TMJ Disorder Causes Tooth Pain – Symptoms & Causes
By Jennifer DeChant, DDS
Many say there is nothing worse than a nagging toothache!
Your pain may be due to a multiple factors, such as genetics, arthritis or a jaw condition. Some individuals who suffer from ongoing jaw pain also tend to clench or grind their teeth (bruxism). While many people never develop a TMJ disorder from habitually clench or grind their teeth, others do.
The Minnesota Head & Nead Clinic can help diagnose chronic conitions that need pain relief. We are skilled at determining the root causes of persistent pain. People ask why after haing a painful tooth treated, the pain still persist. At times the patient didn’t even have tooth pain until AFTER a filling or crown was placed. We’ll start with answering some common questions.
Why Does my Tooth Hurt After Completing Dental Treatment?
Our body’s are intriciately connected. Many people are unaware of the work our jaw muscles do to help us chew, open our mouth wide, etc. The TMJ pain comes from the soft tissues that attaches to the bone.
When a dentist places a restoration on a tooth, she or he generally needs to remove some tooth structure and decay (a cavity) before filling the tooth. There are three layers to your teeth. Enamel is the hardest layer and makes up the outside layer of your tooth. The middle layer is Dentin. The Dentin is what gives your tooth its yellow color. And the inside layer is called the Pulp. The nerve of the tooth is in the Pulp and extends into the roots of your tooth.
When your dentist places a filling, usually part of the enamel and dentin layers are removed. This can cause some irritation to the nerve of the tooth. This irritation can cause the cold or hot sensitivity. The more tooth structure that is removed, the higher chance that the nerve could become irritated. This is why it is very important to see your dentist regularly for a check-up. If you have a cavity in the tooth, it will continue to get bigger and bigger over time. The larger the cavity, the higher chance for temperature sensitivity after the filling is placed.
There are several reasons why a tooth could hurt after dental treatment. The most common complaint is temperature sensitivity in the tooth directly following a filling or crown. Your dentist can address questions and solutions for this.
Can TMJ Tooth Pain be Triggered by Bite Changes?
If your bite becomes slightly different after a new crown or filling than it was before, this may impact your chewing and jaw. New crowns or fillings with a slightly different shape than original teeth affect the way your teeth come together. Because of the change in your bite, you may experience a slight twinge in the tooth when you bite. This usually settles down after a couple of days or weeks.
However, if you cannot bring your teeth together or have extreme pain when biting or chewing directly following this type of treatment, call your dentist. If not provided or lost, ask for information about patient self-care after receiving novocaine for dental work. It may be necessary to be evaluated for a bite adjustment. Teeth crowns or fillings may have a touchpoint that is too tall or too high. In this case, a slight adjustment to the restoration often is the fix. Once peples’ bite is adjusted, the pain thypically resolves.
If it persists then your dental may refer you to our team of pain specialists. We’ll evaluate your jaw’s temporomandibular joint among other things.
What is my Temporomandibular Joint?
Your temporomandibular joint is a highly functioning hinge that connects your jaw to the temporal bones of your skull. These are locatedin front of each ear. It is the mechanical arm that moves your jaw up and down and side to side. This is what enables you talk, chew, scream, whistle, and yawn.
If facial nerve pain sensitivity develops after your tooth treatment, definitely request a doctor appointment. If an abscessed abscess is ruled out, you may have developed something called “irreversible pulpitis”. That is just a fancy way of saying that the nerve in you tooth is very inflamed and will not resolve itself. A tooth that has a large filling or crown can sometimes can lead to an abscessed tooth or irreversible pulpitis. Other causes are trauma to the tooth or a history of clenching and/or grinding your teeth. This is where a temporomandibular disorder should be checked.
TMJ refers to an array of conditions that relate to your TM joints, jaw muscles and facial nerves. TMJ may occur when the jaw twists during opening, closing or side-motion movements.
