By John Halmaghi on January 18, 2018
This 50+ year old patient presented to our office with complaints of tooth aches, headaches, and jaw pain. Her pain was mainly localized to the right side of her face. She had visited 3 general dentists and 2 root canal specialists for her pain issues. Nobody could explain her “ghost pain” despite completing 3 root canals along the way. The only advice she received was to have the root canals redone.
Initial analysis showed that she had a tilted smile and torsion of her upper skull (tilt of the maxilla). Notice how the teeth slant from upper right to lower left. Her tooth pain was constant, yet nobody could figure out where it was coming from. The general dentists and root canal specialists gave up on her. Her neurologist could not control her headaches. She was distraught and her husband was at his breaking point. This case was an enigma to all… except us.
Our comprehensive TMJ Analysis revealed that this patient suffered with a moderate displacement of her lower jaw. Although her jaw joints were not dislocated, her occlusion (bite) was dysfunctional. She had no biting areas on her teeth. As she stated: “I have never known how to bite down. My teeth never bite together in any one spot, it’s always different.” She was also distraught at the fact that she could not alleviate her right side facial pain and headaches. She had no history of trauma.
Regardless, diagnosis was critical. We realized that her jaws were an issue, however we were skeptical that all of her symptoms were dental related. It did not fit the picture. Our complete examination also revealed an unusual response to our cervical (neck) testing. This was evident clinically as well as through our Jaw Track analysis, which showed that both the neck and jaws were functioning out of normal parameters. This led us to believe that she had a chronic neck dysfunction that her physicians had not been able to diagnose, or failed to diagnose. We were worried about our findings and we immediately referred her to our neurologist for full evaluation. The diagnosis we received was: severe neck dysfunction with bulging discs (compression on spinal column) and degeneration. She was hospitalized immediately for cervical neck fusion surgery. Without this emergency surgery she could have suffered paralysis. We were as stunned as she was, considering that she had been seeing her physician and neurologist for many years, with ongoing “therapy” for her pain (obviously unsuccessful).
The patient and her husband came back to our office after recovery. Most of her pain problems were 50% improved. Her husband stated: “Thanks for finding the real cause of her pain problems. We can’t believe that a dentist discovered what other specialists missed along the way. "We owe you her life. We just can’t believe that nobody else was able to find out the problem.”
The patient wanted to see if we could alleviate the rest of her symptoms. She was still complaining of moderate jaw and facial pain, with ongoing but milder headache symptoms. An improvement of her bite dysfunction was required and jaw stabilization procedures were needed in order to relieve her remaining symptoms. We gladly helped her!
Utilizing EMG studies for diagnosis of her bite deficiency, we provided a conservative treatment with 4 crowns and 2 bridges. This helped to improve her jaw function and stabilize her jaw position. This was also critical because bite problems can cause stress to the neck muscles and worsen already existing neck dysfunction. Stabilizing appliances were also constructed, which the patient wears at night. She is now 95% pain free and only has minor pain when the weather does not cooperate here in Michigan.
Patient stated: “I can eat much better now. I don’t have any more jaw or face pain and my headaches are a thing of the past. Although I know that my neck will never be normal, I am thankful to have the comfort I have without all of the symptoms I used to have. You helped me so much, I can never thank you enough.”