Temporomandibular Joint dysfunction (AKA TMJ syndrome) more commonly affects women than men. Symptoms can include any of the following: jaw pain with wide opening of mouth  (i.e. to bite an apple), pain with chewing (i.e. taffy or a piece of steak), jaw clicking with opening /closing of the mouth, ear pain and/or fullness, ringing in the ear(s), neck pain, headaches.  Many people (including physicians and dentists) do not realize there is Physical Therapy treatment available for these dysfunctions.

The temporomandibular joint can become irritated from activities such as clenching or grinding of the teeth, chewing on pens/pencils, excessive gum chewing, biting fingernails, increased stress levels (which then increases tension in the neck, shoulders, face and jaw), poor posture (the head sits too far forward on the body and this affects the alignment of the neck and jaw), and/or a history of extensive orthodontia work.  The muscles which control the jaw (i.e. used for chewing) are forced to work “overtime” and thus increased stress is placed upon the joint.   There are different joint structures which can become inflamed and irritated (joint capsule, articular disc, ligaments).

Take into consideration the following: the only time our bottom teeth meet our top teeth is when we swallow.  As the teeth meet, the tongue raises up to the roof of the mouth to push the food/water back to swallow.  As we chew, there is asymmetrical activity occurring on one side of the mouth versus the other (i.e. certain teeth come into contact and others do not).  This is important to realize especially for those who clench or grind their teeth.  In both situations, the teeth are coming together for an excessive amount of time and with excessive force over time.  You can then see how this could cause dysfunction to the joint and the surrounding muscles.

If you are clenching your teeth during the day, the first step is to complete “clenching checks” throughout the day to break the habit. If you find yourself clenching your teeth: 1. place your tongue on the roof of your mouth (behind your front teeth) 2. while maintaining that tongue  up position, gently open your mouth about 50% of full opening and then return to a relaxed closed position 3. repeat this five times.  This sequence will help decrease the tendency to clench your teeth.

A mouth guard (usually made by your dentist) can be worn at night to protect your teeth and help reduce tension from teeth grinding.

Physical Therapy can help this situation in many ways.  Treatment focuses on improving joint mobility of the jaw and decreasing tender and trigger points via myofascial release and soft tissue mobilization.  These hands-on techniques help to restore normal joint mechanics and help to relax the muscles of chewing as well as surrounding neck muscles.  Your Physical Therapist (PT) will also educate you on topics such as correct posture, joint protection techniques and exercises to improve jaw motion.  Most often, headaches related to TMJ dysfunction will decrease in frequency and intensity.  In most situations a person with this dysfunction will have to work hard at staying symptom-free.  After working with your PT, you will have a new sense of awareness of your jaw, neck and posture and will have learned how to maintain optimal functioning.  For more information contact abyington@probilitypt.com.