TMD, A Short Upper Lip, And How I’ve Dealt With Them
Sunday, December 20th, 2009Productivity is something we’re all interested in. How can we optimise our time so that we can do more, achieve more and have fun while we’re doing it? There are all sorts of ways to become more efficient, and they work well, but sometimes we have a health issue that holds us down. Most everyone has something of this nature at some point in their lives.
This post is about Temporomandibular Joint Disorder and having a short upper lip. Jaw joint problems seem to be fairly common and the symptoms that can arise from jaw misalignment are many. Yet it’s rarely considered by doctors or dentists as being a possible cause for a disconcertingly large array of otherwise unexplained symptoms.
Last February during a routine dental checkup a dentist alerted me to the fact that I had jaw problems. Consequently during this last year I’ve had to learn about it and how to deal with it. I’m hoping that this post might be helpful to others in raising awareness of this condition. I’m not a medical doctor so I can’t advise in a medical capacity.
It turns out that I’ve had jaw problems all my life, with severe symptoms to go along with it. I had braces from the age of 7 until I was 16 or 17 years old. I’ve had regular dental checkups throughout my life and then I had braces reapplied seven years ago for a couple of years to attempt to stop my teeth moving around so much and having teeth pain.
No one ever mentioned the possibility that the jaw could be out of alignment, nor did they ever mention that having a short upper lip could cause problems. I’ve had to live with intense pain and many other side-effects from this most of my life. With each passing year, it was getting harder to keep going and I was beginning to lose hope of ever accomplishing my goals, so I’m very grateful for the timing of the dentist I went to see earlier this year.
I’m sharing here what I’ve learned in the hope that by raising awareness of the difficulties that can arise through simple jaw misalignment, perhaps it can save others from going through years of misery. Below, I briefly describe the effects of TMD, having a short upper lip and how I’ve managed to fix these problems for myself. If you have no interest in this topic, you could stop reading at this point.
Temporomandibular joint disorder – that’s a real mouthful. It’s often abreviated to TMD or TMJ disorder. Whatever you call it, it can be a huge problem. What it boils down to is that for some reason the jaw joint is not working the way it should.
There are many things that can cause the joint to become misaligned: an injury to the joint itself, poor posture, an accident, injury to the spine, the need for orthotics, orthodentistry performed without consideration of jaw alignment with respect to the teeth,…and perhaps some combination of these things. This means that it can be tricky to find out what’s causing the problem.
Symptoms resulting from jaw misalignment can also vary from person to person, both in severity and in the number of symptoms. It can cause havoc with a person’s ability to function, and when the symptoms are significant, it can even result in a person being essentially disabled. If the source of the problem is identified, that person can recover and the symptoms can be eliminated.
A brief description of some of the symptoms that can occur: severe migraine-type headache pretty much most of the time, eye pain and blurred vision, light sensitivity, jaw pain, tooth pain, inability to swallow properly, ear pain without infection, severe constant dizziness, nausea, neck and shoulder muscle strain resulting in inability to move neck, sore throat, difficulty breathing with asthma-like symptoms, inability to sleep for more than a few hours at a time, teeth clenching, teeth grinding,…the list goes on.
It’s much more complicated than this, and this isn’t a technical medical explanation, but if the symptoms are bad enough the scenario can go something like this: to cope with the pain and these symptoms, the body pumps high levels of adrenaline; in the long-term the adrenal glands eventually become fatigued; this affects the production of other hormones in the body and before you know it, you’ve got allergies, digestion problems, the body can’t clear toxins effectively, chemical sensitivity can develop, energy levels hit rock bottom and it’s virtually impossible to exercise.
Then if you go to a doctor, they typically can’t figure out what’s causing the problem because the body is actually healthy, so no test will uncover anything inherently wrong. And there you are at a dead end, always in pain, unable to sleep, not knowing why, but unable to live. Well, that might sound rather grim, but it really is. What does a person do then?
I was super lucky. Last February I went to the dentist for a routine checkup. He took an interest in me because he specialises in TMD and recognised just by looking at me that I could have a jaw problem.
It has been a hard path trying to understand the problem and figure out what to do about it. There were many days when it seemed nothing could successfully be done about it.
I learned where my lower jaw needs to be positioned relative to the upper jaw, in order for me to not experience the TMD symptoms. In my case the upper front teeth and lower front teeth coincide in position. If I bring my teeth together in a normal bite, then the lower jaw is too far back.
