Key Points For Healthcare Providers
Can Lyme Disease Cause Dental Problems
The connection between dental health and Lyme disease isnt widely understood. This could be due to the fact that dental symptoms are rarely at the forefront of the infection. The connection is there, though, and having Lyme disease can affect oral health in many ways. When it comes to dental health, specifically, Lyme disease can lead to a condition known as temporomandibular joint dysfunction .
TMJ disorders affect the temporomandibular joint the joint that connects the jawbone to the skull. Each person has one joint on each side to ensure the proper opening and shutting of the mouth. When a person suffers from a TMJ disorder, they can experience symptoms such as pain in the jaw joint and muscles that are responsible for the movement of the jaw, and have difficulty opening up the mouth. Lyme disease can cause facial pain that can mimic or present as a TMJ disorder.
Image by Kassidy Sherburne on Can Lyme disease affect your gums?
Neck Pain From Lyme Disease
Lyme disease is commonly associated with tick bites and a big circular rash. However, a tick bite does not hurt and many people do not recall being bit or seeing the rash. Further complicating matters, Lyme disease symptoms may start out minor and not become problematic for months or longer.
Lyme disease causes neck pain in more than 30% of cases. Watch:Neck Pain Causes Video
Media reports rarely focus on neck pain with Lyme disease, but some estimates note that it occurs in more than 30% of the cases and is typically one of the earlier symptoms.1 Recognizing Lyme disease early and seeking treatment can make a big difference in the outcome.
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You Have More Than One Symptom
Lyme disease is a multisystemic illness. That means that people dont usually complain of just one symptom, but instead notice a cluster of symptoms, such as:
- Chest pain with palpitations
- Psychiatric symptoms such as depression and anxiety
Others may also complain of day sweats, night sweats and chills, as well as shortness of breath, with an unexplained cough if they have contracted babesiosis. A different tick-borne infection than Lyme disease, babesiosis can be transmitted with the same tick bite. It’s a malaria-type parasite which makes people much sicker and difficult to treat with resistant symptoms.
Chronic Lyme Arthritis: A Mystery Solved
- By John Ross, MD, FIDSA, Contributing Editor
In 1975, researchers from Yale investigated an epidemic of 51 patients with arthritis who lived near the woodsy town of Lyme, Connecticut. The most common symptom was recurrent attacks of knee swelling. A few had pain in other joints, such as the wrist or ankle. Many had fever, fatigue, and headache. Some remembered a round skin rash before the onset of knee swelling.
We now know that Lyme disease is an infection acquired from tick bites, caused by a spiral bacterium named Borrelia burgdorferi. After a tick bite, Borrelia bacteria wriggle through the skin away from the bite site. This leads to a circular red rash, known as erythema migrans. In its more advanced stages, erythema migrans may take on a bullseye appearance. Many people are unaware of the rash, as it is usually painless, and ticks may bite in less visible locations, such as a buttock or shoulder blade.
Lyme disease is diagnosed with blood tests that detect antibodies to B. burgdorferi. Two-step testing is traditionally performed. A rapid enzyme immunoassay is performed first. If this is positive, a more time-consuming Western blot test is sent for confirmation. The FDA recently approved two rapid tests for Lyme disease that are performed simultaneously, reducing the turnaround time.
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What Is Neurologic Lyme Disease
Neurologic symptoms of Lyme disease occur when the Lyme disease bacteria affect the peripheral or central nervous systems.
- Cranial nerve involvement: When the cranial nerves are affected, facial palsy can occur on one or both sides of the face.
- Peripheral nerve involvement: When the peripheral nerves are affected, patients can develop radiculoneuropathy which can cause numbness, tingling, shooting pain, or weakness in the arms or legs.
- Central nervous system involvement: When the central nervous system is affected, Lyme meningitis can cause fever, headache, sensitivity to light, and stiff neck.
Out of every 100 patients whose cases are reported to CDC, 9 have facial palsy, 4 have radiculopathy, and 3 have meningitis or encephalitis. Because of reporting practices, this statistic may overestimate how often these manifestations are seen by clinicians.
