evaluate your locked jaw. I am thinking there is a picture of Cymy's splint in the TMJ Library. If not, she will be around soon and will post the picture of it for you. I hope some others will come by to offer their advice. Please let us know how the doctor's appointment goes for you. We do care! Best wishes, Michelle Last Edited By: Michelle Denise 03/10/09 09:26:45. Edited 1 times.
Caletera1		#7	[-]
Member Posts: 67 (03/10/09 11:56:15) Reply Quote More My Recent Posts	Hi Violet! Everyone here has made some great suggestions. I reguarly see an Osteopath who works on the muscles and the joints. The one I see is has done research on TMJ and osteopathic treatments, but I know that osteopath's, like chiropracters should be trained in TMJ treatments. Like everyone said, surgeons suggest surgery, and conservative approaches are always the first step. Good luck!
violet		#8	[-]
Member Posts: 9 (03/19/09 05:50:37) Reply Quote More My Recent Posts	Hi everyone I went to the medical doctor, but he wasn't that helpful. He just touched my face and jaw & he said the muscles around my jaw were 'spasmed' and very tight. It's strange because if they were spasmed wouldn't it hurt? I already took valium for a week with no results. My face definately doesnt feel normal- my mouth area feels tight, but its hard to tell if its the muscles that are tight or if my face just feels weird because my jaw isn't freely moving so I don't get the full array of facial expressions. I told him I only had a normal X ray done and I suggested an MRI. He said it wouldn't be helpful- so I don't think he knows what he's talking about. Isnt that the main scan you would get done for muscle problems?? He was by no means an expert in TMJ, he was just a GP. But he did recommend physiotherapy, but he couldnt give me any names of any therapists dealing with TMJ. I'm definately looking into it (as I have very few alternatives), is there anyone on this forum who is from Melbourne, Australia who can recommend anyone to me? Has anyone had any bad experiences with physical therapy ie their pain increased, their limited opening worsened. I'm really scared that the physical therapy could make me worse, I'm coping at the moment becuase I dont get pain. Do you feel that physiotherapy is safe to do? Its just really hard because noone seems to deal with locked jaws & its very difficult to find anyone with the same problem... Thanks!
Caletera1		#9	[-]
Member Posts: 67 (03/19/09 20:34:54) Reply Quote More My Recent Posts	Hi Violet, I'm so sorry the GP wasn't helpful! I had an MRI --which will show if your discs are displaced, and what's happening with the actual joint. I think it's pretty common(MRI's for TMJ). But the real problem here, I dont know about Australia, but in the US--the classification of TMJ as a dental or medical procedure is kind of sticky. No one wants it, so we have 'TMJ specialists' with no real training other than 1 hour courses, or we could hav esomeone who has studied the condition intensively. I never did any physical therapy--my jaw isn't cured, but it's workable. I would highly reccomend seeing a chiropractor or osteopath. And if you have access to a sauna that always helps my jaw. It relaxes the muscles and lets the joint open more. A steam room might work too, or hot compresses. I took valium for a week too and it didn't help my jaw, but the sauna and the osteopath does! Good luck!
FPDChief		#10	[-]
Posts: 815 (03/19/09 20:54:42) Member Reply Quote More My Recent Posts	Remove this ad Hi Violet, Muscular TMJ, which yours sounds like it is, is difficult to diagnose. MRIs will not really help in my opinion. You need to concentrate on getting the muscles to relax. That's where physical therapy can help (or a good massage therapist). Sure, there's no guarantee it will, but I would be shocked if it hurt you. To find a physical therapist trained in TMJ, call every PT place in your area. Melbourne is a big city. You should have little problems. You may have to try more than one or two, etc., tho, before you find THE one. When talking to the PT, find out if they do intra-oral massage. I find that to be one of the best things to break up spasms. It will hurt like crazy and should be done for only a few minutes per session. I now do a self massage when needed. In addition to PT, you might also want to consider taking some sort of medication, whether it be a muscle relaxant, anti-depressant or pain medication, or a combination of two. At least until your can get the muscles to relax. I also highly suggest evaluating your posture. It's amazing how much bad posture affects TMJ. I am now very careful with my neck and shoulders and it has made all the difference in the world. There is more I can suggest but I have to go now. I'll try and return with more recommendations. Take care. God bless... Carol

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Sudden onset closed lock Treatment?

Sudden onset closed lock Treatment?