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December 29th, 2010
09:33 AM ET

Ask a dentist about jaw problems

Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University and an expert in the mind-body connection for health, responded to a reader question about antidepressants and jaw pain yesterday. He would like to add the following, based on a comment about the post:

To my readers,

Every once in awhile I get a response to one of my mental health answers that I feel deserves to be posted. Below is such a response pointing out that for the patient with depression, tinnitus (ringing in the ears) and temporomandibular joint (TMJ) problems I failed to mention that a dental consult would also be indicated. I agree completely and appreciate Dr. Friedlander providing this excellent suggestion. Antidepressants can make people grind their teeth (i.e. bruxism) as a result of changes in brain neurotransmission. Bruxism, in turn, can lead to TMJ. Being a “grinder” myself, I know how valuable a night guard can be!

Dear Dr. Raison:

I recently encountered your response on CNN to a woman receiving antidepressant medication for major depressive disorder. The patient complained of developing comorbid tinnitus and pain in the temporomandibular joint in association with either the underlying illness or the medication regimen. I concur with your suggestion of an ENT consult but would suggest that your omission of a referral to a competent dentist to fabricate a night guard to ameliorate the TMJ pain and certainly damage to the dentition [in the eventuality that the medication regimen could not be altered] was incomplete. It is believed that SSRIs and AAs may cause bruxism because these medications increase extrapyramidal levels of serotonin, thereby inhibiting dopaminergic pathways that control movements [Bostwick JM. J Clin Psychiatry 1999 ; Brown ES. J Amer Dent Assoc 1999].

Sincerely,

ARTHUR H. FRIEDLANDER, DDS
Associate Chief of Staff for Education / DLO
VA Greater Los Angeles Healthcare System


soundoff (4 Responses)
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    Next is something that would change my view of the legal system in Georgia. WSB News ran a story live that Redshield Entertainment hired and did not pay employees. I did my best by phone to explain as a re-seller of Clearwire mobile Internet service commissions were paid to my Redshield Entertainment in sixty days. Clearwire pays Redshield Entertainment then my sales representative get commissions earned. A reporter contacted by Mathew S. McCloy and Holly Madison knowingly lied on air, resulting in Clearwire revoking my agreement due to bad press. Norcross Police Department began harassment daily. Two weeks prior Mathew and I, at my place of business, got mail rejecting activation of my utilities due to incomplete application. As I opened the envelope I saw my company check and three other documents with my signature forged. Mathew confirmed Holly had attempted to put utilities in Redshield Entertainment's name. Holly had not come in that day so I called her to find out why, and who authorized her to sign my name. She also produced a memo on my behalf authorizing herself and signed my signature. She shouted at me over the phone and quit. I then instructed Mathew to file a complaint for me, due to my personal issues with Officer Butynski, this would prove to be not one of my brightest decisions. Norcross Detective Beverly Parnell badge number 120 with Officer Butynski influenced her and her report stated, "Warrants were not obtained on Mrs. Maddison because of lack of information at the time of the report.", even with all the documentation presented and Mathew's statement that Holly had forged my signature. In less than two weeks from this filling I was charged with felony forgery in my False Report of a Crime warrant. If you are reading this you must be thinking, huh? Yes, yes, yes this is my whole case! This is Georgia legal system in full effect.

    As you can see, there are several factors working against me in this criminal case. Even though a person like myself can be innocent, like on television shows the police, prosecutor demonize the accused and definitely work against the defendent. An investigation that may be based on false evidence only made important by police officers bent on malicious motives taking the attention off the actual charge being brought. I now rely on the media to get involved as I take legal precautions in this situation.

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