Fibromyalgia and Dental Issues

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Do you hate your dentist? Well you are not alone, especially if you have FM symptoms. Get professional advice on surviving dental treatment with least FM pain.

Some get a terrifying rush when seeing the words “dentist visit” on the calendar. But when you have FM, these appointments can be more than just frustrations – they can be quite scary, agonizing experiences that can cause you to ignore this vital health check. “As a dentist, I find people with FM usually ignore their dental condition because of other concerns in their body,” says Timothy Kosinski, DDS, an assistant professor at the University Of Detroit Mercy School Of Dentistry and a dentist in Bingham Farms, Mich.

FM pain usually happens in the head, face and neck parts, which can make dental appointments intimidating. However because dental problems are normal in people with FM, consistent trips to the dentist are necessary.

Why going to the dentist is worse for fibromyalgia patients

Some people enjoy going to the dentist, but for someone with FM, it can be quite scary and painful experience. The pain increase caused by a dental appointment can be enough to send someone with Fibromyalgia syndrome into a panic attack long before the appointment day even arrives.

Fears of the physical and emotional distress of a dentist visit are very real if you have FM, but the last thing you want to do is skip going to care for your oral health at all.

Bringing extra anxiety

Going to the dentist is worse for FM patient as it is stressful thinking about the pain and flare that a dentist appointment can possibly cause, setting you on a descending spiral for weeks.

Sensitivity to touch

The fear of going to the dentist with FM is generally founded in the sensitivity to being touched. Simple touching can produce pain in overly sensitive FM nerves. This symptom can cause a lack routine dental hygiene, like brushing and flossing, to be avoided because of the pain it causes. This would make those with Fibromyalgia Syndrome more in need of regular dental appointments than most.

No tolerance to pain

It is a bit of a catch-22 for FM victims since going to the dentist can cause pain, but not going regularly can cause more pain as you will have to sit in the chair longer and have more work done on your teeth. Moreover, it’s important to make sure the pain in your jaw that you have been considering part of FMS for the last few months is not actually a dental issue.

Don’t give up the Dentist

It is important if you have FM to not give up on going to the dentist for regular appointments. Ask your friends about their dentists. Find a dentist who is not only familiar with FM but its influence on the widespread pain. You also want to make sure that the dentist you chose is sensitive to your particular needs, whether it is extreme stress, more than average numbing, TMJ, or low tolerance to pain – all part of FM.

Tips to Dampen Dental Fears

The good news if you are living with FM is that there’re many methods that can help you cope dental phobia. The first stage, Schlesinger says, is to find a dentist who understands that FM can increase pain, even from routine dental care like taking a hygiene or X-rays appointment, and who takes suitable precautions.

To make your dental experience more pleasing, question your dentist about these methods:

  • Oral medication to decrease your level of stress
  • Comforts to make you feel more calm in the chair, like a blanket, a massage pad, or soothing music
  • Complete sedation
  • Intravenous medications that change consciousness

Timothy says that complete sedation decreases all stress and can be the best choice in the face of a severe dental fear. Not every dentist is qualified to carry out sedation, though, so he proposes cautiously checking the credentials of individual dentists to pick the right one for you.

Finding the Right Dentist for You

To find a dentist who is both delicate and experienced about the effect of FM pain on dental visits and dental care, ask such questions:

  • Do you propose prescription to lessen anxiety during my treatment?
  • Do you have the modern equipment, like digital lasers and X-rays, in your office?
  • Do I have the choice of complete sedation?
  • Do you have any experience handling people with FM?
  • Are you experienced, skilled, and comfortable dealing with temporomandibular disorders (TMJ), as this disorder is common with FM?
  • How do you feel FM pain effects dentistry?
  • Do you propose any other non-drug means of relaxation that might help ease stress, like listening to comforting music?

The more you share your worries with the dentist before treatment, the more easily that treatment is expected to go.

Dealing With Fibromyalgia Pain after a Dental Treatment

An appointment to the dentist can be stressful, both emotionally and physically, and can produce a body-wide FM flare distinct from any discomfort caused by the dental procedure itself. A dentist experienced in treating people living with FM will know that your pain handling methods may be more difficult than for other patients. Ask about methods that may help control extreme pain, dental or otherwise, after treatment also. Relaxation or deep-breathing methods may help handle anxiety and avoid a post-dentist FM flare.

