TMJ Diziness?
 

Since my accident in May/13 I have had clicking, slight facial discomfort (on and off) and fullness in ears, tinnitus and chronic nausea. Prior to the accident I had never encountered any of what I suspect to be TMJ related issues.

Had a panoramic x-ray of the jaw completed around 4 months ago and all looked normal. That said, I know that TMJ issues can be hard to spot on x-ray.

I have an appointment coming up with a TMJ specialist, however very expensive. The consultation alone is $360.00 and from what I hear, treatment in the form of a mouth guard and a couple of visits can quickly escalate to over $2,500. My dentist offered to make me a guard for a fraction of the specialist, however would feel much better going to a specialist, who is renowned in the area as being 'the best.' The dentist also is only making the guard under the assumption that I may be grinding my teeth at night.

Would it be feasible to consider the TMJ causing some, or most or some of my dizziness/lightheadedness? Although my dentist mentioned my TMJ looked fine, should I be exploring further with a specialist? I am certain that it is damaged given the research I have done and also the general clicking sounds when opening mouth and constant ear fullness.

I am also starting vestibular rehab again next week to see if I make some progress.

http://www.saididentalgroup.ca/blog/...symptoms-2690/

I don't think your TMJ has anything to do with the other symptoms.

I am in agreement with your dentist who thinks you may just be grinding your teeth at night. More likely just clenching your jaw. I did this. SSRI's can cause jaw clenching.

My jaw actually locked and I could only open it 1 finger width for about 6 months. I looked into the various treatments that were expensive and uncomfortable. Finally, I told my physical therapist and she did some in mouth therapy and got it to unlock. She uses myofacial release techniques. A PT treatment from time to time allowed healing. Now, I can open my mouth 2 1/2 to 3 finger widths.

I have lots of clicking in my right TMJ and mild clicking in my left. People near my can hear it. It is no big deal. Once I stopped the night time and even some daytime jaw clenching, both sides improved. No mouth guard or anything but the PT and resolving the jaw clenching. The gabapentin I take nightly appears to help me stop the jaw clenching as it helps my muscles relax.

Jaw clinching and body rigidity issues are common to PCS and even worse if one is taking an SSRI. I added 4 inches to my chest because I was constantly holding my upper body rigid.

If you are a side sleeper, that can be rough on a TMJ, especially if you have a tendency to sleep with a hand under your cheek like many do.

There is a Botox treatment for jaw clinching. They shoot Botox into the muscle that closes the jaw so it is weaker and less prone to clinching. I was about to have it done when I found the PT treatment.

So, I suggest you focus on whether you jaw clinch and work at resolving that. Otherwise, you may experience a situation where the cure is worse than the ailment.

randomguy: I mentioned TMJ years ago to my Neurologist and he ordered an TMJ MRI. Not sure you have done it. They gave something to put in the mouth which opens mouth little wide for each click. After each click an image will be taken. It was painful for sure but I survived.

My result : No TMJ issues :)

Have anyone suggested an TMJ MRI?

BTW : I have done X RAYS too and nothing.

No one has recommended this yet, no. I do have a follow up MRI and on a waiting list (4-6 months). I may call my GP and have this added.

The reason I was further exploring the TMJ route was a friend of mine who was in an accident 12 months ago experienced relief from all symptoms (dizziness, headache, tinnitus, etc.) within 3-4 weeks after seeing the TMJ specialist and wearing his guard nightly. He did mention that things got worse for 2 weeks before they got better, which led me to pursue it. I do notice that the dizziness is worst when my ears act up and feel full and sometimes pop, which is a daily occurrence. I also believe that feeling better could have just been a part of the body healing naturally and he was lucky in that he now feels 90% better a year after his accident. Something that a lot of us wish we could achieve.

At the end of the day, I don't want to throw too much at my body all at once to ensure I know what's working and what's not, however I do know that things have gotten much worse lately and not better, despite no changes. I will start with vestibular rehab next week and see how that goes for a month or so before doing anything else. The PT noticed a slight left eye nystagmus, which I can attest to. When I stare at a static object, or point on a wall for instance, my left eye starts wandering on it's own and has a hard time holding focus and causes objects below to appear wavy. I would imagine that this is where a lot of the nasuea is coming from.

I've had nystagmus in my left eye for decades. It only causes a problem with my ability to track a fast moving object like a baseball . From what I've learned, Nystagmus is an eye movement symptom, not a stationary symptom. They diagnose it by having you follow an object as it is moves from side to side. A normal eye will follow it smoothly. An eye with nystagmus will jerk as it moves from side to side. There would be no nystagmus symptom when looking at a stationary object with the head still. If you move your head while trying to stay focused on a stationary object, the nystagmus would manifest.

Some will use the term nystagmus to define other eye movement disorders.

One can have nystagmus and other eye movement disorders at the same time.

You may need a behavioral optometrist to assess your vision. This sounds more like your left eye is hunting to line up with your right eye. This is a convergence 'like' issue where the two eyes are not lining up the image so the brain can stitch the two images into one. Some terms are strabismus. accommodation/vergence disorders. These disorders can cause dizziness because a large part of balance issues are visually based.

It sounds like you need to find someone who can help you with the ear popping and fullness issues. Those symptoms are likely easier to treat than strabismus, nystagmus (rarely treatable) and the other eye movement disorders.

Randomguy

If you opt to give the mouth guard a try, its just a matter of getting impressions made and sending it off to a lab to be made so having your dentist do that should be fine - you can still see the specialist but you might as well save money where you can.

Regarding the vision issues, my opthomologist referred me to the orthoptics clinic at the local hospital and I was prescribed prism lenses for my left eye convergence. The orthoptics clinic visits were covered by my provincial health care plan so all I ended up paying for was the glasses.

randomguy : You are in Canada and know it takes a long time to get the MRI done. Since I lived there and know people complain about that :)

Have you done any vestibular testing ? I have done 3 times so far by different ENTs. Only once it showed nystagmus but they said non-localized. Meaning it is not coming from ear but from neck I think. Ofcourse nothing they can do from ENT perspective in spite of clear indication :eek:

Also Physical Therapists and one Neurologist tilt my head suddenly and check my eyes. No nystagmus.

As Estreetfan mentioned you can try prism lenses and some TBI patients benefited a lot from that. Ofcourse I tried that too. No luck for me :)