I would like some advice please on how to get a... - Thyroid UK

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I would like some advice please on how to get a mouth guard made for me.

dizzy864 profile image
44 Replies

I have had a mouth / jaw problem since last December. I have been in constant pain, although oddly the pain has changed. My levo thyroxine was increase and this really helped, but I still have pain. My dentist told me that it was most probably nerve pain due to needing a root canal. I finally saw a max face consultant on Tuesday. The consultant disagreed and told me that there is no evidence of infection and therefore no need for root canal. He told me that my mouth pain is caused by grinding my teeth. I just want the pain to go away!!

The consultant told me to get a lower mouth guard made. It will then take up to four months for the constant pain to stop.

I phoned my dentist. The receptionist told me that it was £269.30 to get one made on the NHS as it is in group 3. She offered no alternative in spite of me saying that I could not afford that. When I told her that I expected it to be £100, she then told me that I might be able to have one made privately. That would now cost £110. ( it had recently increased ) I would have to pay £22.70 for a consultation and check up. I would then be told if I were suitable to have one made privately. When I said I did not need a check up as I've had two check ups in the past four months due to my mouth problem, she advised that I put off the visit for six months until I am due a check up!!! This is definitely not feasible as I am in so much pain. The £22.70 will be a complete waste of money if I am not suitable. I asked what was suitable and was told it was too technical to explain!!

Firstly, can anyone explain why I have started grinding my teeth? I am 67 years old and the first I was told of this was last November when I had a routine check up. I am completely unaware that I am doing this.

Secondly, what options do I have for getting a mouth guard made? My dentist has no bookable appointments in the next month. I really don't want to wait that long to start having one made. I have researched on line and did find one company that will supply one. They send me a kit and instructions to make a mould and then make it from that. They charge between £69 and £139 depending on how much one grinds their teeth. How do I know how much I grind my teeth when I am completely unaware that I am doing it? Has anyone used this kind of service? Does it work well?

Thirdly, I think I may have another problem with my mouth although the consultant would not listen. Since the pain started back in December, I keep biting the inside of my mouth - inside my lower lip and inside both cheeks. I know my bite has changed - my top teeth overhang my bottom teeth by what seems a lot, when previously they did not. My mouth feels really crowded - there seems no room for my tongue which rests on my bottom teeth under the over hang of my top teeth resulting in my often biting the tip of my tongue. Much of the time, I have my mouth open a small amount as I am more comfortable.

The consultant just told me nothing had changed and that it would be fine when I've used a lower guard at night for three or four months. Has anyone else had a similar experience?

Thanks for any help or advice anyone can offer.

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dizzy864
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44 Replies

Do you take any antidepressants? That was what triggered my grinding.

I paid for a mouth guard from my dentist and later had Botox injections for it.

dizzy864 profile image
dizzy864 in reply to

No I be never taken anti depressants. There had been no new meds and no cold or bug. I had been very hypo and increase to Levi did help

MaisieGray profile image
MaisieGray

If all you want is a basic protection from teeth grinding and to even out the pressure at night, you can just buy a cheep silicone guard from any pharmacist. They will obviously be a general fit rather than an exact mold of your mouth but if that's all you need it for, it should likely be adequate. If however, you want a perfect match, or as you intimate, something that will more soecifically, address and correct any occlusion etc problems , then something made to your requirements by an orthodontist will be necessary. You can phone around however many, to get a feeling for cost, but I doubt any Ortho or ordinary dentist would proceed to making any dental apparatus for you, without the initial consultation - they won't be willing to go on what someone else's opinion is.

dizzy864 profile image
dizzy864 in reply to MaisieGray

Thanks for your reply. I already tried buying a standard one that you mould yourself and cut to size. It made me retch . I think it’s because I have 2 honey growths at the bottom of my mouth it would not seat properly. My problem with my dentist was not that they insisted on a consultation but that they could not guarantee that I could then have one made privately. There’s a big difference in price between private and nhs.

