TMJ Tongue pain, Tongue Position and Deviate Swallows

Dr. Shapira tongue pain TMJ 20 Comments

TMJ Problems Can Be Identified Early By Identifying Scalloped Tongues

The normal swallow is completed with the teeth in full occlusion (contact between the upper and lower teeth).  When patients develop deviate swallows they turn their tongue into an orthotic that leads to cascading problems.  The scalloped tongue, most commonly found on the sides of the tongue are actually the impressions of the teeth as the tongue remolds for improper use.

Scalloped Tongues are 70-80 % Predictive Of Sleep Apnea

Patients with deviate swallows can adapt to incorrect jaw position when they are awake but as they fall asleep the muscles relax and the airway collapses.  This can be simple snoring, UARS (upper airway resistance syndrome) or Sleep Apnea.  Sleep Apnea in children leads to ADD, ADHD, Behavioral Disorders and decreased intellectual performance.  Deviate swallows are also associated with over closed bites and forward head postures.  Sleep Apnea affects every system in our body in a negative fashion.

Scalloped Tongues are a Warning Sign That Should Not Be Ignored

There is almost always abnormal swallowing in patients with scalloped tongues.  While our muscles can adapt, repeated adaptations lead to repetitive strain injuries. TMJ is a Repetitive Strain Injury similar to Carpul Tunnel or Tennis Elbow.  In children, it tells us to worry about airway and development.  In adults it usually means early intervention opportunities were missed.

When TMJ Causes Trouble With Your Tongue

tmj-tongue-pain-chicagoIf you are experiencing troubles with your jaw, TMJ could be the culprit. Otherwise referred to as a temporomandibular disorder, it revolves around issues with the temporomandibular joint. This vital hinge is the connection between the lower and upper jaw.

When everything is working properly, it is a true thing of beauty to see this essential part of the human body at work as a combination of bone, nerves, ligaments, and muscles engage in fluid movement. You should have no problem with biting, chewing, yawning, or talking.

However when something is out of balance, there is an issue with the formation of the jaw or mouth, the jaw is undergoing undue strain due to stress, or inflammation has affected any part of the joint and surrounding muscles, you could find yourself dealing with a gamut of unsettling symptoms.

Burning Mouth Syndrome can be a frustrating dillema and it is usually multifactorial.  It may be due to depression (common with chronic pain), from allergies or reactions to medications, may be secondary to dry mouth or snoring and/or sleep apnea.  Burning Mouth may be secondary to a neurological disorder.

Symptoms of a TMJ Disorder

The classic symptoms of a TMJ disorder focus on problems with the jaw. They can be caused by an injury, such as a blow to the face, continuous pressure on the jaw from teeth grinding at night and clenching during the day, or actual problems with oral structures.

Symptoms may include:

In addition to the possibility of sleep disorders that are connected to TMJ,  you may even find that you are experiencing trouble with your tongue.

How TMJ Affects the Tongue

tmj-tongue-problemsWhen TMJ disorders strike, problems that stem from the jaw can throw every thing off balance in the mouth. According to the TMJ Orofacial Pain Disorders Center, tongue position during swallowing and speaking can be part of the problem with TMJ.

Whether improper placement causes a TMJ disorder, or the TMJ disorder results in problems with the tongue, the two are closely related. Numbness, tongue tingling, and TMJ tongue pain are common symptoms that indicate a TMJ disorder.

Imagine the jaw is a mechanical structure that must be properly aligned at all times to allow a smooth and easy motion. When it is misaligned, normal functioning is impaired. If the tongue is not allowed to fall into the proper position, it causes strain and could hinder nerve functioning, resulting in discomfort that can truly be upsetting and get in the way of daily life.

Tongue Reflexes:  Both Helpful and Problematic

The tip of the tongue reflex also known as the nursing reflex or kissing reflex is essential for newborns to learn to breastfeed and causes release of oxytocin in the mother.  During kissing this release of oxytocin is involved in true, love and feeling safe.  This same reflex will make us play with a sharp edge of a chipped tooth until our tongue bleeds.  Patient can struggle with a sharp edge and create a host of TMJ problems with both muscles and joints.  There are other important tongue reflexes in other areas of the tongue.  Patients with narrow jaws elicit retrusive tongue reflexes that can exacerbate sleep apnea or cause severe gagging.

