TMJ & the Shape of a Mouthpiece

[sealskin98]

(A)TMJ can cause aching in and around the ear, but intense pain localized in the ear and accompanied by feelings of fullness, muffling of sounds, itching and the like is more suggestive of an infection.


Helpful?

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice with you or any other individual and should not be construed as such.

Regards,

DocVikingo

This is a great response. I have had clicking in my jaw for years that a Dr. said was TMJ. No pain, just clicking once in awhile.

Then, last weekend I tried a comfo-bite mouthpiece to maybe help with some of the hose pull on my reg. Don't know if I'm just not used to it or not but my jaw at the hinge on the left side hurt all of the next day, was clicking, and had some pain while eating. It's better now. I've got a sea cure mouthpiece on order and will try that.

As to the "full" feeling in the ear, on most all of my trips to Coz. I would get "stuffy" feeling ears about the third day that lasted all of the trip and several days after I returned home. Muffled sounds, like you get when you are congested and can "hear yourself talk" thing. There never was any pain. A physician that I dive with sometimes told me it was fluid buildup in the ears, but didn't say what might have caused it.

The last trip to Coz. a couple of months ago I started having a "stuffy" feeling in my left ear (the one that is hardest to equilize) for one afternoon, but then it went away for the rest of the trip and I didn't have any problems after that. No pain either.

Matt, did you take any type of decongestant before diving? I don't have a clue if this would make any difference but I usually take Claritin before diving blue water just as a "precaution" but this trip I didn't take anything and only had the one "hint" of a problem for one afternoon.

Could Doc Vikingo give his opinion if this one variable that I changed of not taking anything for possible congestion could have made any difference? Not knowing anything about the medical field I wondered if the decongestant may have loosened up some fluid in the eustation tubes or somewhere and that may have contributed to the "stuffy" ears problem in the past. Our deepest dives this time were to 85 fsw. and most of them were 70 to 50 fsw. I was using a computer for the first time this trip but I don't think that I ascended any slower than usual.

I've been curious about the cause of the "stuffy ears" for years, a lot of my dive buds say they never have that problem.

 

[Matt P]

I do take Claritin & Nasonex every day. I did have the stuffy feeling. But there was also an intense, very acute pain in the ear

 

[DocVikingo]

Hi Sealskin98,

A number of issues are raised:

1. "I have had clicking in my jaw for years that a Dr. said was TMJ. No pain, just clicking once in awhile."

A temporomandibular joint (TMJ), located just in front of the ears on both sides of the head, attaches the lower jaw to the skull ( http://www.jawdoctor.com/images/tmj1.jpg ).

As can be seen, there is small disc in these joints and under certain circumstances it can become unstable. When it does, a clicking sensation can occur as it slips in and out of place. If this results in no discomfort or other signs or symptoms, typically no treatment is indicated.

Referring to the sole compliant of occasional clicking of this joint as "TMJ" is a somewhat loose use of the acronym, but does no harm as long it doesn't interfere with proper diagnosis and treatment.

In practice, the acronym TMJ is most frequently used to refer to a syndrome which includes several of the following: ear pain, sore jaw muscles, temple/cheek pain, jaw popping/clicking, locking of the jaw, difficulty in opening the mouth fully and frequent head/neck aches.

2. "Then, last weekend I tried a comfo-bite mouthpiece to maybe help with some of the hose pull on my reg. Don't know if I'm just not used to it or not but my jaw at the hinge on the left side hurt all of the next day, was clicking, and had some pain while eating. It's better now. I've got a sea cure mouthpiece on order and will try that."

Finding a mouthpiece that's right often involves some trial and error, so patience is in order. However, if a mouthpiece appears to cause or aggravate jaw joint clicking and discomfort on more than one or two occasions, it probably should be changed out. If use is continued, a vicious cycle can be established.

3. "As to the "full" feeling in the ear, on most all of my trips to Coz. I would get "stuffy" feeling ears about the third day that lasted all of the trip and several days after I returned home. Muffled sounds, like you get when you are congested and can "hear yourself talk" thing. There never was any pain. A physician that I dive with sometimes told me it was fluid buildup in the ears, but didn't say what might have caused it."

A "full feeling" in the ear and the muffling of sounds usually does indicate congestion in the middle ear space (http://www.american-hearing.org/images/master-ear.jpg). Such fluid build up can be the result of harsh equalization techniques resulting in bleeding and other effusion, inadequate Eustachian tube function that impedes drainage from the middle ear, diving with a cold or other malady associated with increased mucus production, or a combination of factors.

If such congestion is a common occurrence, the diver will first want to make sure he is equalizing early, often and gently. The following is quite educational in this regard: The Diver's Era: Under Pressure http://www.uwtv.org/programs/displayevent.asp?rid=789. Decongestants such as Sudafed (pseudoephedrine) can provide significant benefit to congested recreational divers, but should be used only as directed.

4. "Could Doc Vikingo give his opinion if this one variable that I changed of not taking anything for possible congestion could have made any difference? Not knowing anything about the medical field I wondered if the decongestant [Claritin] may have loosened up some fluid in the eustation tubes or somewhere and that may have contributed to the "stuffy" ears problem in the past. Our deepest dives this time were to 85 fsw. and most of them were 70 to 50 fsw. I was using a computer for the first time this trip but I don't think that I ascended any slower than usual."

While technically an antihistamine rather than a decongestant, Claritin (loratadine) can dry secretions and open passageways to the movement of fluids when taken before diving.

Helpful?

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

Regards.

DocVikingo

 

[sealskin98]

Dang this guy is good.

 

[DocVikingo]

Thanks, Sealskin98.

Regards,

DocVikingo