Each person has a different jaw alignment position. Usually it coincides with the bite placement of the teeth, which makes things easy. If it doesn’t, then it’s important to find the correct alignment. Of course, it’s possible to have injury inside the jaw joint and then this would need to have proper attention.
The goal is to align the jaw correctly and relax the facial muscles. In my case, I have a further complication in that I have a very short upper lip. There’s an 8 mm gap between my upper and lower lips when they’re at rest. This is a real problem. It means that the facial muscles can never be properly relaxed. Closing the mouth under these circumstances requires constant muscle work, pushing the lower lip up to meet the upper lip. This is like constantly holding your arm out horizontally. Eventually you’d experience difficulties trying to hold that arm out all the time; it could cause cramps in the arm and back muscles and who knows where else. The jaw joint and all of its attendant ligaments and muscles is the most complicated in the body.
This year I have learned not to attempt to close my mouth. But this still isn’t enough in itself. The muscles can’t relax because they have nothing to rest on. This means that the face muscles still contract and tense all the time. In my case, this tensing of the muscles in the face is enough to pull my lower jaw backwards relative to the upper jaw, the face muscles constrict and tighten, resulting in TMD and all its symptoms.
Another complication that can occur is that if the muscle contraction is sufficient to cause nasal constriction then it can become difficult to breathe freely through the nose, especially if the mouth is open. This encourages mouth breathing, which causes the tongue to assume a tensed position, which in turn can cause further tensing of the facial muscles. All of this serves as a feedback loop, one effect aggravating another. If the nose has been broken through injury in the past it’s well worth getting it checked to see if there is a deviated septum or some obstruction that needs correcting.
In my situation, the problem that needed solving was: what to do about having a short upper lip. If orthodentist treatment is started at an early enough age, then the growth of the bone above the front teeth and below the nose can be halted. I believe this is why I was given orthodental treatment at such an early age, but we moved country every couple of years and maybe something got lost in the treatment along the way.
As an adult, it’s possible to operate to shorten that bone, but there’s controversy as to how well this works. I’ve chosen not to take that route.
I found something else that works. I had taken up playing the trumpet a few years ago, and when I asked my dentist if it was ok for me to play it, he encouraged me to do so, saying it might help to strengthen the facial muscles. Playing the trumpet regularly through the day really helped remove many of the symptoms to a workable level. 
Pulling the upper lip low to play the trumpet caused it to press against the upper gums, even though the trumpet mouthpiece was placed very lightly on my face. The shortness of the lip requires that I really need to pull it down much more than would be necessary with a more normal length upper lip. Eventually this caused discomfort to the gums. I decided to take a break from playing the trumpet to rest them.
Within a week of not playing the trumpet I sank deeply back into the TMD symptoms and had lost the improved productivity that I had maintained for much of this last year. It was a devastating loss.
Soprano Saxophone
Desperate to find another solution so that I could at least function and have a life, I looked at all the other wind instruments I might be able to play, with less need to pull the lower lip down so far. I decided to try the saxophone. It works to control some of the muscle and TMD problems even better than the trumpet did.
In time though, as I lost the strength of the trumpet muscles through not playing the trumpet at all, I discovered that it’s also necessary for me to continue playing the trumpet regularly to maintain what it does for the facial muscles. So now I play both instruments and the result allows me to function well and live an active, normal productive life. I sleep well and have loads of energy. The balance of how much time playing, how often, and which instrument, is something I work out by trial and error for the most beneficial results.
I’ve tried to think of some way to invent something that could be put between my lips to prop them in a similar manner to having the lips contact with one another like they would in a normal mouth. The complications of how to shape such an object and how to keep it in position have thwarted me in pursuing it. It would be costly and I don’t have access to a workshop to create such a device. But I think it could solve the problem without the need to play an instrument to help the muscles.
Tenor Saxophone
It’s hard to believe that playing the trumpet and saxophone regularly through the day could reduce the symptoms to nearly nothing, but it does. If I go beyond much more than a couple of hours without playing, I’m soon reminded by the tightening of the facial muscles, jaw pain, a blocked nose and a deep headache for starters. Playing the trumpet and saxophone is an odd solution, and certainly not a perfect solution, but it’s enabling me to live life fully and with energy.
I’ve experienced TMD difficulties all of my life without knowing the cause. Each person will likely have a different set of methods to solve their problem, but if relating my experience here can be of help in some way to you or someone you know, that would be great.