Finding Help for TMJ Disorders and TMJ Tongue Pain

In order to find a solution for TMJ tongue problems and other symptoms that pinpoint a problem with the jaw, it is important to take the first step and get help.

Obstructed-AirwayA thorough evaluation from Dr. Shapira is a good place to start. It is important to seek assistance from a dentist who specializes in TMJ disorders, has experience with the host of problems can result, and will draw on the latest developments in technology to resolve the problem.

Once your TMJ disorder has been properly diagnosed, we can begin to review your options for treatment. There is a broad range of solutions that can address your symptoms, including any issues that have been affecting your tongue.

Generally, the least invasive approach is the first place to start. Physical therapy, relaxation techniques, and the use of an oral appliance at night may be all that is needed to align your jaw properly, providing the relief that you are looking for. More involved treatment options may involve surgery and can be discussed.

Discover how TMJ can be treated effectively and become a thing of the past.

Comments 20

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  2. Pl help mam, i am from india, i have dull pains all the day in my teeths, i feel dull when i chew for 3-4 bites, feel pressure or heavyness pain in upper teeths, dont know the reason as doctors here unable to find, pl help me

    Regards
    Rajeev Murarka

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  4. Can you help me with some Doctors referral in dealing similar TMJ cases in sunnyvale (zip code 94087), california region

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  6. Hello,
    I have been having pain when swallowing food or drink since September. The pain may be less depending how I position my neck, i.e. if I crane my neck the pain is less, when I lower my chin there is more pain. I’ve seen a dentist, I have seen an ENT, had an endoscopy of the throat and a CT scan w/contrast to rule out cancer. Nothing was abnormal. I do have Eagle’s syndrome bilaterally, however, never had problems on the left side before and never this particular symptom. Two days ago when I went back to the ENT to go over my scan results, he did another quick exam of my mouth, where he pressed on the base of my tongue and ever since then, it has been worse than before. Of course the ENT has exhausted all his options and said to see my GP for a referral to another specialist, maybe a neurologist. I somehow feel like my tongue is involved because it hurts on the base quite frequently and all along the length of the side of my neck. And again, there is the pain when swallowing food or drink. I am now wondering if it could be TMJ – I do clench my teeth heavily, and was given a mouthguard to wear during the night a couple of years ago, but found it bothersome, so I didn’t wear it but a couple of times. Do you think this could be TMJ, and can you tell me how I can find a specialist in the Phoenix, AZ area?? Any help would be greatly appreciated – this constant dull ache is really reducing my quality of life. Thank you!

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    Author

    Pain with swallowing can definitively be a TMJ /MPD disorder. I would have palpation done to evaluate for possible blocked salivary gland or enlarged lymph node. You can try sucking on sour lemon drops if that either makes the pain better or worse it is likely related to a salivary gland in the floor of the mouth.

    More likely it is Myofascial Pain and needs to be addressed with functional evaluation and trigger point therapy and or TMJ orthotic. See http://www.triggerpoints.net to understand the pain referral patterns.

    It may be sympathetically mediated pain which can be treated with “Self administered SPG Blocks”

    It is also possible it is nerve impingement and an Atlas/Orthoganol chiropractor might help.

    It could be a symptom of your Eagles syndrome or possibly Ernst syndrome.

    Dr Nick Meyers is in your area but I frequently see long distance patients in my Highland Park office.

    Check my you tube channel to hear patients stories: https://www.youtube.com/channel/UCk9Bfz6pklC7_UluWFHzLrg/videos

  8. My tongue ‘burns’ especially when I yawn. I wake with a dry mouth most mornings and eating is very uncomfortable due to great sensitivity brought on by a lack of protective saliva. This started about 4 months ago. It is quite debilitating and depressing.

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  10. Thanks very much for your prompt reply and the link. I’m not on any medication at present. I do have an on-going problem of not sleeping in bursts of no more than a couple of hours at a time which doesn’t help me feel too bright during the day. This has been going on for a long time. I might get about six hours sleep but in three instalments.