MaisieGray profile image
MaisieGray in reply to dizzy864

Ah, I have those bony growths too, but when I told my dentist I'd be concerned if I ever had to have dentures she said it wouldn't be an issue as it would be moulded to fit my mouth. So I guess that definitely indicates you will need to have a purpose-made guard. There's probably no way around having the assessment session I'd guess.

bantam12 profile image
bantam12

Has your dentist checked your bite ? If you are biting your cheeks it could be because your bite is out.

You really should get either a bite raiser or guard made to fit you otherwise you risk causing more problems with either your bite or jaw being put out of line.

dizzy864 profile image
dizzy864

No. No one will listen to me when I say I have a problem. I waited over 5 months to see a consultant and he was not interested when I said I had a problem with bite. I d never heard of a bite raiser.

bantam12 profile image
bantam12 in reply to dizzy864

Whatever you do you will have to have a consultation and check up with a dentist first, if your dentist can't help you would need to pay privately for a second opinion, either with a dentist or an orthodontist. There is no way anyone can make you an appliance without seeing you first as measurements and impressions need to be taken. It may also turn out that an appliance is not something that will help your problem.

dizzy864 profile image
dizzy864

I m not convinced that it will. But consultant was!! I can only try what he said. I have to go back in 5 months but may not see same person as he was a locus

Tinacros profile image
Tinacros

I’ve had one made. It unfortunately did nothing for me. My pain was from TMD. X

in reply to Tinacros

My dentist said the splint was to give me something to destroy that wasn't my teeth. :)

dizzy864 profile image
dizzy864

Sorry, what isbTMD?

RedApple profile image
RedAppleAdministrator in reply to dizzy864

TMD is Temporomandibular disorder. See here for some info nhs.uk/conditions/temporoma...

greygoose profile image
greygoose

There are certain dentists - and I've seen so many dentists in my time! - that just love to tell you - nay, insist! - that you grind your teeth. Now, I don't know if you've ever lived with someone who grinds their teeth, but believe me, it doesn't go unnoticed! You can hear it from three bedrooms away! And the next morning, you just can't wait to tell them how they destroyed your sleep!

Well, dentists have told me that I grind my teeth. But, no-one that has ever lived in the same house as me has ever said that - and I've asked. No, I don't grind my teeth. But, I've been hypo for a long, long time, and my teeth are soft and friable. And the inside of my mouth and my tongue were swollen when I was sub-optimally treated for hypo. So, my teeth wore away easily, and I was always biting my tongue and my cheeks, and my mouth was a bit of a disaster area! But I didn't grind my teeth.

I would suggest you look towards your thyroid treatment. Are you optimally treated? I guess not. So, maybe it would be a good idea to post your latest lab results on here, and let's have a look, see what's going on. It would be cheaper than dealing with dentists, anyway!

I used to call my dentist Jaws, because he was a bit of a shark. Always on about a mouth guard... Now, I've got a lovely, cuddly, teddy bear of a dentist, and I feel so much happier. :)

in reply to greygoose

Some people don't grind, but clench instead, and that isn't noisy. It's still classed as bruxism and it can do damage - and apparently we can inflict more pressure that way.

My dentist has been great over many years, very low intervention etc, but once he saw the damage I was doing and the pain I was having from it, and the need for specialist dental care,

he was insistent that I needed to address it. The mouth guard (called a splint) is apparently to give you something to destroy that isn't your teeth. :)

Mine was a side effect from SSRIs (or at least, that made something minor that I do into a major problem). Now that my SSRI dose is really low, it isn't a problem any more, thankfully.

greygoose profile image
greygoose in reply to

OK So, why don't they say that. Telling you you 'grind' your teeth is confusing if what you're actually doing is clenching. My granddaughter used to grind her teeth when she was little. It was horrible! But, I know I sleep with my mouth open, due to the state of my mouth when I wake up! And, I wasn't in any pain. 'Jaws' just wanted to make me a mouth guard for the money - and he wasn't cheap!

in reply to greygoose

Small kids often do grind, apparently and it's okay and they grow out of it.

