TMJ Sensitive Teeth Symptoms

TMJ Sensitive Teeth Symptoms

Sensitive or sore teeth are common symptoms of TMJ (temporomandibular joint disorder). If the teeth are the cause of TMJ then any or all of the teeth may be sore. The teeth may also become sensitive because of clenching or grinding the teeth, a common action in many people, when the TMJ disc is displaced.  In cases where tooth sensitivity is cause by night grinding (bruxism), a custom fit dental night guard may help lessen the damage and sensitivity.  However, a dental examination and x-rays or an assessment of the temporomandibular joint by a neuromuscular dentist may be required to understand what is causing sensitivity if night grinding is not the cause.

Unfortunately, when seeking relief from this tooth pain many patients are misdiagnosed and may even go as far as having the nerve from the tooth removed with root canals or even having the tooth extracted. The worst part is that these measures may not relieve the pain, and can actually make it worse!

Neuromuscular dentists relieve sensitive and sore teeth related to TMJ by going to the source of the problem—the “ bad bite ” and misaligned jaw. In most cases, correction of the bite can be accomplished without the use of surgery, and patients report long-lasting pain relief.


Intro to TMJ and Teeth Sensitivity

In this article, we explore tooth pain and sensitive teeth and the relationship to TMJ dysfunction (TMD). While tooth pain can happen for a number of reasons, our focus is providing trusted information to the TMJD community to help find the best solutionquickly.  Tooth pain is a common symptom of TMD which effects an estimated 10 million people in the USA alone.


What is tooth pain?

Tooth pain, also known as dental pain, is pain in the teeth and/or their supporting structures, caused by dental diseases or pain referred to the teeth by non-dental diseases.

Let us start by understanding the mechanism of tooth pain due to dental diseases.

Sensory nerve fibers in the tooth pulp consist of myelinated A-fibers and non-myelinated C-fibers.  A-fibers are responsible for strong, immediate, sharp, localized pain and C-fibers for dull, continuous, and irradiating pain.

In the peripheral pulp, nerve fibers extend to the odontoblastic layer, predentin, and dentin and terminate as free nerve endings. All forms of pulpal stimulation sensitive and stimulation causes symptoms of pain.

Evidence indicates that certain inflammatory mediators and intrapulpal pressure changes lower the pain threshold of nerve endings in the pulp. This sends the painful signals to the brain through the spinal cord.


Common causes for classic tooth sensitivity

Classic tooth pain can be due to tooth decay, an abscessed tooth, tooth fracture or a loose, broken or damaged filling.

Tooth pain can also result from non-tooth related causes.  These can be repetitive motions, such as chewing gum, grinding teeth (bruxism), infected gums, receding gums, periodontal abscess, sinusitis, teething or angina pectoris.

Other non-tooth related causes include neoplasms of the gingival or alveolar mucosa, Burkitt’s lymphoma, infarcts in the jaws caused by sickle cell disease, Osteomyelitis, trigeminal nerve conditions like trigeminal zoster, trigeminal neuralgia and trigeminal neuropathies and other psychogenic causes.  However, one of the main non dental causes for tooth pain is TMD, a jaw joint disorder that manifests itself in many differing symptoms.

Common TMD tooth sensitivity causes

  • Malocclusion (bad bite)
  • Stress and tooth grinding
  • Bruxism (night grinding)
  • Muscle Tension
  • Poor posture leading to further muscle tension
  • Dislocations
  • Inflammation of the TMJ disc
  • Injury to the disc
  • Arthritis or disc degeneration
  • Structural problems present since birth


Differences between TMD and Classic Tooth Sensitivity

The similarity of TMD tooth pain to a classical toothache will cause some patients to undergo dental treatments in multiple teeth before a diagnosis is established. It is important to exercise caution in having irreversible procedures performed, such as a root canal or an extraction, in these situations.

The character of the pain is the differentiator between classical tooth pain and TMD tooth pain.

A classic toothache features localization of the pain in a specific tooth. It might be accompanied by thermal sensitivity, pain on biting and spontaneity of the pain.

Factors like hot drinks and percussion (chewing) usually make the pain worse. Accompanying clinical examination might show dental caries (decay), or pain on percussion.

