eustacian problems post wisdom extraction

[oeconomicus]

About 7 years ago I had my wisdom teeth extracted (all 4).  I had infections in both lower sockets after the extraction for which i was prescribed antibiotics.  About 6 months after the extraction both of my ears filled with pressure similar to what happens on an airplane and it has turned out to be chronic, the pressure never dissipated on its own.  I went to my primary care physician who made me feel as if i "didn't really need to go to an ENT," but i could if i wanted to.  So feeling the resistance from my doctor i reluctantly did not go see the ENT.  

Because the pressure never dissipated I started to do what i could to relieve it, which was opening my jaw as wide as I could, and clenching it as hard as I could, which would help to relieve the pressure temporarily.  I then switched primary care doctors and he said I have TMJ, "theres nothing I can do and I won't give you a referral to an ENT."

As you may guess, after more than five to seven years of this, my jaw and teeth are really screwed up and there is still pressure in my ears. My jaw joints hurt, i can pop both of them similar to cracking a finger knuckle, and it feels like there is fluid in both sides.

In addition to this, my two lower middle front teeth have worn through the enamel and now have a chisel like sharp edge on top.  Because the edges are thin, they have chipped and are now serrated like a steak knife. (one chip happened during my last cleaning). A also started to bite the sides of my cheeks at night and eventually my jaw started to clench all night so as not to bite through the side of my cheeks.  I try not to do this but it has become automatic when i fall asleep. I started to wear a dental guard at night and my jaw still clenches all night. My jaw doesn’t grind, it clenches tight all night after I fall asleep.

Now I cannot close my jaw without using extreme force. I can only comfortably close it to where only two teeth on the right side of my mouth touch. If I go further my lower jaw must flex to make all teeth meet.  My x-rays now show bone loss etc. What should I do?

Forever indebted, seriously, for any advice. Thanks-

[oeconomicus]

Thanks for the reply scottma.  I've thought about a different guard. The one I have is a boil and form which fits well but maybe a different type would help better.  My current primary care doctor, the third I have switched to, is working with me to get a referral to an ENT. I guess if the ENT is not competent with TMJ, I hope they will refer me to a doctor that is. All this provided my HMO allows the ENT referral.

Thank you kindly

[scottma]

Seeing a competent tmj specialist is advised. A well made night guard generally will stop clenching or bruxism. The only purpose of night guard is to establish an ideal occlusion which is compatible with neuromuscuoskeletal function of masticatory system
It appears that your current night guard is not doing the job. Although maybe all night guards look similar, a device made by a competent pratitioner can make significant difference.