I'd think that grinding as an adult might look different to clenching though, so hmmm. I was in a lot of pain - headaches, stiff neck, dental pain, and I had to have expensive dental work to repair some damage.

This is an article about it. Not about me :), just bruxing. abc.net.au/news/health/2017...

greygoose profile image
greygoose in reply to

Thank you for the link. I'll read it later. :)

in reply to greygoose

It's not all that exciting, but talks to the clenching. I'm always focussed on clenching, since I've done myself a lot of damage that way!

greygoose profile image
greygoose in reply to

To be honest, I don't think I've ever clenched. My problems, as I said above, are due to being hypo. And that's possibly true for the OP, as well. The interior of her mouth is obviously swollen, and that changes a lot of things. And the swelling is not likely to be due to teeth grinding. :)

in reply to greygoose

A swollen tongue is a sign of bruxism, medicalnewstoday.com/articl... Mine is still a bit scalloped, so I must still be doing it, but it no longer hurts so I'm good with that.

I ended up having botox injections, which doesn't stop the bruxing, rather it makes the muscle atrophy a bit so that you can't inflict as much damage on yourself. This was a good solution for me except when I was at my highest SSRI dose, and until I got the SSRI dose down low enough that it is no longer an issue. My dentist said it was only for extreme cases, but he felt I'd got to that point, sadly.

Headaches and a stiff neck were my earliest symptoms, it took longer for the dental damage to become apparent.

greygoose profile image
greygoose in reply to

A swollen tongue could be a sign of bruxism. It could also be a sign of hypothyroidism and/or low B12.

in reply to greygoose

Yes, could be lots of things. Or, I wonder if the hypo or Hashi could somehow induce it? Will never know...

greygoose profile image
greygoose in reply to

Induce what? Bruxism? More than likely, I would say.

dizzy864 profile image
dizzy864 in reply to greygoose

I know it’s not low B12. I be been supplementing for many years since having a problem. It’s been tested several times over past couple of years. It’s always right at top of range.

dizzy864 profile image
dizzy864 in reply to

Thanks for your reply. I had absolutely no symptoms. I went to my dentist last November for a routine check up. She told me that I'd started to grind my teeth. I was surprised but did not really understand what she meant. A couple of weeks later, whilst on holiday in Orlando, I woke up and all of my teeth ached. I had not been unwell. My mouth has been a problem ever since. I've had a pretty rough time since. My levo was increased and over the next month the teeth ache got less and less but it did not go completely. I then got a quite severe tooth ache, which I thought was part of the same thing. I put up with it for almost three weeks as my dentist was away. She then told me that a rather deep filling had cracked and the crack was touching a nerve. I had the filling replaced, which was quite painful. It took a further ten days for the nerve pain to stop. Since then all of my teeth are uncomfortable. It's really hard to explain. The pain is all over my mouth. It never goes away. I've been in pain since 10th December last year. Needless to say, I've really had enough!!

dizzy864 profile image
dizzy864 in reply to

Hi, I just read your link so thanks for that. However, none of it applies to me. I have never smoked. I do drink alcohol but very little. I had not been stressed prior to being told that I grind my teeth - in fact I was actually on holiday very much enjoying myself when the pain started. My husband tells me that he never hears my teeth grinding in the night. I was not having any sleep problems although like most people I have in the past. I have not had neck pain and no more head aches than I usually have. I'm not sure where this leaves me though!!

in reply to dizzy864

I personally think the stress thing is rubbish.

dizzy864 profile image
dizzy864 in reply to greygoose

Thank you for your reply.

I was surprised when the consultant told me how noisy I am grinding my teeth. My husband has always woke up several times in the night and reads. I've got used to it now. He says I do not make a noise at night at all.

I am not optimally medicated. I have not been for five or six years. I was getting more and more hypo, yet my gp continued to tell all of the partners that I was severely over medicated. He put a note on my records stating this. He based this on what he called, a very low TSH. I call it suppressed because I've been on T3 for 12 years.