Take comfort in the fact that FM doesn’t have to get in the way of good dental fitness. “The mouth is the access to a healthy routine, and prevention is the finest method to dental care,” Timothy states. “The best way for everyone – as well as people with FM – to preserve their smiles is to have regular oral hygiene appointments and by oral examinations.”

Study TMJ in Fibromyalgia and Chronic Fatigue Syndrome

Millions of peoples are thought to be ill with from temporomandibular joint disorder (TMJ), a condition that is frequently misdiagnosed or goes undiagnosed because many of its most broadly reported symptoms — severe headaches, facial pain, neck and shoulder uneasiness, jaw popping or sticking — either seem indistinct or are connected with other medical conditions.

Temporomandibular joint disorder (TMJ) causes jaw pain, and it is more frequent in people with fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS) than it is in the general healthy people. In United States more than 10 million people are believed to be affected by the jaw pain TMJ, and women are more affected than in men by this disorder.

What is TMJ Disorder?

The temporomandibular joints attach your jaw to your skull. They are stabilized and supported by muscles and ligaments that function to open and close your mouth. Pain or tenderness in or around the joints is referred to as a TMJ disorder.

The causes that lead to this disorder are not still unknown, but most experts have the same opinion that jaw injury can be the cause. Other related conditions contain nervousness, stress and rheumatoid arthritis. The pain can vary from mild to severe and treatment usually depends on the severity.

There are two types of TMJ

There are two types of disorders of the temporomandibular joint—(1) Joint TMJ is caused by injury to the cartilage or ligaments of the joint.  Patients with joint TMJ may go through from bursting and clicking of the jaw joint and the fail to open the mouth very broad.  According to the American Dental Association, arthritis can cause joint TMJ, injury or displacement.  (2) Muscular TMJ is more possible to influence people living with Fibromyalgia.  It affects the muscles used to masticate and move the face, neck and shoulders. Sleep deficiency, (a main constituent of Fibromyalgia), stress and muscular Injury may cause muscular TMJ.

The Temporomandibular Assists in Opening and Closing the Mouth

The temporomandibular joint (TMJ) is located on both sides of the head.  This joint, along with the lower jaw and jaw muscles, makes it possible to open and close the mouth.  I had experienced whiplash years ago and had become factually speechless and could not open my mouth more than an inch,  I was not capable to speak properly.

I would also take the anxiety of the day out on my jaw, clenching my teeth at night. A talented massage therapist was able to relax the tight muscles, even the muscles inside of my mouth!  My dentist at the time introduced me to a mouth protector that I would put on at bedtime that was molded to fit my teeth, supporting me to sleep more deeply.

My jaw is able to move again, I can even keep my mouth open for long time in the dentist’s chair!

If not trapped early enough, as a result of the clenching or grinding, the jaw joint can become injured or dislocated resulting in clicking, humming, and popping noises which are heard in the ears.  Chronic teeth grinding can result in a fracturing, loosening, or loss of teeth. In intense cases, the chronic grinding may wear the teeth down to stumps.

Patients with tooth alignment problems may need dental intervention

Missing teeth, teeth which are not placed in correct place, dentures that do not fit properly, they can be the cause of TMJ.  I had orthodontic braces at the age of 58 and just had them detached.  As I did years ago as a youngster, I now have to put on a retainer.  The braces enhanced my bite and also permitted me to retrieve my smile.

It is hurtful, but most indemnity companies do not identify the benefits of teeth alignments or massage for the treatment of the symptoms of TMJ.  Your doctor and dentist will have to synchronize a plan and speak with the insurance company about the requirement of therapy.  Luckily my dentist has a plan that was reasonably priced to me, but for a massage, I go to the local school and the students get to carry out their skills.

The Overlap Between TMJ, FMS and Chronic Fatigue

We do not know up till now why people with FMS and ME/CFS come out to be more liable to this condition. When TMJ occurs first, it is possible that the pain could add to the development of central sensitization, which is believed to be a basic constituent of FMS and ME/CFS. When the other conditions are diagnosed first, TMJ may be related to sloppy connective tissues thought to be related with them.

A rising hypothesis is that all of these conditions may fall beneath the umbrella term central sensitivity syndromes. In view of the fact that people with FMS and ME/CFS feel pain more intensely than others, they may endure more from hurting conditions.

