TMJ, Dental & Jaw Issues
Part 2
J N J Dent Assoc. 1998 Winter;69(1):19, 21, 62-3 passim.
Lyme disease awareness for the New Jersey dentist. A survey of orofacial and headache complaints associated with Lyme disease.
1 Department of Oral Pathology, Biology and Diagnostic Services, UMDNJ, USA.
Abstract
The incidence of Lyme disease is increasing in New Jersey. In 1996, 2,190 cases were reported, representing an increase of 487 cases from the 1,703 reported in 1995 [Table 1]. Symptoms associated with Lyme disease include headache and facial pain that often mimics dental pathology and temporomandibular disorders. Patients with complaints of vague, non-specific dental, facial or head pain, who present with a multisystemic, multi-treatment history, are suspect. This article discusses Lyme disease in New Jersey and the clinical presentation of Lyme disease that the dental practitioner may encounter. A summary of data is provided which was collected from 120 patients diagnosed with laboratory confirmed Lyme disease. The most common orofacial, head and dental complaints seen in the Lyme disease patient are reviewed. This information will hopefully aid in establishing a diagnosis and appropriate referral where indicated.
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Mund Kiefer Gesichtschir. 2001 Jul;5(4):258-60.
[Acute temporomandibular joint arthritis after Lyme borreliosis].
[Article in German]
Vesper M1, Röder K, Siegert J, Friedrich RE, Schmelzle R.
1 Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg. mkg@uke.uni-hamburg.de
Abstract
CASE REPORT:
This report is about a rare connection between Lyme disease and an inflammation of the left temporomandibular joint. In this case, an infection was documented in 1998, 5 years after contact with Borrelia burgdorferi. The patient, a 49-year-old female, first came to our department in 1999. She showed the symptoms of a left temporomandibular joint infection.
THERAPY:
We suggested treatment with ceftriaxone 1 x 2 g/day i.v.
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J Craniomaxillofac Surg. 2007 Dec;35(8):397-400. Epub 2007 Oct 17.
Temporomandibular joint involvement caused by Borrelia Burgdorferi.
1 Department of Infectious Diseases and Febrile Conditions, Teaching Hospitals Celje, Slovenia.
Abstract
BACKGROUND:
Lyme borreliosis is an endemic disease in Slovenia with an incidence of around 150 patients per 100,000 inhabitants. Although the large joints are most typically affected in Lyme borreliosis, there are also periods of disease activity with arthritis or arthralgias involving smaller joints, including the temporo-mandibular joint.
PATIENTS:
During the years between 2000 and 2003, two patients with Lyme borreliosis affecting the temporo-mandibular joints were treated. The patients presented with fatigue and pain in diverse muscle groups accompanied by arthralgia, which was most pronounced in the temporomandibular joint area. None of the patients were febrile or had joint effusions.
METHODS:
Both patients were examined by means of biochemical and serological examinations for Borrelia burgdorferi using ELISA assay and Western blot test (both for IgM and IgG), plain radiographs, MR and CT scans, and scinti-scan of the temporo-mandibular joints. They both had positive serum markers for an acute B. burgdorferi infection and were treated with intravenous ceftriaxone.
RESULTS:
None of the patients had clinical or laboratory signs of chronic Lyme disease activity two and four years following therapy, respectively. Roentgenographic and nuclear magnetic resonance imaging of the temporo-mandibular joints had not shown any persistent sign of acute inflammation.
CONCLUSION:
There are only few reports of patients with manifest temporo-mandibular joint involvement of Lyme borreliosis in the literature. This report emphasizes the importance of differential diagnosis of acute temporo-mandibular joint arthralgia, of early diagnosis of Lyme borreliosis, and of the necessity for prompt antibiotic treatment.
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Ann Agric Environ Med. 2010;17(2):319-21.
Orofacial symptoms related to boreliosis--case report.
Wolańska-Klimkiewicz E1, Szymańska J, Bachanek T.
1 Department of Conservative Dentistry, Medical University of Lublin, Lublin, Poland.
Abstract
Lyme disease (borreliosis) is an infectious disease caused by the Borrelia spirochaetes, usually transmitted to humans by the Ixodes ticks. It is manifested by a wide spectrum of clinical symptoms varying according to the time elapsed from the infection. The paper describes orofacial symptoms of the disease in a woman who has suffered from a chronic borreliosis for 3 years. Multiorgan clinical manifestations of borreliosis might occur in the masticatory organ and this fact should be taken into consideration in the differential diagnosis of pain by medical and dental practitioners.
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Arthritis Care Res (Hoboken). 2010 Mar;62(3):434-8. doi: 10.1002/acr.20093.
A 46-year-old woman with chin pain and a fainting spell.
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Saudi J Anaesth. 2018 Jan-Mar;12(1):112-114. doi: 10.4103/sja.SJA_47_17.
Exacerbation of chronic pain after dental extractions in a patient with post-treatment Lyme disease syndrome.
1 Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA.
Abstract
A subset of patients who had Lyme disease experience postinfectious signs or symptoms called post-treatment Lyme disease syndrome (PTLDS). PTLDS is a chronic condition including pain in joints and muscles, neurological symptoms including demyelinating diseases, peripheral neuropathy, headaches, sleep disturbances, fatigue, and cardiac conditions.
