More than 15 percent of American adults suffer from chronic facial pain, such as jaw pain, headaches or earaches.
The source of these aches and pains may be related to one or both of the temporomandibular (TMJ) joints. Located on each side of the head, these joints work together, with a complex system of muscles, ligaments, discs and bones, to make different movements for chewing and speaking.
But it has been proven that Virtually ANY professional TMD Treatment works for a few months. Then you get a relapse. My point is don’t be in a rush to seek professional treatment for TMD problems.
That is the purpose for this article. So you can make yourself comfortable at home, which techniques are absolutely reversible and may actually last longer than professional TMD Treatment.
What is TMJD/TMD?
Temporomandibular Disorder (TMD) refers to a variety of conditions that affect TM joints, jaw muscles and facial nerves. TMD may occur when the jaw twists during opening, closing or side-motion movements. People with TMD may experience these symptoms:
• pain in or around the ear
• headaches and neck aches
• tenderness of the jaw or jaw muscles
• jaw pain or soreness that is more prevalent in the morning or late afternoon
• jaw pain when chewing, biting or yawning
• difficulty opening and closing the mouth
• clicking or popping noises when opening the mouth
• sensitive teeth when no other dental problems can be found
TMD affects more than twice as many women (particularly those of childbearing age) as men and is the most common non-dental related chronic facial pain.
What causes TMD?
• Improper bite (how teeth fit together)
• Jaw dislocation or injury
Stress and TMD
Stress is thought to be a factor in TMD. Even strenuous physical tasks, such as lifting a heavy object or stressful situations, can aggravate TMD by causing overuse of jaw muscles, specifically clenching or grinding teeth (also known as bruxism).
“Mutifactorial” Other Contributing Factors to TMD
• Parafunctional habits (eg, nocturnal bruxing, tooth clenching, lip or cheek biting)
• Emotional distress
• Acute trauma to the jaw
• Trauma from hyperextension (eg, dental procedures, oral intubations for general anesthesia, yawning, hyperextension associated with cervical trauma)
• Unstable or ‘Crooked’ Bite
• Laxity of the joint
• Comorbidity of other rheumatic or musculoskeletal disorders
• Poor general health and an unhealthy lifestyle
• Most changes in occlusion (bite) are the consequence of TMD (symptom) rather than the cause (sign).
Not all of the following signs are evidence of TMD. Only the ones accompanied by: Pain, Swelling, Limited Opening or Locking of the Jaws either in the opened or closed position.
If You Think You Have TMD
Keep in mind that for most people, discomfort from TMD will eventually go away whether treated or not. Simple self-care practices, such as exercising to reduce teeth-clenching caused by stress, can be effective in easing TMD symptoms.
If more treatment is needed, it should be conservative and reversible. Avoid, if at all possible, treatments that cause permanent changes in the bite or jaw. If irreversible treatments are recommended, be sure to get a reliable second opinion.
Many practitioners, especially dentists, are familiar with the conservative treatment of TMD.
Pain clinics in hospitals and universities are also a good source of advice and second opinions for these disorders.
Success of Active and Placebo Therapies
• 75‐95% of primary care patients with various TMDs benefit from currently offered intervention administered by an array of health care providers with a wider array of treatment modalities – OAT, occlusal equilibration, thermal pads, medications, orthodontics, prosthodontics, surgery, physical therapy, relaxation training, acupuncture, biofeedback, psychological, and diet counseling, even placebo occlusal adjustments!
Primary Care Treatment of TMD
Treatment Component Description
• Education Explanation of the diagnosis and treatment
Reassurance about the generally good prognosis for recovery and natural course
Explanation of patient’s and doctor’s roles in therapy
Information to enable patient to perform self-care
• Self-care Eliminate oral habits (eg, tooth clenching, chewing gum)
Provide information on jaw care associated with daily activities
• Physical therapy Education regarding biomechanics of jaw, neck, and head posture
Passive modalities (heat and cold therapy, ultrasound, laser, and TENS)
Range of motion exercises (active and passive)
Passive stretching, general exercise and conditioning program
• Pharmacotherapy NSAIDs, acetaminophen, muscle relaxants, antianxiety agents, tricyclic antidepressants
• Behavioral/relaxation techniques Relaxation therapy
• Intraoral appliance therapy Cover all the teeth on the arch the appliance is seated on
Adjust to achieve simultaneous contact against opposing teeth
Adjust to a stable comfortable passive mandibular posture
Avoid changing mandibular position
Avoid long-term continuous use
Instructions to Patients for Self-Care as Part of Initial Therapy
Be Aware of Habits or Patterns of Jaw Use
• Avoid tooth contact except during chewing and swallowing.
• Notice any contact the teeth make.
• Notice any clenching, grinding, gritting, or tapping of teeth or any tensing or rigid holding of the jaw muscles.
• Check for tooth clenching while driving, studying, doing computer work, reading, or engaging in athletic activities and also when at work or in social situations and when experiencing overwork, fatigue, or stress.
• Position the jaw to avoid tooth contacts.
• Place the tip of the tongue behind the top teeth and keep the teeth slightly apart; maintain this position when the jaw is not being used for functions such as speaking and chewing.
Modify Your Diet
• Choose softer foods and only those foods that can be chewed without pain.
• Cut foods into smaller pieces; avoid foods that require wide mouth opening and biting off with the front teeth or foods that are chewy and sticky and that require excessive mouth movements.
• Do not chew gum.
Do not test the jaw.
Do not open wide or move the jaw around excessively to assess pain or motion.
Avoid habitually maneuvering the jaw into positions to assess its comfort or range.
Avoid habitually clicking the jaw if a click is present.
Avoid Certain Postures
• Do not lean on or cup the chin when performing desk work or at the dining table.
• Do not sleep on the stomach or in postures that place stress on the jaw.
Avoid elective dental treatment while symptoms of pain and limited opening are present.
During yawning, support the jaw by providing mild pressure underneath the chin with the thumb and index finger or with the back of the hand.
Apply moist hot compresses to the sides of the face and to the temple areas for 10 to 20 min twice daily.
Legal CMA Disclaimer:
Although this article may contain factual information, the information contained in this article has probably not been evaluated by the FDA nor is it in any way intended to be medical advice.
Unfortunately I must recommend that for any change in medical or health behavior or for any change in the way you use prescribed drugs by your healthcare providers or before acting upon any of the advice given in this or any other article, that you consult with your licensed healthcare provider or physician.
Dr. Locker and his friendly, knowledgeable staff invite you to
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greatest, most advanced, painless dental experience you have ever had.