Most of the time, if you visit your dentist and tell him you're experiencing TMJD symptoms, he will suggest fitting you for an occlusal guard, also known as a bite splint or a night splint. This serves several purposes - protecting your teeth and gums from the wear and tear caused by grinding or clenching during your sleep, helping to optimally reposition the jaw joint, muscle relaxation, and altering the inputs the muscles and joint receptors in the TMJ provide to the brain, which ultimately can lead to an inhibited reflex from the trigeminal nucleus in the pons medulla, AKA less pain!1
But is that enough to promise relief from the clicking, popping, pain, headaches, and limitation in movement? Studies on the efficacy of splints alone in treating TMJ dysfunction are inconclusive.2 This does not mean that they do not serve a purpose or just plain don’t work, but it does mean that there are other non-invasive treatments (like physical therapy!) that may help in conjunction with the right splint.
Your physical therapist can help make sure your horizontal occlusal plane (read: the way you bite and where you contact first with your teeth) is level through addressing postural and mechanical problems, aid in relaxing areas in your head, face, and jaw muscles that are painful from overuse even at rest, and work with your dentist to make sure your splint is appropriate for the changes your bite may undergo during treatment. The right combination of treatments is an effective and cost-efficient approach to making sure your jaw is stable and able to function properly while you bite, chew, smile, yawn, and sleep. Unsure if your splint is doing enough to get you relief? Ask your dentist to refer you to HouseCall Head and Neck for physical therapy, it may be the smartest health move you’ll make!
1. Okeson, J. 2013. Management of Temporomandibular Disorders and Occlusion. 7th Edition.
2. Dao, TT; Lavigne, GJ. “Oral splints: the crutches for temporomandibular disorders and bruxism?” Critical Review of Oral and Biological Medicine. 1998; 9:345-361.
(Image courtesy of http://teethgrindingsupport.com/clenching-teeth-jaw-use-mouth-guard-clenching/)
Happy TMJ Awareness Month! Fall is notorious for jaw pain, and the culprits are all things you’ve likely eaten this season. Now you probably won’t be eating pumpkin quite like this guy, but here are a few things you might want to think twice about putting on your plate this Thanksgiving if you have popping, clicking, or pain with chewing or opening your mouth:
-Corn on the cob
-Tough, thick cuts of meat
Repetitive motions such as prolonged chewing (think chewing gum) can fatigue the jaw through unnecessary stress put on the TMJ muscles and ligaments. Similarly, opening too wide to bite into an apple or corn on the cob can lead to not only pain, but sometimes even what we call an acute closed-lock, or lockjaw.
The best way to combat jaw pain during your holiday parties is to pick softer foods or cut up food into smaller, more manageable bites. Sweet potatoes, tender cuts of turkey, cranberry sauce, and pumpkin pie are all TMJ-friendly foods, and are good for you, too!
If you do start to experience a sudden, sharp onset of jaw pain or difficulty opening your mouth, visit your dentist as soon as you can. They may be able to prescribe some medications to help with the discomfort, and they may also refer you to physical therapy to help regain any lost motion and help stabilize your jaw so you are able to enjoy your favorite holiday foods without pain or limitation. Don’t wait for your dentist to refer, ASK for a physical therapy referral! Patients who receive physical therapy from a trained craniofacial PT in conjunction with dental interventions get better faster and more completely than those who only have dental treatment. Take this referral form with you when you go.
We have so much to be thankful for at HouseCall Head and Neck, and wish you and your family a Happy Thanksgiving full of love and gratitude.
For as many people as there are who suffer from jaw pain, very few know that physical therapy can help alleviate their symptoms, and even fewer understand how it can help. I'm here to answer some frequently asked questions about physical therapy for the TMJ, and inspire hope in those who feel like they've tried everything and are still suffering. This is the first post in a series of posts, so keep a lookout on our Facebook page for updates. And while you're there, give us a like if you haven't yet!
"So, how does physical therapy work for the jaw?"
I'm asked this question a lot! Physical therapists who are trained to treat patients with jaw (or TMJ) pain focus on the big picture in what is causing the dysfunction. The TMJ (short for temporomandibular joint) is controlled by muscles in the face and neck, and when these muscles don't function properly, it can lead to poor movement patterns which can cause painful clicking, popping, and locking in the joint. While patients often come to me with a primary complaint of pain in their jaw or face, the underlying issue is almost always their posture. Sometimes patients recall having pain in their neck or head when asked, but others forget even having pain until I bring it up!
On the first visit, I perform a thorough examination of the cervical spine, face, and jaw, and assess movement and posture. This gives me an idea of what factors are at play in the mobility of the TMJ. From there, I implement manual therapy techniques to help relax muscles and improve mobility in areas that are stiff, and also teach my patients specific exercises to help alleviate their pain and improve function between treatment sessions. Other important components to therapy treatments include muscle relaxation techniques, and neuromuscular re-education to retrain muscles to function properly, identifying habits that are detrimental to daily function, stress management solutions, and lifestyle modification.
"I wake up with headaches, my jaw hurts, and sometimes even pops and clicks when I open my mouth too far. Can I come to you for treatment?"
Absolutely! Before we get started, be sure to ask for a referral for physical therapy from your dentist, physician, or nurse practitioner. There are a few other providers who can refer you, too. When you ask them, take this form with you and have them fill it out, then email it before your first visit or have it handy at your initial evaluation. Also, check out our Getting Started page, and fill out those forms beforehand. After that, we can start getting you back to your personal pain-free best!