We report a case of difficult acute pain management in a patient with PTLDS who underwent dental extractions and required admission to an intensive care unit for pain control.
Articles
Lyme Disease By Dentists
QUOTE- "Symptoms of Lyme disease can vary a LOT from patient to patient. Many of those symptoms can also be associated with OTHER medical conditions, which can result in misdiagnosis. For example, most folk do not realize that jaw pain associated with Lyme disease may actually look like a tooth abscess, or a TMJ (jaw joint) problem. It is actually often misdiagnosed as TMJ! SO, if you have a jaw or tooth pain that your dentist cannot explain, you should consider the possibility of Lyme disease. Some of those symptoms of Lyme disease listed above only occur if the disease becomes systemic and spreads throughout the whole body." Source
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Lyme Disease Have You Ticked? Ask Your Dentist!
Lyme disease, which is initiated by the bite of an immature deer tick, is difficult to diagnose, but your dentist may be able to detect this mysterious disease, reports the Academy of General Dentistry, an organization of general dentists dedicated to continuing dental education. Patients with Lyme disease report pain in their teeth, chewing muscles and jaw joint, which drives them to the dentist.
"Unfortunately, most patients are not diagnosed properly until their Lyme disease is at a later stage, and when it is more difficult to treat," says Manuel Cordero, DDS, a spokesperson in New Jersey for the Academy of General Dentistry. "Diagnosing this disease is very tricky because it can hide itself behind many dental problems, including toothaches and jaw pain."
A study of 120 patients with Lyme disease revealed that about 75 percent of patients reported pain in the chewing muscles and 72 percent reported temporomandibular joint pain. Burning mouth was reported by 25 percent of these patients, and 70 percent reported a sore throat. About 47 percent of the patients visited up to 10 doctors before being properly diagnosed.
"Your dentist may suspect Lyme disease if you have a mysterious toothache that can't be attributed to cavities," says Dr. Cordero. "The disease may be really causing you to feel pain underneath the tooth."
About 70 percent of patients with Lyme disease reported dental pain in the absence of dental disease, and the dental pain tended to move from tooth to tooth. Of these patients, 36 percent had multiple dental treatments, including root canals and tooth extraction unnecessarily.
Source Links Broken
http://www.agd.org/consumer/topics/tmj/lyme.asp
http://www.agd.org/support/articles/?ArtID=1348
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Lyme disease. Lyme disease also should included in the differential diagnosis of TN (trigeminal neuralgia). Lyme disease or Lyme borreliosis is an infectious, tick-transmitted disease, caused by spirochetes of the Borrelia burgdorferi species complex. Lyme disease can manifest with an array of symptoms involving multiple organs and systems, such as skin, heart, eye, joints and the peripheral nervous system and the CNS.42
Neurological manifestations of the disease may include meningitis, single or multiple cranial neuropathies, painful radiculopathies and diffuse polyneuropathies.43,44 On rare occasions, patients with Lyme disease may have neurogenic pain similar to that of TN.45,46 This possibility should be ruled out via hematologic assessment for Lyme titers.
Failure of dental treatment to provide long-term pain relief should raise the suspicion of trigeminal neuralgia.
Dental pain. When the sharp, paroxysmal pain of TN is localized in the dentition or the surrounding structures, it may be misdiagnosed as dental pain.16,36 Frequently, patients with TN undergo numerous dental procedures until the diagnosis of TN is made. These procedures may offer temporary pain relief for a few weeks; however, the pain always recurs and often is even worse. Failure of dental treatment to provide long-term pain relief should raise the suspicion of TN. An important feature that distinguishes TN from dental pain is that TN typically does not interrupt the patient’s sleep. Moreover, pain originating from dental pathology usually is progressive, and its character changes with time. Tooth vitality tests and radiographic examination also will serve to exclude dental pathology.
Source- http://jada.ada.org/cgi/content/full/136/4/469
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QUOTE- "Lyme gravitates toward some teeth. It is my experience that Lyme gravitates especially to the upper and lower centrals, and to the upper and lower first molars. That's eight teeth."... Root canals and old extractions are common focal infection sites. When you have a root canal, a dead tooth is left in the mouth. The dead tooth lacks a blood supply to its interior. Antibiotics circulating in the bloodstream have no way to penetrate this dead tissue. Over time, the material packed inside the dead tooth shrinks a bit.
Now bacteria come in and morph. The tooth has both bacteria and toxins as a result of being dead for so many years and these toxins are infiltrating into the bloodstream. In extraction sites, the healing may not take place correctly. If the healing is incorrect, the space can fill in with fatty tissue, dead bone, improper bone, or it can fill in with infected material. All of these processes are wrong and the organ associated with that extraction site will always show this improper healing." Lyme Disease Often Resides in the Mouth- Link Here
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QUOTE- "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." Source
Continued...
Lyme Disease- Dental & Jaw Issues
Basic Information
https://sites.google.com/view/symptoms-of-lyme/dental-jaw
Part 1
https://sites.google.com/view/symptoms-of-lyme/dental-jaw/tmj-jaw-dental-issues
Part 2
Last Updated- June 2019
Lucy Barnes