Getting a Diagnosis

TMJ disorders are most often diagnosed and treated by dentists. There is no solitary broadly acknowledged test. Your dentist may examine the jaw for tenderness, popping, clicking and difficulty opening and closing your mouth. Your dentist may also see how your teeth fit jointly by taking an x-ray and a cast of your mouth.

It is a excellent idea to ask your regular doctor to rule out other causes of facial pain, such as sinus headaches or earaches. Also, if you have myofascial pain syndrome(which is common in people with FMS), trigger points on the sternocleidomastoid muscles in the front of the neck can cause jaw pain. It is unidentified whether these kinds of trigger points actually cause TMJ or just cause analogous symptoms.

Fibromyalgia and TMJ Pain  – What’s the Connection?

It is predicted that about 90% of people living with fibromyalgia bear some type of jaw or facial pain. However, that does not mean that all of those will have TMJ.

Some people believe that you have to experience a absolute jaw lock before you are diagnosed with TMJ, but that is not the case. The incidence of other related symptoms when all other possible causes have been ruled out is sufficient for the diagnosis in some cases.

TMJ and the related facial/ jaw pain can be an expansion of fibromyalgia when a diagnosis for fibromyalgia is already in place. Others will give a secondary diagnosis of TMJ. No matter you have confirmed both diagnosis or not, the combination of both conditions is fatal.

When the pain do not allow you to sleep at ease, confines range of movement for your head, and affects proper chewing, this can influence the value of life.


Other than headaches, the symptoms are somewhat distinctive from symptoms of FMS and ME/CFS. They consist of:

Jaw pain, Uneasiness or obscurity in chewing, Painful clicking in the jaw, not easy to open or close, Teeth do not fit properly.


In some cases, TMJ symptoms vanish away without any treatment. If you have unrelenting symptoms, your doctor may advise either traditional treatments or a more violent approach.

Traditional treatments include:

  • Anxiety reduction
  • No gum chewing
  • Wide yawning should not be done
  • Ice packs
  • Anti-inflammatory drugs, such as Advil (naproxen) and Motrin (ibuprofen).

More violent treatments include orthodontics or surgery. These violent treatments are notorious, so you may want to get a second opinion before allowing for them.

Long-Term TMJ Relief

However the research leads to more questions, it also contributes to a more inclusive information base about the connection between TMJ, fibromyalgia and other chronic pain conditions. Even though there is no treatment for fibromyalgia, there are medications accessible to help handle the pain.

The news is good for those with temporomandibular joint disorder. There are a number of TMJ treatments accessible, counting oral appliances to clutch the jaw in an most favorable position, and BOTOX® Cosmetic to relax the jaw muscles and alleviate nerve pain.

The first step to discover long-term liberation from TMJ pain is to discuss with with a well-informed neuromuscular dentist who will advise the finest selection for you based on cause and harshness of your state

TMJ Treatment vs. FMS/ME/CFS Treatment

TMJ treatments do not normally hinder with FMS or ME/CFS treatments. On the other hand, those people with high temperature sensitivity may have a tough time tolerating ice packs or improving from surgery because of their other conditions. Also, some experts consider that many people with ME/CFS are receptive to definite types of anesthesia, Even though this has not been confirmed in clinical studies.

Any time you are taking medication for more than one condition, you should talk with your doctor and pharmacist about likely drug interactions.

Living With Multiple Conditions

The pain of TMJ can make your FMS or ME/CFS more complicated to handle, making treatment especially important.

Scientists from the National Institutes of Health are carrying out a broad range of studies to better comprehend the pain procedure, As well as the facial pain of TMJ and what it has in frequent with disorders involving extensive muscle pain. This investigation could help us better appreciate TMJ and its connection to FMS and ME/CFS, leading to better treatment for all of them.

Reviewed by : Dr. Muneeba, MD MBBS, FUMDC.


American Dental Association. All rights reserved. Chronic Fatigue Syndrome.

British Journal of Anaesthesia. All rights reserved. “Anaesthesia for patients with idiopathic environmental intolerance and chronic fatigue syndrome.”

Lapp, Charles W., MD, Hunter-Hopkins Center. All rights reserved. “Recommendations for Persons with Chronic Fatigue Syndrome (or Fibromyalgia) Who are Anticipating Surgery”

National Institute of Dental and Craniofascial Research. “TMJ Disorders”


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