So, Hi... I'm new. But I've been lurking for a while; it was nice to find somewhere where other people understood.
I'm wondering if anyone else has experienced something similar to me. Here's the jist: I'm a bad person and haven't seen the dentist in 8 years (no insurance, poor graduate student, you know). Since I now have decent insurance, I decided it was time. Went in, got my check up (and a lovely plan for how they were going to take all my savings because I have a billion teeth that need drilled), and started work Monday.
Monday was the worst of it - three cavities and a crown (ugh, luckily though, no root canal, just too much filling for one tooth to hold well). The biggest problem I had was one pissed off jaw. In fact it's still not happy. I kind of feel about 1/4-ish as bad as when I had all four wisdom teeth pulled and couldn't open my mouth for two weeks.
Does anyone else experience jaw pain related to PsA? I should probably note that I've got the weird clicky jaw thing. Every time I open my mouth beyond a certain point it clicks, then I have to kind of wiggle it back in to place (which sounds horrible, but isn't so bad. I did once startle the hell out of a nurse taking a swab for strep; she was more concerned about the noise my jaw made then the fact that I couldn't swallow without wanting to stab something.) I'm not sure if the jaw-pain is related to the PsA or just the abnormal jaw clicky problem (maybe I should ask my rheum); but I have noticed it get worse with flares.
The weird clicky thing is probably TMJ, and it may have been aggravated by all of the dental work. That's a long time to have your mouth pried open. It's definitely something to talk to the doctor about, and they may talk to you about a bite guard for at night.
That said, since it's a joint, yes, you can have inflammation of the joint as well. So it may be an underlying problem that gets worse when you flare. A dentist once scared the piss out of my husband by telling him that one day his jaw was going to get stuck open. But didn't offer up a great solution either.
Are you on anti-inflammatories? You may want to speak to the doctor about taking them now, just to get you over this.
It's funny you mention what the dentist said, since mine actually does get "stuck" - in that it takes me a moment to get my jaw moving when it's stuck open. Really fun when the hygienist is trying to suction and you're drooling all over the place. (luckily the one I had had a sense of humor).
I'm on MTX and the occasional 500mg naproxen (which I don't take very often), and did take the naproxen when my jaw was hurting the other day. I just don't like to take too much of it because I build up a tolerance to stuff so quickly and I want it to work when I really, really, need it to.
I've wondered about the TMJ thing for awhile, but since it hasn't bothered me much until recently - and even then it was more of a inflammation pain then pain from clicky-jaw (I really just like saying clicky in my head) - I've never mentioned it. The weird thing is that I don't grind my teeth at night. I occasionally clench my jaw when I'm stressed but have learned to consciously relax it (and right now the crown's a little too sensitive to do any of that anyway). I'll talk to my rheum about it when I go in next month (he's too far away for me to want to make an in-between appointment).
Good for you that you've been able to consciously not clench. My husband clenches and grinds, a lot! And he can't seem to increase his awareness of it. Hope it feels better soon. In terms of the rheumy, does s/he have a nurse or PA that returns calls?
I always get the smallest bite block, which helps. Halfway through we always take the bite block out and let me move my jaw around to rest before resuming. When I get home I hot pack my jaw joints on and off throughout the day. I have had a lot of dental work and have learned some tricks to help with the various problems that come with. For example, it takes me longer to heal from the numbing injections; I always swish with saltwater or Biotene a few times a day until my gums (which get sore from a crown) / injection sites are no longer sore. I rest the whole rest of the day after a big appointment, otherwise I flare. I keep up on pain meds the day after, so I don't clench my jaw from pain.
I wish I could do the nitrous. Unfortunately it just makes me slither down the chair, completely unable to move, yet my mind is 100% awake and feeling everything. It's like being awake during surgery and unable to move. UGH.
tntlamb said:
Valium and Gas eliminate the problem for me.........
Since having PsA I now dread the dentist a little only b/c trying to keep my mouth open is tiring and hurts after about 5 minutes of keeping it open. I am also often sore for a few days after too. I never used to mind going to the dentist at all. :(
I have also had a flare in my jaw before where the joint was hot and inflammed and hard to chew for a few weeks.
I think so - If it's still bugging me on Monday I may give them a call. Although I don't usually have much luck in that area I did just recently switch rheums so his might be better at returning calls.
I also didn't know they still used nitrus - haven't had that since I was a wee one. The pain during isn't bad though, so I'm not sure if it'd help (and from what I remember from my last experience I have something similar to Marietta's experience, far to aware for it to be any kind of useful).