When you clench or grind your teeth, you are putting excessive pressure on your teeth which could lead to nerve damage. Once you develop an abscess or irreversible pulpitis, the usual treatment is to have a root canal on the tooth. When a root canal is performed, your dentist or endodontist will place a small hole in the top of the tooth after it is numb, and then he or she will place some small files down inside the roots of the tooth to clean out the diseased nerve tissue. Once all of the diseased tissue is cleaned out, they will place a rubber material into the roots of your tooth and then close up the tooth with a filling or cover the tooth with a crown. If a root canal cannot be performed on the tooth, then the tooth will most likely need to be extracted.
TMJ Treatment may Start by Reviewing X-Rays of Teeth & Jaw
Following a root canal, your tooth could be a little sore for a few days or weeks. This is very common. But what if your pain does not resolve? What if the pain increases? Or worse, what if you had your tooth pulled, but the pain still persists? This is more common than you could probably believe. In fact, it is estimated that over 680,000 teeth per year are treated with root canals unnecessarily. Although you could feel certain that the pain is coming from your tooth, there just may be another cause.
Here’s what a tooth looks like on an x-ray after having a root canal. The white lines in the roots of the tooth indicate that the tooth has been treated with a root canal. The lines are the rubber material that was placed down inside of the tooth after the diseased nerve was cleaned out. The white on the top of the tooth is a crown. (Some people call them a “cap”.)
Now take a look at this patient’s x-ray. Can you see that EVERY tooth has had a root canal? It’s hard to believe, isn’t it? This patient would experience a toothache and then have a root canal. And then another tooth would hurt. And then another and another. This continued until every tooth had a root canal. And yet, surprisingly, this patient still had persistent tooth pain. And that is were our chronic pain treatment can be your answer!
Believe it or not, tooth pain could actually be coming from your jaw muscles. Here’s why.
How do Jaw Muscle Bands Cause Painful Teeth?
When a muscle is injured, overused, or overloaded, it can develop taut bands in the muscle called trigger points. These trigger points can, in turn, refer pain to other parts of your body. For example, if you develop trigger points in your masseter muscle in your jaw (possibly from clenching or grinding your teeth), these trigger points could cause pain in your back teeth as illustrated below.
If you develop trigger points in your temporalis muscle, they could cause pain in any of your upper teeth. Both the masseter muscle and the temporalis muscle are activated when you use your jaw for talking or chewing. They can also be activated if you are clenching or grinding your teeth.
Trigger points in muscles can cause many other issues beyond toothaches, such as tension headaches and ear pain. Trigger points are often a sign of temporomandibular joint (TMJ) disorder, a disorder causing pain in your jaw joint and the muscles that control jaw function. Some other signs of TMJ disorder include pain with chewing, clicking or popping or grating noises in your joints, facial pain, locking of your jaw, or an ache or ringing in your ears.
Oftentimes TMJ disorders goe undiagnosed. Sometimes a patient has TMJ disorder for years without knowing. They often present with tooth pain, earaches, jaw pain, and headaches that they have been living with for years and years. Once they are treated for TMJ disorder, the accompanying symptoms resolve. At MN Head and Neck Pain clinics, we perform a thorough exam on your head and neck to identify if you are suffering with TMJ disorder. We then establish a treatment plan specifically tailored to you in order to address your complaints.
We accomplish this through multiple avenues, depending on what we deem is the correct treatment for your particular case.
Types of TMJ treatment may include:
1. Patient education and self-care
3. Injections such as Botox or Acupuncture
5. Behavioral modification
Once you have been evaluated by one of our providers, our team works together to take an interdisciplinary approach to reducing your symptoms. No worries if traveling to our clinic is challenging for a time; we provide telemedicine doctor appointments. So, if you are suffering from persistent tooth pain after dental treatment and not finding any relief, you could very well have TMJ disorder.
Call 763-577-2484 for a deep diagnosis for a possible TMJ disorder or Contact Us For Your Consultation
Dr. Jennifer DeChant is passionate about treating patients with TMJ disorders, jaw pain, and obstructive sleep conditions at the MN Head and Neck Pain Clinic. She graduated with honors from the University of Minnesota in 1999 with a Doctor of Dental Surgery degree.