The Pain Changes And Moves Around The Body
Another classic trait of Lyme disease is the migratory nature of the pain. The muscle and joint pain, as well as the tingling, numbness and burning sensations often tend to come and go and move around the body. For example, one day the joint pain might be in the knees and a few days later it may be affecting another nerve. Especially when untreated, research says Lyme disease can spread to the joints, heart, and nervous system.
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Facts About Lyme Disease
- You can only be exposed to Lyme disease from the bite of a specific infected tick, so you cant get it from just any tick bite. In the western United States, the disease is passed on by infected Western blacklegged ticks.
- Lyme disease is present on every continent in the world except for Antarctica. All 50 states have now reported Lyme disease. Utah was once considered a Lyme disease-free state, owed to the long, cold winters. But in recent years, the cases of confirmed Lyme disease have risen significantly in the Beehive State.
- Although a bullseye rash is the sure telltale sign of an impending infection, fewer than half of those bitten by an infected tick demonstrate this symptom.
- Lyme symptoms dont always come up immediately. Some people dont develop any symptoms for months, years, or even decades after the initial infected bite.
- Other than the rash, common symptoms of Lyme disease may include stiff neck, muscle pain, headaches, lightheadedness and fainting, jaw pain, swollen lymph nodes, gastrointestinal issues, vision problems, confusion, memory lapse, and swollen, painful joints, especially in the extremities such as knees and ankles.
- Left untreated, these symptoms can become chronic issues. While your symptoms can still be treated, the damage thats already be done may not be reversible.
- Even with treatment and early intervention, theres a chance that Lyme disease could become chronic in some individuals. Doctors are still unsure why this occurs.
When Should I Go See My Doctor
Anyone who has been bitten by a black-legged deer tick is at risk for Lyme disease. The highest risk groups include those living in or visiting endemic areas, especially people who spend significant time outdoors such as gardeners, hikers, or outdoor workers.
Patients should seek advice from their doctor if they have a suspicious round expanding red skin lesion, and/or show signs of summer-flu, particularly during Lyme disease season, which is highest-risk late spring through July/August. If those circumstances apply or symptoms persist it is very important to go to a physician.
For the west coast and other more temperate regions Lyme disease can be a year-round concern.
In the later disseminated stages, Lyme disease can be a much more insidious and complex illness. An individual should seek medical care if experiencing symptoms such as prolonged fevers, unexplained fatigue, painful joints, new or unusual headache, or heart or neurologic symptoms. If unexplained viral-like symptoms last for more than 1-2 weeks, please seek the advice of a physician.
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Three Phases Of General Clinical Manifestations
- Early localized: distinct, bulls eye or target skin lesions in warm areas of the body that may itch, burn or hurt.
- Early disseminated: if treatment is not initiated involvement of brain or heart may occur.
- Late disease: also called as Post Treatment Lyme Disease Syndrome , this phase leads to muscle and bone involvement.
. They appear corkscrew shaped. If left long enough they form colonies and you can watch them attack immune cells like neutrophils, leukocytes.
What Is Lyme Disease
Lyme disease is a tick-borne illness. If you get a tick bite, the animal may transmit to you a bacteria that will spread through your body, causing numerous symptoms. Lyme disease can be fatal and it can result in lifelong disability. Early treatment is generally successful with a two-week course of antibiotics, but if the disease goes undetected, it may be untreatable.
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Open Communication Could Save Your Life
At B & D Dental Excellence, we know that keeping you healthy takes the combined minds of many medical professionals and your own self-advocacy. Many known conditions and diseases present similar symptoms to one another. This makes it difficult to diagnose the problem for some individuals on the first try. The same can be said about jaw pain. We encourage you to maintain open communication with all of your medical providers about your symptoms to make sure that you receive the correct treatment whether for TMJ or Lyme disease.
For more information about treating jaw pain and symptoms of TMJ, please call or contact us online for an appointment at B & D Dental Excellence in West Nyack.
