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TMJ and how it relates to CPAP use - TexasDon - 11-05-2022

Hi,  I tried to search for TMJ but couldn't figure out how to search for a short term.  So, there may very well be a great discussion, regarding TMJ and cpap therapy but I couldn't figure out how to search for it.

I've got it ... TMJ.   I am worse when I wake up.   My particular TMJ has been diagnosed as muscular.   No joint issues.   Did the whole diagostic workup with MRI, joint animation and so forth.  Currently seeing a very expensive dentist.  BTW ... have also seen cardiologist, ent, sleep doc and prothodontist.   My problem is that these providers won't talk amongst themselves and so I find myself trying to understand how I can influence my TMJ through CPAP therapy.

CPAP therapy = resmed 10 on auto with min 5 and max 12.2 and epr of 1.   I use a nasal pillow mask and tape my mouth.  humidity on auto.  AHI (if you care) is less than 1.

So, this isn't a thread about do I have TMJ or did I try this or that for my TMJ.  Rather, I'd like to see if anyone has thought about CPAP therapy and how it might be contributing or therapeutic to TMJ.

Regards,  TexasDon

RE: TMJ and how it relates to CPAP use - greatunclebill - 11-05-2022

Everybody has 2 TMJ's. I also have TMD and apnea like you. I don't have any problems with one affecting the other.  
This may help:

What are the temporomandibular joints (TMJ)?
The temporomandibular joints (TMJ) are the 2 joints that connect your lower jaw to your skull. More specifically, they are the joints that slide and rotate in front of each ear, and consist of the mandible (the lower jaw) and the temporal bone (the side and base of the skull). The TMJs are among the most complex joints in the body. These joints, along with several muscles, allow the mandible to move up and down, side to side, and forward and back. When the mandible and the joints are properly aligned, smooth muscle actions, such as chewing, talking, yawning, and swallowing, can take place. When these structures (muscles, ligaments, disk, jaw bone,  temporal bone) are not aligned, nor synchronized in movement, several problems may occur.
What is temporomandibular disorder (TMD)?
Temporomandibular disorders (TMD) are disorders of the jaw muscles, temporomandibular joints, and the nerves associated with chronic facial pain. Any problem that prevents the complex system of muscles, bones, and joints from working together in harmony may result in temporomandibular disorder.
The National Institute of Dental and Craniofacial Research classifies TMD by the following:

  • Myofascial pain. This is the most common form of TMD. It results in discomfort or pain in the fascia (connective tissue covering the muscles) and muscles that control jaw, neck and shoulder function.

  • Internal derangement of the joint. This means a dislocated jaw or displaced disk, (cushion of cartilage between the head of the jaw bone and the skull),  or injury to the condyle (the rounded end of the jaw bone that articulates with the temporal skull bone).

  • Degenerative joint disease. This includes osteoarthritis or rheumatoid arthritis in the jaw joint.
You can have one or more of these conditions at the same time.
What causes TMD?
In many cases, the actual cause of this disorder may not be clear. Sometimes the main cause is excessive strain on the jaw joints and the muscle group that controls chewing, swallowing, and speech. This strain may be a result of bruxism. This is the habitual, involuntary clenching or grinding of the teeth. But trauma to the jaw, the head, or the neck may cause TMD. Arthritis and displacement of the jaw joint disks can also cause TMD pain. In other cases, another painful medical condition such as fibromyalgia or irritable bowel syndrome may overlap with or worsen the pain of TMD. A recent study by the National Institute of Dental and Craniofacial Research identified clinical, psychological, sensory, genetic, and nervous system factors that may put a person at higher risk of developing chronic TMD.
What are the signs and symptoms of TMD?
The following are the most common signs and symptoms of TMD:

  • Jaw discomfort or soreness (often most prevalent in the morning or late afternoon)

  • Headaches

  • Pain spreading behind the eyes, in the face, shoulder, neck, and/or back

  • Earaches or ringing in the ears (not caused by an infection of the inner ear canal)

  • Clicking or popping of the jaw

  • Locking of the jaw

  • Limited mouth motions

  • Clenching or grinding of the teeth

  • Dizziness

  • Sensitivity of the teeth without the presence of an oral health disease

  • Numbness or tingling sensation in the fingers

  • A change in the way the upper and lower teeth fit together
The symptoms of TMD may look like other conditions or medical problems. See a dentist or your doctor for a diagnosis.
What are the treatments for TMD?
Your healthcare provider will figure out the best treatment based on:

  • How old you are

  • Your overall health and medical history

  • How well you can handle specific medicines, procedures, or therapies

  • How long the condition is expected to last

  • Your opinion or preference
Treatment may include:

  • Resting the temporomandibular joint (TMJ)

  • Medicine or pain relievers

  • Relaxation techniques and stress management

  • Behavior changes (to reduce or stop teeth clenching)

  • Physical therapy

  • An orthopedic appliance or mouthguard worn in the mouth (to reduce teeth grinding)

  • Posture training

  • Diet changes (to rest the jaw muscles)

  • Ice and hot packs

  • Surgery


RE: TMJ and how it relates to CPAP use - TexasDon - 11-05-2022

Thanks for the info.   Anyone with TMJ or rather TMJ disfunction soon learn a great deal about it after their first flareup.   I've read research on how apnea plays a part in TMJ but really nothing about apnea therapy and its impact on TMJ.   Just thought I'd throw it out there in this forum.   Thanks again.   -TD

RE: TMJ and how it relates to CPAP use - KeepSmiling - 11-05-2022

TexasDon,

After starting CPAP, I started having sever pain and thought I had an issue with my back teeth. The dentist told me it was TMJ. I am assuming, I started clenching hard keep to mouth closed. I got a mouth protector made by the dentist. I started wearing my mouth piece when bike riding because I notice bumps made the area sore.

It never hindered my CPAP therapy. It was good for over a decade.

Whenever you see a dentist remind them of your condition and be careful how much you open your mouth.

When you say the letter M do your lips stay open. That is another story, which I post later. For that osteopath gives fastest results. At least for me.

RE: TMJ and how it relates to CPAP use - TexasDon - 11-05-2022

My TMJ started when I switched from a ResMed 9 to a 10.   I also started mouth taping.   Woke up one morning with it.   But I was also recovering from an accident and was suffering from anxiety and depression and was clenching and grinding for sure.   Spring 2020.  

I have a bite splint and am suppose to get dental work to optimize the occlusion into a good resting position so muscles can relax.   crowns for the occlusion ... cha ching.

My suspicion is that respiratory arousal events trigger clenching.   Its just a suspicion though.   It is said that apnea can cause TMJ for the same reason; produces unnatural movements to wake you up enough to breathe and the movements irritate the TMJ.   So, I think it would follow that tuning to eliminate RERA events might be beneficial to me.   Just a theory.

Thanks for the reply!

-TD

RE: TMJ and how it relates to CPAP use - readingteacher - 11-05-2022

I have a severe TMJ disorder caused by faulty TMJ implants in 1986, that were recalled by the FDA in 1990. Although I had surgery to remove the as much of the implants as possible, they caused permanent and irreversible damage. I have worn a dental splint 24/7 ever since.

I was diagnosed with apnea and started on CPAP two years ago. After I got settled in and comfortable with the CPAP, the dentist who takes care of me and my splint told me that I was clenching and grinding my teeth less. He can see wear marks on the splint from clenching, and they were less.

I chalk that up to getting actual quality sleep without struggling to breathe.