For many years, I was on 100mg levo and 60mg lio

My bloods were:

23/11/16 Free T4 16.4 ( 12 - 22 ) Free T3 4.84 ( 3.1 - 6.8 )

Nov 2017 Free T4 17.4 (11 - 23 ) Free T3 5.08 ( 3.2 - 6.8 )

26/3/18 Free T4 18.5 ( 11 - 23 ) Free T3 not tested This result was very slurred because I saw an endo who insisted that I gave blood there and then even though it was less than two hours since I'd taken my thyroid meds. He would not take no for an answer and told me he could "extrapolate back"!! He wrote to my gp to say I was over medicated and should stop T3 completely. I refused and my doctor reluctantly agreed to continue prescribing it at the same dose.

Mar 19 Free T4 14.7 ( 11 - 23 ) Free T3 5.11 ( 3.1 - 6.8 )

My Levo was increased to 125mcg in mid April

11/6/19 Free T4 16.5 ( 11 - 23 ) Free T3 5.58 ( 3.1 - 6.8 )

My TSH has been suppressed for many years.

I felt a bit better but still had a lot of hypo symptoms. My gp told me that she thought I needed to have T3 increased because she believes I am T4 resistent. She said she was not allowed to increase my T3 so referred me to an endo. She said I could try an increase of T4 and see how I got on with it. I'm still waiting for an appointment.

My levo was then increased to 150mcg. I was on this dose for 6 weeks. A lot of the hypo symptoms were much improved but I also had symptoms of hyper - I sweated profusely and although I had a lot more energy and generally felt a lot better, I completely zonked out after any exercise. I did grow a few hairs under my arms after having absolutely none for years. I then put myself back down to 125mcg. My new hair growth stopped!!

I never got my bloods but both T3 and T4 were well over range.

I had my vitamins and minerals checked back in March. Everything was well up in range except ferritin, which I always struggle with as I react really badly to all iron tablets. I have been using a spray since then so it should have gone up a bit. I supplement with Vit D3 + K2, a B complex, magnesium and silenium as well. I take a gentle iron table once or twice a week as well.

My dentist does not want me to have a mouth guard. It's my gp and the max face consultant that say I should have one.

Personally, I think I need to increase T3 and reduce T4 a little. I think my mouth problem is thyroid because I have been so hypo for the past six years. I told the consultant that I thought my problem was thyroid. He said definitely not. But he also refused to accept I have a problem with bite or my mouth generally. He did admit that the mouth xray which I had taken six months ago was very poor quality and he could not see much. I suggested having another xray done, but he refused. He wants to see me again in five months after I've been using the mouth guard for four months.

I have not had a diagnosis other than "bruxism". I'm reluctant to pay out more money on something that I am not convinced is the answer especially as the dentist and consultant disagree completely.

Unfortunately, I'm not convinced that the endo will be any help when I do eventually get to see him. Even my gp admitted that endo's are usually experts on diabetes and not the thyroid!!

I'm thinking about self medicating with increased T3.

greygoose profile image
greygoose in reply to dizzy864

I think that last sentence sums it up beautifully: you need to take charge of your own health. Getting passed from pillar to post like that is not good for your health, either. Cut out all those useless middle-men and do it yourself - you couldn't make a worse job of it!

dizzy864 profile image
dizzy864 in reply to dizzy864

If I do increase T3 how much should I start with? How much and when should I reduce T3?

I m unsure as T3 and T4 take differing times to work

Teresamarie profile image
Teresamarie

Well, I’ve had an upper mouth guard for many years. It was just crazy expensive! Not covered by insurance (though don’t know why). I have TMJ in both sides of my jaw. Could I tell stories about that, but now is not the time....

I would not do without my mouth guard. It has lasted for years! Right now I am biting my cheeks like you said was happening to you. I’m to go get root canal tomorrow to help with abscessed tooth. Bummer!

I hope that you will find answers for what may help with grinding your teeth. Experience has shown me that if you don’t protect your teeth from grinding you will have no options later on.

My best to you!

Teresamarie

SlowDragon profile image
SlowDragonAdministrator

Teeth clenching is a hypothyroid symptom

sarahwilson.com/2014/07/300...