About Dr Gloria Maczuga
Dr. Gloria Maczuga-Stern has practiced general dentistry in New York and Connecticut for 19 years. Her own personal experience with TMD led her to pursue further training for her pediatric, adult, and geriatric patients. At the Center for Sleep & TMJ Disorders she has been providing conservative, non-invasive treatment to patients with sleep breathing and temporomandibular joint disorders since 2008.
Dr. Stern strives to provide her patients with the highest level of care. Passionate about continuous education, she has over 2,500 hours of advanced education including orofacial pain, tmj disorders, and sleep disorder dentistry. As a result she is able to offer her patients the latest advancements in this field.
Dr. Stern received advanced training in temporomandibular disorders and sleep disorder dentistry from the Institute of TMD and Sleep Disorders and the Craniofacial Pain Center at Tufts University, and is a Diplomate of the American Academy of Dental Sleep Medicine as well as a Certificate holder of the of American Academy of Integrative Pain Management.
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The Link Between Lyme Disease And Dental Health
Most spirochetes are free-living and anaerobic. They are cork screw shaped. They flourish in an environment that supports this condition.
Acidosis which reduces available oxygen to the cells can contribute to the increased presence of this bacteria. Every time the oral pH is less than 6.5 it is usually correlates to seeing spirochetes in the gums. We encourage our clients to work on their pH and keep an alkaline mouth. We provide tips on how to be alkaline.
Root canal treated teeth harbors spirochetes in record numbers in their dentinal tubules. Spirochetes are usually seen with chronic periodontitis which also presents with systemic inflammation symptoms.
A simple plaque sample under phase contrast microscope or a histopathological slide of a root canal treated tooth can reveal spirochetes. Root canal treated teeth can be sent to DNA connexions lab for testing to see what pathogens reside in them and usually spirochetes are one among them.
It has been observed that Lyme and many other chronic diseases are fed by spirochetes that develop in root canals where teeth have been extracted. Lyme bacteria exists in the teeth, not in the enamel. The spirochete bacterium love to occupy in the dentin and some up to three miles of tiny tubules.
Can You Tell The Difference Between Tmj And Lyme Disease
Ticks, a problem all across the United States, lurk in tall grasses and latch onto unsuspecting victims. A bite from a deer tick, one of the most common ticks around, could infect you with Lyme disease. This inflammatory disease can incubate for months, even years before significant symptoms manifest. Even then, a person might mistake their symptoms for other conditions. One condition that Lyme disease often looks like is temporomandibular joint disorder . Knowing other symptoms associated with Lyme disease could help you find the right diagnosis before serious damage occurs.
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Lyme Disease And Oral Health
Lyme disease is well known, but the popular understanding of the condition is often wrought with misconceptions and partial understandings of what the illness is and does. In particular, many of the long-term health complications resulting from Lyme Disease are often underreported. This applies to the complex relationship between Lyme Disease and oral health, which can have serious implications for the person dealing with the illness. As we move into summer, lets take some time to learn about Lyme Disease and how it can affect your mouth, teeth, and gums.
Symptoms Of Oral Presentations
Symptoms associated with Lyme disease include headache and facial pain that often mimics dental pathology and temporomandibular disorders.
Other oral symptoms can be:
- Dry mouth
- Pulpitis, or the oral inflammation of dental pulp
- Bells palsy, or partial facial paralysis
- Cranial nerve palsy may occur in early disseminated disease. Bells palsy is a form of usually temporary facial neuropathy resulting from inflammation/damage to the seventh cranial nerve
- Involvement of the saliva producing glands may manifest as brief inflammation of the gland.
- Bad Breath in spite of impeccable hygiene.
- Acidic oral pH.
Sometimes the dental patient may present nonspecific orofacial pain and headaches that can mimic temporomandibular joint pain. Dentists should consider Lyme disease as a possible cause if a patient presents these or related symptoms and has no specific oral health problem. These patients should be referred to a physician.5
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Tmj Disorder And Lyme Disease Have Similar Symptoms Yet Require Very Different Treatments
Your jaw hurts, maybe you’ve got a headache, your neck is stiff, and you’re having trouble remembering things. After searching the internet, calling your friend-of-a-friend doctor, and briefly letting your mind wander to all the horrible possibilities, you sit breathless on the couch, just as confused as when you started.
