When the dentist has to step in

When people suffer persistently from headaches, back, neck and shoulder muscle pains, and nothing shows in X-Rays and MRI scans, it could be a little-known dental problem called temporomandibular joint disorder

Photos: Dr. Renju Jose; photo by Albin Mathew. Bobby John Mana (extreme right) with former Chief Minister Oommen Chandy

By Shevlin Sebastian 

Businessman Bobby Mana sat in the dental chair of Dr Renju Jose at Kochi. He looked tense. Very casually, Dr Renju pressed his left shoulder. Bobby yelled in pain. 

The dentist looked surprised as Bobby said, “Doctor, I have been suffering from this pain for the past fifteen years. Whenever I move my right arm backwards, during a jog, I get shooting pains. I have consulted many orthopaedic doctors and neurologists, but no solution has been found.”  

Dr Renju nodded and then switched on a ‘Digital Bite Scan’ (T-Scan). This is a machine which is used, along with an electromyogram, to detect the pressure points when the upper teeth hit the lower ones.  

When Dr Renju scanned Bobby’s mouth, as he was chewing, he saw on the computer screen that the latter was using his left side to chew 80 per cent of the food while it was only 20 per cent on the right. “There was heavy pressure on Bobby’s last molar,” says Dr Renju. “He was unaware of it.”  

Dr Renju polished away the excessive ceramic on a bridge on the left side so that the upper and the lower teeth could smoothly hit each other. The next morning Dr Renju called Bobby. The latter said that he was now consciously using the right side of the mouth while chewing. And when Dr Renju asked about his shoulder pain, Bobby suddenly said, “Oh my God, it’s gone completely. I can stretch my arm back and forth without any problem.” 

Dr Renju smiles and says, “It took only 10 hours to solve Bobby’s problem, and that too, without any medications.” 

A large percentage of the world’s population tends to use one side of the teeth. But for most, there is no problem. “Normally people prefer to use both sides if given an option, but sometimes what happens is that they may not have teeth on one side,” says Dr Renju. “Or one tooth may have been removed, for some reason. Automatically the biting shifts to the other side.”  

Even without biting, the jaws and the teeth are under tremendous pressure. That’s because whenever we swallow our saliva, we are unconsciously biting our teeth together. This happens around 5000 times in the day, as well as the night. “So there is tremendous pressure on the chewing and biting muscles,” says Dr Renju. “But there is no time to rest and recover.” 

And so, these muscles end up getting fatigued. “As a result, the muscles produce lactic acid which is what causes the pain. This spreads to the head, neck, shoulders and back muscles,” says Dr Renju. 

Other ailments include migraine headache, neck pain, vertigo (falling down), numbness in the fingers and arms, pain behind the eyes, and tinnitus (buzzing in the ears). “When the pain continues, despite treatment by neurologists and orthopaedic doctors, and if there are no findings in X-Rays and MRI scans, then it means that it is a dental problem,” says Dr Renju.

However, he says, not many doctors are aware of this problem, which is called a temporomandibular joint disorder, and the treatments available. “In India, fewer than one hundred know about this machine,” says Dr Renju. “There is an urgent need to spread awareness among doctors and the public.” 

(The Sunday Magazine, The New Indian Express, South India and Delhi)