An NHS dentist should be able to make a lower mouth guard for about £100

It's extremely effective. I have had one for about 6 years

An enlarged tongue can be hypothyroid symptom too

Or can be low B12

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to regularly test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Have you had vitamin levels tested?

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

dizzy864 profile image
dizzy864

Thanks for your reply. If teeth grinding is another thyroid symptom, can it be stopped? Is it done when meds are not optimal?

My GP thinks I might be resistant to levo. I ve been on a waiting list for some time to see a local endo to discuss this. She did increase my levo from 100 to 125. As I still had many hypo symptoms she then increased it again to 150. A lot of symptoms did improve. I had more energy and my completely hairless under arms grew a few hairs. Unfortunately, I also had hyper symptoms - really sweating. I could do a lot of exercise but completely collapse d immediately after. I went back down to 100 after bloods. T3 and T4 were both well above range.

My GP checked back on all of my thyroid tests over last 10 years. She said I was clearly better on more T3. She wanted to increase T3 but said she was not allowed to. She referred me to an endo instead. I expect an appointment Nov / Dec time.

I m to have thyroid bloods done before I see the endo and I ll ask them to do vitamins too.

Archway profile image
Archway

When I was diagnosed with TMD a few years ago my GP sent me to the maxillofacial clinic in my local NHS hospital. They fitted me out with a customized mouth guard for free. It almost completely got rid of my TMD after a few months.

dizzy864 profile image
dizzy864

Unfortunately, times have changed. I was told to go to my dentist and pay for it.

I have the additional problem that my dentist can’t see me for a month,

MaryMary profile image
MaryMary

I don"t know think I can name the company that make mouthguards for sport, but you could search online. My boys had these mouth guards for rugby and from memory you get a kit which allows you to do a mould from which they make the real one. They are much cheaper than your other sources.

dizzy864 profile image
dizzy864

Yes, I found a company that did that. My original post was asking if any one had used this type of company.

penny profile image
penny

As a therapist I was taught a TMJ release. If one’s jaw is tight it can be excruciatingly painful but the pressure is adjusted accordingly. One places ones tongue behind the lower teeth and relaxes the jaw; the index finger on each hand is placed in the corresponding position under the earlobe (when moving the jaw one feels the TMJ move). With mouth open the index fingers are pressed inwards; do not attempt to close the mouth while doing this. It can be repeated as often as one wishes. The object is to gradually release the TMJ, not cause too much pain.

penny profile image
penny in reply to penny

I wish to add that I take no responsibility for any adverse effects or otherwise of this exercise (I’ve never known any). This is an exercise I use and I tell my clients about but the latter have had a health profile done.

dizzy864 profile image
dizzy864 in reply to penny

Hi Penny

I tried this exercise. I had no movement on one side. The side where I be been having most pain, moved quite a lot. My mouth and teeth have been much better since. Thank you so much.

I am left wondering why the consultant I saw did not suggest this. He told me only to wear a mouth guard for four months!!

dizzy864 profile image
dizzy864

Thanks for that. I loved give it a try

penny profile image
penny

I’m pleased to hear this. I have come to the conclusion that ‘experts’ are not necessarily across everything in their sphere. I have saved toes by using scar techniques when the ‘expert’ wished to amputate them. I have treated back problems which have resolved in 1 session when an ‘expert’ advised having a leg shortened. My colleagues in the therapy world could supply more examples. I was reading Dr Kendrick’s latest book ‘The Statin Nation’ and learnt that a hospital in America has been successfully treating atherosclerosis with vitamin C; has anyone heard of that? Wishing you well.

dizzy864 profile image
dizzy864

Yes, it amazes me where the so callled experts learn their trade. Years ago I suffered with a very painful back. I had 2 young children and a 9 month old. I had seen numerous doctors and experts. Their advice was complete rest and absolutely no lifting!!

My husband was rushed into hospital one night. I stayed in a hotel for the night and had to share a bed with my baby. I woke up in the middle of the night. My baby had kicked me hard in the middle of my back - he cured my back pain!!

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