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  12. Hello,

    I have been dealing with an open bite which developed in adulthood for several years now and have seen various specialist and have undergone orthodontic treatment (relapse) in addition to a lingual frenectomy ( which I think made things worse). With worsening clenching/grinding and progression of open bite (along with postural issues as a result), I am sort of at a standstill. Being bounced around with various approaches to treatment, I am very confused. Having been offered extraction of 4 teeth to jaw surgery and spending lots of money on seeing specialist have left me wondering what to do next. I am wondering your thoughts or input and perhaps how to go about treatment. I do live in the Chiacagoland area and am considering a consultation. Your feedback would be greatly appreciated. Thank You

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    Dr Shapira response: The question is what is the underlying cause of the open bite. This is a video of a long term open bite patient treated without extraction or surgery.

  14. hi
    i am from india and having dull pain off and on in my cheeks and sometimes on jaw both sides, feel like pressure on middle lower teeth.
    sight postnasal drip and feel at times something stuck at the base of tongue and not able to swallow and something is there ….
    very troubled by this
    please advice..seen ENT doctor and they gave me OTC pain killers which i am taking for 2 weeks

  15. I have problems with tmj for a lot of years. Now my problems are swallowing ,speech and tongue switching. I am in the phila pa area dr Shapiro do you know who I can go see because I am being told this is not tmj but als . Please help! Thank you . I have gone into the city to big institution for facial dentists and they after hearing from my dentist that it is not tmj they are also saying it is als.

    Dr Shapira’s response:
    Elizabeth, ALS is a serious neuromuscular disease. It can occur in patients with TMD. While treatment may alleviate symptoms temporarily if you actually have ALS it is usually progressive. This does not mean treatment may not improve you quality of life.

    ALS is a difficult diagnosis and it varies greatly in its presentation.
    A recent article discusses possibility of false positive diagnosis of ALS:
    Research Article:
    https://www.tandfonline.com/doi/abs/10.1080/21678421.2016.1249886

    Is firstly diagnosed ALS really ALS? Results of a population-based study with long-term follow-up which concludes “At the time of a first diagnosis of ALS, the possibility still exists that another, less severe clinical condition, is present.”

  16. Dr Shapira,

    For the past 2.5 months I’ve had a tension headache that started in my jaws and back of neck that gradually moved to the front of my head, the tension moves around from behind eyes, to teeth, jaws, top of head. my right jaw pops constantly. My right jaw hurts for a few days and then pain goes away, this process repeats itself. I went to my primary care over a month ago and he thinks this is all stemming from anxiety. I don’t disagree but it’s lasted for so long. Very annoying. The past few weeks I’ve started having very mild sharp pains behind my left eye or top of head or side of head. My head also has had some tingling, which strangely my tension seems to be better when I’m having tingles. When I bend over I feel lots of pressure in my nose and face. Can all this be from Tmj? I also know my allergies are really bad this time of year and they seems to inflame my sinus nerves, at least that’s what happened last year.

    Dr Shapira Response: Anxiety can be a trigger for TMJ disorders but that does not mean you should ignore the structural components. Primary care physicains know very little about these problems. The pain is normally Myofascial Pain or referred pain from the muscles. The Trigeminal nerve links the teeth and jaw neurologically to the sinuses, the ears and the brain. Almost 100% of headaches are trigeminal in nature and can respond well to
    Neuromuscular Diagnostic Orthotic.
    Sphenopalatine Ganglion Blocks are also very useful. Self Administration is key to best success.

    Pain like you describe is often eliminated or vastly immproved in just the first or second visit.

  17. Hello,
    I have been suffering from pain in right jaw, ear, neck , shoulder it goes till head all on right side . It’s severe sometimes . Ringing in ears, right throat ache and younger ache. I had wisdom tooth extracted it was impacted after since it’s more.
    Pls help
    Sharon

    Dr Shapira’s Response: Dear Sharon, You have described typical Myofascial Pain Patterns that are commonly seen secondary to TMJ disorders or part of TMD in general. Extractions of third molars, ie wisdom teeth frequently is traumatic and can set off a series of problems with both muscles and joints.

    You should have an examination by a doctor who understands Myofascial Pain and Dysfunction and neuromuscular dentistry. I can help. Please contact my office.

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