I've had severe tmj type symptoms for two years. i have worn a mouth guard for one year with no improvement. any other reason for this pain?

Custom or OTC?: Wondering if the mouthguard that you are wearing was made by a dentist or bought over the counter? Also, mouthpieces alone usually don't help the tmd. Exercises, physical therapy, and change of habits are important. Tmd symptoms can often recycle and come and go. The way mouthpieces are made and adjusted by he dentist is also important. See a tmd specialist. Get another opinion!

Wrong guard: There are many types of guards. And the right device needs to be properly fitted and adjusted. Just because you've. It improved, does not mean the diagnosis is wrong. I would begin with a new doctor who has greater understanding about tmdisorders and begin with a more comprehensive diagnostic review. Let treatment evolve from there.

Multiple Causes: TMJ: We mostly see that muscles are the biggest cause of TMJ pain. You should see a TMJ specialist who knows and treats myofascial trigger points.

Yes: Yes. Many reasons. You need to be evaluated by a TMJ expert. If you're seeing an "expert" with little improvement, get a second opnion. Consider seeing a TMJ surgeon for an opinion.