(I’m a dentist with a unique focus – I treat people who suffer from jaw problems associated with the temporomandibular joints – commonly known as TMJ.)
Today’s blog deals with this question:
Can Lyme disease cause TMJ?
Starting in the early 90’s many patients have visited my office exhibiting all the common symptoms of TMJ – jaw pain, limited jaw opening, and severe facial pain. Upon evaluation of these patients, however, I did not find the common histories and risk factors that typically cause the muscle strain and inflammation associated with TMJ problems.
For example, in 1992 I treated a patient named John. John was a 38-year-old landscape gardener who worked at a golf course on the east end of Long Island. His complaints were acute jaw pain, limited jaw opening, and an inability to bring his teeth together in a consistent way.
At first glance it seemed that John had the type of jaw problems that I see every day in my office and I prescribed the treatment that helps most of my patients. But it didn’t help him. One year later I heard from another patient that John had been diagnosed with Lyme disease.
It was then that I began to wonder: “Can Lyme disease cause TMJ symptoms?”
Lyme disease infects over 300,000 people in the United States every year. But making a diagnosis is extremely difficult due to the fact that the only blood tests available are unpredictable. On top of that, only 25-50% of infected people ever develop the telltale rash associated with a deer tick bite (the tick that carries Lyme).
If left untreated Lyme can cause facial tics (contraction and twitching of muscles), jaw pain, headaches in the temples, neck stiffness, and episodes of pain during talking and smiling.
Here’s another example: A recent patient named Anne. She is a 52-year old female. She describes her symptoms this way: “I have pain in my face that can be so intense that I have thought about going out on disability.”
Ann’s pain is triggered whenever she talks. And her jaw muscles feel as if they’re “pulling all the time”. At times her teeth ache. And when the frames of her glasses press on her temples, the pain escalates. Anne’s facial and jaw symptoms have been present for seven months and are accompanied by exhaustion, disabling headaches, and what she describes as “bizarre sensations in my body”.
As with John, my evaluation did not suggest the reason for Anne’s suffering was a typical TMJ problem. But evaluations don’t always indicate Lyme, either. Due to the fact that she takes long walks in the Connecticut woods and because she remembers getting bitten by insects (she never had the telltale rash) her infectious disease doctor has considered starting her on antibiotic therapy for Lyme disease.
Another patient named Sue, a 45-year old female, came in with jaw problems, too. She had been diagnosed with Lyme disease seven years earlier. Sue felt sure that her Lyme had been “successfully treated with alternative remedies.” But still, she suffers from tight jaw muscles, intense pain when she lays her face on a pillow, fragile emotions that prompt daily outbursts of crying, and “raging pain in my face and jaw”. She was sure she had TMJ but never imagined that the effects of Lyme disease cause TMJ symptoms.
Sue also suffers from bouts of intense back pain with a nerve-like character, that comes on suddenly and as quickly passes.
As noted, Sue believes that her Lyme disease has already been “cured” by alternative remedies. But as in the cases of John and Anne, my evaluation provided no evidence of the typical causes of TMJ symptoms. With her belief in alternative treatments, it is no surprise that Anne is very reluctant to try antibiotic therapy. But she is about ready to move in that direction.
The outcome of the two recent cases remains to be determined, but they are very similar to many other confirmed cases of Lyme disease I have encountered since 1992 when I first began to wonder if can Lyme disease cause TMJ symptoms.
It is my conclusion, therefore, that the impact of Lyme disease on the peripheral and central nervous systems can produce nerve and muscle pain that mimics the symptoms of TMJ. I am hopeful that better testing, control of the deer tick population, more effective treatments, and even perhaps a vaccine is on the horizon for these suffering patients.
If you would like to add your comments please feel free to do so below.