Day 107 - Temporomandibular joint disorder (TMJ)

“Temporomandibular joint disorder (TMJ, TMJD or TMD) affects the temporomandibular joint, an area that includes the hinge jaw joint (the bridge for the lower jaw or mandible) and the temporal bone of the skull located in front of each ear, the muscles surrounding the jaw and the jaw itself.

The most common factor contributing to TMJ is a bite problem affecting the joint itself. Interferences in the structure of individual teeth may force displacement of the lower jaw, leading the muscles to position the joints out of their sockets to force the upper and lower teeth to fit together. Anatomical factors within the joint or surrounding muscles (such as the presence of scar tissue) may also interfere with the bite and cause TMJ disorder.

People with TMJ may experience severe pain and discomfort in the face, jaw joint, neck and shoulders. You may also experience swelling on the side of the face, toothaches, headaches, neck aches, earaches and hearing problems.

The pain and discomfort caused by TMJ disorder may be severe, can be either intermittent or constant and may last for many years.”*

*http://www.yourdentistryguide.com/tmj/

My mother is convinced my headache is related to TMJ. TMJ symptoms are often mistaken for migraine headache, sinus trouble, ear infection, or toothache.

During the dental consultation, the dentist evaluated the possibility of having TMJ through electrical nerve stimulation. She placed some adhesive pads over my jaw joint which transfered data to a computer monitor via a tracking devise. For 45 minutes an electric-shock like pain was produced, stimulating my facial muscles and causing my jaw to jolt.

The hyperactivity of the face and of my jaw muscles was recorded to determine whether or not the jaw is in a strained position.

The entire test lasted a grand three hours. I explained that I do not grind my teeth at night, and do not have difficulty when chewing.

At the end of the consultation, the dentist determined that no structural disorder exists. Despite this, she prescribed a mouth guard to reduce the possible effects of tooth grinding and clenching.

She explained that the appliance would also possibly help improve my bite and the ability for the lower jaw to fall properly into the temporomandibular joint socket.

Following the appointment, it seems evident that my jaw is not causing the problem, but I have nothing to lose by wearing the guard at night. I might as well give it a go.

Day 58 - Wisdom Teeth

"Adults can have up to 32 teeth. The third molar teeth (commonly referred to as wisdom teeth) are the last to come through, right at the back. They usually appear between the ages of 17 and 25, although sometimes they appear many years later.

Nowadays people often have jaws that are too small for all 32 teeth – 28 is often the most we have room for. So if all the other teeth are present and healthy there may not be enough space for the wisdom teeth to come through properly.

Wisdom teeth can contribute to headaches. If a wisdom tooth is impacted or somewhat erupted, swelling can occur and gum tissues may be infected. The swollen gums and teeth can leave an individual with a badly aligned bite, which may then cause pain in the jaw area.

Inflammation and additional pain in the jaw joints and muscles leaves a person with what is called a wisdom tooth headache. If left untreated, pus may form and further inflame jaw muscles."*

*http://www.dentalhealth.org.uk/faqs/leafletdetail.php?LeafletID=43
http://www.headacheexpert.co.uk/DentalConnection.html

The drops for my low blood pressure that the Senegalese doctor prescribed have not alleviated my strong headache. I have been taking them religiously but have not seen any sign of improvement.

I was recently put in touch with a family friend who has suffered from similar headaches to mine - similar in the sense that no one knew what was wrong with him until he eventually found out what was causing the pain: his wisdom teeth.

I have therefore decided to have my teeth checked. The only problem is that I am currently in Banjul and there are hardly any dental clinics. I have asked around and have been told about one which is known to be fairly good.

As our car came to a halt off the dusty road, a hand painted wobbly wooden sign vaguely indicated that the Swedent Clinic was a few metres ahead.

The rundown building, with rolls of paint peeling off the walls, was open and I was greeted - to my great surprise - by two Swedish female dentists.

They explained they were living in the country for a few months training locals in dentistry.

I happily sat on the dusty reclining chair. I wondered how many people had (if any) sat on the chair before me.

I was surprised to hear the clinic had xray facilities.

“Your teeth are in excellent condition, and you haven’t even had any fillings” I was told. The dentist told me she couldn’t see any wisdom teeth but I begged her to do an xray just to make sure.

She did some xrays with an obsolete machine which nonetheless processed the results immediately: “You will never have wisdom teeth. Thirty percent of people never get them, and you’re one of them.”

Great, I thought to myself - at least I won’t have to go through all the pain of removing wisdom teeth.

But now another possible cause of the headache has been ruled out. The dentist nonetheless advised carrying out some small exercises by stretching and moving my jaw, should my headache be related to problems with my mandible.

I am however - once again - back at square one, with no concrete results.