The key features of pain from a toothache of TMD origin (in contrast to classical toothache) can present in many different ways.  Tooth pain is usually accompanied by one or more other TMD symptoms like clicking or popping jaw joints, depression, facial pain, tmj headaches, jaw pain, lockjaw or a stiff jaw, neck and shoulder pain, numbness or tingling in the fingers, hands and arms, tinnitus, sleep apnea.

Some patients have a low-grade, bothersome ache. Others experience an excruciating pain, described as throbbing, sharp or shooting.

The pain can be present all the time or come and go. Pain may radiate beyond just a tooth. Unexpectedly, the pain can migrate from one tooth to another and even change sides of the mouth. The pain may be present from weeks to several years (as time goes by there is no relief or change in quality or intensity). Pain may be aggravated in the morning or after heavy jaw usage. Also, Pain does not disappear when the dental structures are anesthetized.

If you have had one or more reasonable dental treatments and the pain still persists, it is possible that the source of your problem is not in your teeth but in the TMJ.


Management of classic toothache

If there is serious pain or you suspect tooth damage see a dentist right away.  

After proper diagnosis with help of clinical examination, radiographs, pulp sensitivity tests, the dentist will start treatment of the involved tooth ranging from simple advice, removal of dental decay with a dental drill and subsequent placement of a filling, to root canal treatment, tooth extraction, or debridement.


Managing TMJ tooth sensitivity

If you are experiencing other symptoms that may be related to TMJ disorder you should  see a trained neuromuscular dentist. They will be able to properly diagnose the cause whether it is related to the TMJ, from a damaged tooth or from infection.  


Neuromuscular Dentistry and TMJ Tooth Sensitivity

Your neuromuscular dentist will compile a thorough clinical history, carefully listening to the description and associations of your pain. He or she will want to know things such as how long you have had it, how it started, characteristics of the pain (quality, intensity, episodic or continuous, spontaneous versus provoked), aggravating and alleviating factors and past treatments and consults.

Then, the dentist will perform a physical examination feeling the joint and muscles for tenderness.  The jaw movements (opening and closing, sliding side to side) will be carefully examined.

Some tests may be performed; for example, ice and heat test over the painful and non-painful areas, and pins and brushes to assess small nerves in that area, or nerve blocks (numbing one or more areas of your mouth or head with local anesthetic injections) to rule out other causes.

Diagnostic tools like X-rays, CT, MRI, ultrasonography, electromyography, and kinesiograph are used to confirm the TMD tooth pain diagnosis.  Learn more about how Neuromuscular dentists diagnose TMJ disorder here.

If the pain is minor and muscle related, you can try measures like massage, soft diet, exercises, staying hydrated, reducing stress, keeping jaw relaxed.  There are many other TMJ home remedies to try when you experience a painful TMJ flare up.  However, if there are other more serious symptoms such as migraine headaches, sleep apnea, neck or shoulder pain or night grinding you should see a trained neuromuscular TMJ dentist to ensure the proper treatment.

According to Dr. Mark Duncan, DDS, the clinical director of LVI Global, considered by many the worlds’ leading post-graduate dental training facility, dentistry focuses on hard tissues whereas trained neuromuscular dentists start the diagnosis and subsequent treatment with soft tissues and muscles. They will help to bring the jaw back to its natural resting position by relaxing jaw muscles and then work to correct a bad bite which is effective in most cases of TMD tooth pain.

They do this using treatment recommendations that include TENS therapy, orthotics, splints, and bite adjustment.  Once a healthy bite is created, restorative dentistry may be used to ensure that the position of the teeth maintain a healthy position of the jaw and path of movement.  In cases where there is not any internal derangement, TMJ jaw surgery is seldom needed and only recommended as a last resort.

Unexplained tooth pain can be very frustrating and limiting. Hence, it is very important to take the help of a trained neuromuscular dentist and his team to manage TMD tooth pain.  This helps in avoiding unnecessary dental treatments like fillings and extractions for tooth pain which is TMD in origin. A neuromuscular dentist with the help of accurate diagnosis and proper treatment will take care of your TMD tooth pain.


Other TMJ Disorder Symptoms:



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