Thursday, October 17, 2013

Self Care Program For Temporomandibular Joint Disorders (TMJ)


Noises in the jaw joint are extremely common and do not automatically mean that something is wrong. Like your knee or shoulder, the TM joint and/or muscles in our jaw can be strained or injured. The injury can be the result of a specific trauma or can result from prolonged microtrauma due to oral habits. Once a joint or muscle is strained, it can be easily re-aggravated like a sprained ankle which is subsequently more prone to re-injury. Because we use the jaw for so many activities (talking, eating, yawning, and laughing etc), TOTAL relaxation of the jaw joint and surrounding muscles is difficult. However, holding the jaw muscles and joints in a relaxed position is very manageable with practice. This plus avoidance of activities that would overwork the area will be helpful to reduce pain and prevent additional strain. The following suggestions should help:

1. Eat a Pain-Free diet. Avoid hard foods, such as nuts or bagels. Avoid chewy foods such as steak or candy. Cut fruits into small pieces and steam vegetables. Chew with your back teeth rather than biting with your front teeth. Eat anything you want as long as it does not cause pain or locking in your jaw. If "normal" food causes pain, put any food you like in a blender and start on grind. Blend the food to the chewiest consistency that does not cause pain or locking in your jaw. Do not stay on a soft food diet too long and periodically increase the hardness/chewiness of your diet as tolerated. Discuss the details of your diet with your dentist or therapist. Chew your food on both sides at the same time to reduce strain on one side. Specifically, cut your food into its normal size, cut that in half and put one piece on both sides of your mouth and chew. This will take practice.

2. Tongue Up, Teeth Apart (Tatu), And Jaw Muscles Relaxed. The teeth should never be touching/resting together except occasionally they touch lightly with swallowing. We suggest that you closely monitor your jaw position during your waking hours so that you maintain your jaw in a relaxed, comfortable position. This involves placing the tongue lightly on the roof of your mouth while allowing the teeth to come apart, and relaxing the jaw muscles. Another option is to practice "clucking" your tongue.

3. Avoid nicotine and minimize caffeine. Caffeine is a "muscle tensing" drug and can make your muscles feel tighter. Caffeine or caffeine-like drugs are in coffee, tea, soda, "energy" drinks, chocolate and some aspirins. Decaffeinated coffee typically has half as much caffeine as regular.

4. Avoid oral habits that put strain on the jaw muscles and joints. These include teeth clenching, teeth grinding, touching or holding the teeth together, biting fingernails, cheeks, lips, pens or pencils etc. DO NOT CHEW GUM. Avoid resting your jaw on your hand and activities that involve wide opening of the jaw such as excessive yawning.

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