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Can Diabetes Cause TMJ Disorder?

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I’d been having jaw pain for a while and went to see my dentist. He felt it was TMJ and we were working on solutions. First, he gave me a nightguard. That didn’t stop the pain. Next, he adjusted my bite, shaving some teeth and building up others. That cost me quite a bit of money. Again, no change in the pain. He told me to give it time. I gave it a couple of months and still no change in the pain so I went back. Now he saying that my TMJ Disorder is a result of my diabetes and there is nothing that can be done about it. The best I can do is take ibuprofen to manage the pain. Here are my questions. First, can diabetes even cause this problem? Second, if he knew that, why did he cost me all that money with treatments that he knew would not work?

Caroline

Dear Caroline,

Woman holding her jaw from TMJ pain

This sounds very frustrating. Before we get into this in more detail, you should know that ibuprofen is a contraindication for diabetes. While most people can take them, NSAIDs are not a good idea for people in your situation. I don’t want you getting into danger with your health.

Let’s answer your first question first. Is it possible for diabetes to cause this problem? Technically, yes, though it is rare. While about 20% of diabetics develop general neuropathy, only .05% will develop craniofacial neuropathy.

As for the treatments he did thus far, he did start with the least invasive treatment. That was good. However, even if your cause is the diabetes, saying there is nothing more he can do is really dropping the ball. What you need is someone with real TMJ training. Someone not in over his head, which is what I suspect your current dentist is. There are quite a few options left in getting you some relief.

Find a dentist with extensive post-doctoral TMJ training and let him examine you and give you the options. You will be able to get out of pain.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

A Collapsed Bite

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I wonder if you can advise me. I am very self conscious about my smile. When my mouth is at rest, but not completely closed, there is just a black cavern. You cannot see my teeth at all. My jaw also hurts from years of grinding my teeth, which I just found out recently was an issue. My dentist made a night guard for me to wear at night. When I wear that, my jaw hurts less and it gives the slight appearance of my teeth being visible. This makes me think I need to add something to my teeth to make them “show up”, plus it may help with the jaw pain. I asked my dentist about it and he suggested porcelain veneers. Before I make such a big investment, I want to make sure it is the right choice. Have you seen patients in my situation? If so, what worked for them?

Caroline

Dear Caroline,

woman holding her jaw in pain

I am glad that you wrote. I think I know what has happened here and if it is not done right it can completely mess up your bite and leave you in a lifetime of pain. As for porcelain veneers, while if you see an excellent cosmetic dentist it would help with the appearance related issues, it would not solve the root of your problem or the jaw pain, which is like TMJ Disorder as the result of the grinding.

Based on what you have described, it sounds like your teeth grinding has led to a collapsed bite. I wish a dentist would have intervened sooner and protected you from this. However, that is water under the bridge and you need a solution. When your teeth are that ground down, the only real solution is a full mouth reconstruction. This is done by crowning the ground down teeth in order to get your bite in proper alignment and occlusion. However, this is one of the most advanced procedures in dentistry and has to be done very carefully.

A dentist would have to do this starting with provisionals to make sure everything lines up perfectly. It takes years of post-doctoral study to be able to do this well. Look at Dr. Marion’s bio to get an idea of the type of training a dentist would need to work on your case.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

This Full-Mouth Reconstruction is a Disaster

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I need some help. My teeth were in bad shape. I’ve had six dental implants placed and the dentist is placing crowns on the remaining teeth. The implants are done and now he’s on the dental crowns. It doesn’t feel like the sides of my mouth are even. The teeth on one side hit, but not the other. My jaw hurts all the time. While it ached a little before the treatment happened, now it is constant. My dentist said he meets all the checkpoints and thinks I am just not used to having crowns in my mouth. How long should it take me to get used to this? What if I don’t?

Emma

Dear Emma,

woman holding her jaw in pain

Whenever you are crowning all the teeth, the way your dentist is, it is known as a full-mouth reconstruction. This is a very advanced procedure and very few dentists can do it well. I am not certain your dentist has the training necessary to do this correctly and it sounds like you are going to have a disaster on your hands. Your dentist said he met all the checkpoints. However, one of the basic checkpoints is that the teeth come together naturally and simultaneously. His comment that you are just not used to having dental crowns doesn’t give me any more confidence in him either. When dental crowns are done properly, you don’t notice them at all. There is no “getting used to them”.

The reason you are in so much pain is your teeth are not occluding properly. This is essential and will only lead to more severe problems if not repaired. So, where do you go from here?

My suggestion is you find a qualified dentist to look at your case. I suspect it will need to be redone. Look for a dentist who has done extensive training with one or more of the following post-doctoral training institutes:

  • The Pankey Institute
  • The Dawson Academy
  • The Las Vegas Institute for Advanced Dental Studies

Based on your description, I think the case will need to be re-done. Have the dentist check your dental implants as well. If you only need the crowns re-done and not the implants, ask for a refund on crowns only. If both need to be replaced, my suggestion, in that case, is instead of a refund you ask for him to pay to have the work replaced at the dentist of your choosing. This is because the cost of replacing implants is more than the original procedure— a result of needing bone grafting to replace the bone lost during the removal of the original implants.

This blog is brought to you by Dr. David Marion who tries to be the best dentist in Duluth, GA.

Mouth Collapsing

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It seems that the older I get the less I like my smile. When my mouth is at rest, you can’t see any of my teeth, just empty darkness. Even when I am smiling, I have to force my teeth to show. I don’t know if this is connected, but my jaw hurts all the time, except when I’m wearing my mouthguard, which I got not too long ago when my son told me he noticed I was grinding my teeth. My dentist suggested Lumineers might help, but I wanted to get another opinion before moving forward.

Melanie

Dear Melanie,

woman covering her mouth

I’m glad you wrote. Your dentist is going about this the wrong way. In fact, it is very likely to make things worse. Based on what you’ve described it sounds like your teeth are worn down to the point of being over closed. This can result in serious TMJ Disorder, if it hasn’t already.

Lumineers is a brand of porcelain veneers. This particular brand of veneers is often marketed to inexperienced cosmetic dentists. The fact that he’s even suggesting this as a solution backs up my suspicion that he doesn’t know what he’s doing in this case.

The solution for this is a full-mouth reconstruction. This is a very advanced procedure that has to be done very carefully. It usually involves crowning every tooth. It is beyond the ability of most dentists. Just getting the function of your bite correct is a tall enough order for this however, you will want more than function. You’ll want an attractive smile too.

I want you to look at Dr. Marion’s credentials. This would be the kind of dentist you are looking for when it comes to something like this. Also, if a dentist went to one of the following post-doctoral training centers, they will be qualified as well:

  • The Pankey Institute
  • The Dawson Academy
  • The Las Vegas Institute for Advanced Dental Studies

Do be careful with who does this for you.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.