Tuesday, May 20, 2014

TMJ, TMD and Jaw Pain



The temporomandibular joints (TMJ) are the structures that attach the lower jaw to the rest of the skull.  The TMJ along with jaw muscles, tendons and ligaments allow the jaw to move during chewing, swallowing, speaking and sometimes breathing.  TMJ Dysfunction (TMD) is a group of different disorders with similar symptoms.  Of the many different symptoms that can occur, the most common are pain and difficult or limited jaw movement. These symptoms may be due to a problem with the joint itself or more commonly, hyperactivity and spasm of the jaw muscles. Grinding and clenching of the teeth and chewing gum are the most common habits that cause TMD.  You can reduce muscular hyperactivity and prevent pain by practicing some simple exercises and avoiding things that cause muscle tension.

TMD can be managed by exercise/stretching, behavior modification, diet modification, physiotherapy and massage therapy. In some patients, appliances such as biteplates and night guards can be helpful. Medication such as ibuprofen may be used as needed short term and prescription medication such as muscle relaxants may also be needed.

It is important to understand that the majority of TMD problems are muscular. As such, they are usually self-limiting and most would resolve without treatment. The therapies are intended to speed recovery, provide pain relief and prevent re-injury. For more serious conditions, treatment by a medical and/or dental specialist may be necessary.

Exercises to stretch jaw muscles
The purpose of jaw exercise is to stretch the jaw muscles, rest them and prevent them from going into spasm.  Jaw exercise is designed to stretch the jaw muscles similar to the way an athlete stretches muscles before and after physical activity.   

Behavior modification
People who have TMD often have habits that cause the muscles to become exhausted and lose their ability to elongate.

Common habits to avoid
Tooth contact - your teeth should only touch a total of 20-30 minutes per day and only during chewing and swallowing
Clenching your teeth
Leaning you chin into your hands
Biting on pens, pencils, straws or other objects
Biting on cheeks, lips or fingernails
Chewing on ice
Intentional clicking, popping or side to side shifting of the jaw
Wide yawns (limit opening by keeping your tongue against the roof of your mouth)

Work tendencies to avoid
Cradling the phone between you head and shoulder (use a headset)
Spending hours in front of a computer without a break (get up hourly and take a five minute break)
Using a laptop computer while sitting on a bed or laying on the floor
Carrying a heavy bag or knapsack

Diet Modification
During episodes of TMD, a soft diet allows sore muscles to rest.

Food to avoid
Hard foods - hard bread, bagels, pretzels, pizza crust, hard fruits and uncooked vegetables
Hard to chew foods - tough chewy meats and chewy candy
Foods that require wide opening - apples, large heroes and sandwiches

If you think you may have TMD, it is best to seek a consultation with a healthcare professional.
Dr. Frank R. Egan
www.TeethOnTheMove.com

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