And thanks Holly5 - I should have thought of heat instead of ice; I may give the hot pack a try this evening. :)
Stoney said:
Good for you that you've been able to consciously not clench. My husband clenches and grinds, a lot! And he can't seem to increase his awareness of it. Hope it feels better soon. In terms of the rheumy, does s/he have a nurse or PA that returns calls?
in the abscence of nittous an valium which does keep you from tensing up and muscle spasms there are organic brownies. not that I am a dental wimp............ my wife normally has a grandchild or two on hand to humiliate me into submission.........
Mahaha... I love the idea... unfortunately they make me car sick (even when I'm not in a car, or moving, it's the way time feels different I think). I'm also a bit of a control freak. :) I may talk to the rheum or dentist about it before the next allotted work though.. maybe they can give me something to help with the tensing (I didn't think of that).
tntlamb said:
in the abscence of nittous an valium which does keep you from tensing up and muscle spasms there are organic brownies. not that I am a dental wimp............ my wife normally has a grandchild or two on hand to humiliate me into submission.........
I am serious about the tensing imagine hyperextending any other joint in your body for an hour or so without relaxng it..... heck if just sleep in the wrong position for a nap I have joints that wont work (shouler in particular)
Dental work really is a problem. Don't forget to consider what else can go haywire sitting in that chair for an hour or so. he either needs to take breaks, help with medication, prop you etc.
I've been following this thread with interest because I broke a tooth on April 18. When I went to the dentist that following Monday, she started crown placement, but also said I needed gum therapy because I had been bad and not come in for cleanings in several years. In my defense, I told her I had the whole PsA ilness/diagnosis/begin treatment thing going on and wasn't going much further than work and my bed for quite a while.
I'm a big ol' chicken when it comes to the dentist--seriously, Valium the night before and morning of; nitrous and "special anesthetic" because I'm also hard to numb. Because work is being jerky about me scheduling appointments ordering me to come back afterwards and because I wanted to, I decided to try it without Valium. Crown beginning went well sans Valium. My mouth was a bit sore and hurty the next several days but the PsA was calm.
Gum therapy this past Tuesday (only on half of one side of my mouth) was a whole different animal. I think the combination of the therapy and working myself up into a state has sent me into a small flare, hips and upper thighs being the culprits. I'm hoping increasing my Prednisone will send me back to my usual state because I can't take my MTX this evening and Humira is next week.
Mine was similar - except my tooth wasn't broken, but still needed a crown and I needed a special cleaning. I've experienced small flare up since then, but that's partly due to stress of work (I'm an instructor, and it's finals week here, so finalizing grades and doing a whole lot of grading and nothing else). I also had to do a bit of cleaning/therapy (haven't seen the dentist in 8 years) but my hygienist was so awesome that that one didn't bother me much. She gave me breaks and made sure I was doing okay, and would give me a minute to wobble my jaw when it got stuck. A few weeks later and my jaw feels back to "normal". I think the crown irritated my jaw more than anything else.
I hope you recover soon!
PS. I wonder about the hard to numb thing and PsA sometimes... when I had my wisdom teeth out they had to shoot me so full of numbing crap that I was surprised my whole body wasn't numb.
sixcatlawyer said:
I've been following this thread with interest because I broke a tooth on April 18. When I went to the dentist that following Monday, she started crown placement, but also said I needed gum therapy because I had been bad and not come in for cleanings in several years. In my defense, I told her I had the whole PsA ilness/diagnosis/begin treatment thing going on and wasn't going much further than work and my bed for quite a while.
I'm a big ol' chicken when it comes to the dentist--seriously, Valium the night before and morning of; nitrous and "special anesthetic" because I'm also hard to numb. Because work is being jerky about me scheduling appointments ordering me to come back afterwards and because I wanted to, I decided to try it without Valium. Crown beginning went well sans Valium. My mouth was a bit sore and hurty the next several days but the PsA was calm.
Gum therapy this past Tuesday (only on half of one side of my mouth) was a whole different animal. I think the combination of the therapy and working myself up into a state has sent me into a small flare, hips and upper thighs being the culprits. I'm hoping increasing my Prednisone will send me back to my usual state because I can't take my MTX this evening and Humira is next week.
Thanks for this thread! Now I feel better about having put my dental work off for so long! I'm sooooo scared of going through what I went through last time I had work done- major flare, including my jaw, which wouldn't open properly for weeks. The procedure itself, without any meds except the novacaine (sp?) was excruciating because of my jaw issues. As soon as my husband is done with all his dental work, I'm going to try to find a dentist who will put me out and do it all at once, have meds on hand to help me afterwards, as well as have appointments with my massage therapist and acupuncturist scheduled for further help.