I have wicked bouts of TMJ, usually during times of extreme stress. I never "grind" my teeth, but I clench my jaw, usually sucking on my tongue and teeth. I do it in the daytime (which I am aware of), and probably at night also. In addition to affecting the jaw and neck muscles, it also puts pressure on my teeth, so I usually end up needing dental work. If I get dental work done first, a bout of TMJ is on the way, and will last for weeks. The pain is usually so bad that I need Lortab/Lorcet or similar pain killer, then a muscle relaxer also works to loosen up the jaw and neck muscles.
I am in the throws of a TMJ attack right now. After the pain medication and muscle relaxers are gone, and I still had the pain in my teeth and neck/jaw muscles, I got referred to a TMJ specialist by my dentist. He diagnosed that my problem is less jaw malformation, and more muscle related. He said that he could operate on the jaw (the right side pops and clicks), but that I would probably do better having physical therapy.
Thus, I am now in the middle of having physical therapy sessions for my TMJ. I have two sessions a week where the therapist twists and stretches my neck, shoulders and jaw muscles. After all the weird stretching, then I get electronic heat and muscle stimulation for about twenty minutes. Being hooked up to the electric stim machine feels pretty good, but I'm not sure it's actually doing a lot of good for my TMJ. However, I would recommend having the physical therapy 100% before having a mouth guard or splint made, since those really are a waste of time.
I have to go to the dentist again on Tuesday, so whatever progress I've made will just be undone. SSDD.
Wish me luck,
Edit - I forgot to mention that my TMJ is a major trigger for my migraine attacks. However, I have now been labeled a "drug seeker" since I have received narcotic pain prescriptions (LORTAB, LORCET) from both my dentist and my PCP, as well as getting pain shots at the ER for major migraine atttacks. Our town is now on a unified database, so it shows how many times I've received narcotics in the last year. Being labeled as a "drug seeker", I can't even get a Narcotic pain shot at the ER when I get a serious migraine attack. I've been turned away untreated the last three times I've sought relief for a bad migraine at the ER, and no doctor will prescribe any narcotic pain medication for me anymore. I've also now been referred to the local drug rehab center for evaluation and treatment. My legitimate health problems now have me lumped in with the local crackheads and heroin addicts. Isn't that just lovely. I'm so screwed.