Its always wise to consider all the possibilities, but in the case of a TMD, it can be tricky to rule out Lyme Disease since the two present eerily similar symptoms. And misdiagnosis can be costly– if Lyme Disease goes untreated, it can cause facial palsy or even death. Similarly, an improper Lyme diagnosis could land you on antibiotics that not only dont cure your TMJ, but create new problems.
How To Prevent Lyme Disease
You may be at elevated risk for Lyme disease if you have been walking in grassy or wooded areas where ticks hang out, questing for prey.
Once a tick latches on to you, it will crawl around looking for a place to burrow into your skin to drink your blood. It may take the tick several hours to find a suitable place, so taking a shower a couple hours after being out in tick-infested areas can reduce your risk. Take this opportunity to look for ticks. Remember, some ticks may be as small as poppy seeds, so do a thorough check, and dont neglect areas like between your toes or between your legs.
If you find a tick, remove it by grasping it by the mouthparts with a pair of pointed tweezers. A tick must be attached for about 36 hours to transmit the bacteria.
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Symptoms Of Lyme Disease And Tmj
The reason why were calling attention to Lyme disease is that it shares many common symptoms with TMJ. These include:
- Joint pain, including jaw joint pain
- Numbness in the limbs
The most common symptoms of Lyme disease that separates it from TMJ are the bulls eye rash that often appears around bites, and a bout of fever and other flu-like symptoms.
If you are suffering jaw pain and have been checked out for Lyme disease, you likely have TMJ. To schedule a TMJ evaluation, please contact Smile Columbia Dentistry in Columbia, SC today.
Symptoms Of Both Tmd And Lyme Disease Include:
To distinguish a TMD, which is most often caused by jaw clenching and teeth grinding, look for:
- Ear pain and hearing loss
- Jaw clicking
To distinguish Lyme disease, which is caused by bacteria-infected ticks, look for:
- Erythema Migrans rash, or a bullseye pattern centered on the site of the tick bite
- Shortness of breath and irregular heartbeat .
- Flu-like symptoms including fever and chills
Believe it or not, we encounter this scenario quite often. Understanding the differences between the symptoms of a TMJ disorder and Lyme Disease will help you avoid misdiagnosis and make an educated decision about treatment options. Certainly check with your primary care physician and/or ENT specialist to confirm that it’s Lyme Disease. If its a TMD, schedule a consultation with Dr. Stern and put your pain in the past.
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Farmington Hills Tmj Dentist Warns Lyme Disease Symptoms Are Similar To Tmj
With the arrival of summer comes a great nuisance: ticks. Dog and cat owners know well the inconvenience of a tick attack, and most humans know to avoid them altogether if possible. What you may not know is the danger ticks pose to yourself as well as your pet. Perhaps the most notorious risk is Lyme disease. The symptoms of Lyme disease include headache, fatigue, and other symptoms similar to temporomandibular joint dysfunction , and can easily be confused with the jaw joint dysfunction. Dr. Askari provides further information and warns against misdiagnosis of TMJ based on symptoms.
What is Lyme Disease?
If a blacklegged tick bites a mouse or deer that is infected with Lyme disease, the animal picks up the bacteria Borrelia burgdorferi . If the same tick bites you, the bacterial infection may cause Lyme disease. Because blacklegged ticks are almost too small to see, many people with Lyme disease never even noticed a tick on them. There are three stages of Lyme disease. The first stage, or early localized Lyme disease, occurs when the infection is not yet widespread throughout the body. First-stage symptoms of Lyme disease usually begin days or weeks after an infection and include body-wide itching, fever, headaches, muscle pain, and stiff neck. If you did notice the tick that bit you, you may have forgotten about it by the time you exhibit symptoms of infection. The delayed reaction is another common cause for misdiagnosis of Lyme disease.
Are You Sure its TMJ?