TMJ Self-care
The jaw joint just in front of the ears is the TMJ. This is the TemporoMandibular Joint. Individuals experiencing orofacial pain (pain in the head and neck areas) should have a thorough examination to identify the source of pain, which may be from the TMJs, muscles, nerves or many other structures.
Noises in the jaw joints are very common in the general population. As in any joint (wrist, hip, knee), the TMJ or muscles in the jaw can be strained or injured and this is most commonly a result of overuse of the system.
The jaw system is used for numerous activities (talking, eating, yawning, laughing) and when it is not engaged in these activities it should be allowed to rest. The joints and muscles are involved in so many activities it is difficult to allow for this rest period. Frequently humans develop activities (clenching the teeth, fingernail biting, gum chewing) that are not part of the usual functional activities creating additional loads and strains to the system not allowing a sufficient resting/healing period. Regular attempts to relax the jaw and not overwork the area helps reduce strain and discomfort. The following suggestions are designed to reduce injury and discomfort.
Noises in the jaw joints are very common in the general population. As in any joint (wrist, hip, knee), the TMJ or muscles in the jaw can be strained or injured and this is most commonly a result of overuse of the system.
The jaw system is used for numerous activities (talking, eating, yawning, laughing) and when it is not engaged in these activities it should be allowed to rest. The joints and muscles are involved in so many activities it is difficult to allow for this rest period. Frequently humans develop activities (clenching the teeth, fingernail biting, gum chewing) that are not part of the usual functional activities creating additional loads and strains to the system not allowing a sufficient resting/healing period. Regular attempts to relax the jaw and not overwork the area helps reduce strain and discomfort. The following suggestions are designed to reduce injury and discomfort.
- Apply heat to the area of discomfort 2-4 times per day for 10-20 minutes each time. Do not exceed 20 minutes at any session as excessive heat may result in swelling. A microwave gel-pack, water bottle, heating pad or moist heated hand towel are all acceptable. Some individuals find alternating between heat and ice brings more relief. When using ice, there may be an initial burning sensation as the skin becomes cold, this is normal. Apply the ice only until numbness is sensed, then remove the ice.
- EAT A PAIN-FREE DIET. Avoid hard or chewy foods such as bagels, gum, caramels, raw carrots, hard breads, steak and candy. Blendered foods, cutting fruits into small pieces and steaming vegetables are all helpful. Chew with the back teeth and avoid opening wide and biting into large portions of food (apples, large sandwiches). The key is not to cause pain when eating. Also, do not stay on a soft diet for extended periods, periodically increase the firmness of the diet as tolerated.
- Chew food on both sides at the same time to reduce the strain on one side. Cut the food bites in half and place ½ on each side of the mouth. This will seem awkward initially, but manageable with practice.
- TEETH APART AND JAW MUSCLES RELAXED:
The teeth should only touch when chewing and swallowing. The remainder of the time the teeth should never touch, not even resting together lightly. The jaw position should be relaxed and comfortable. Some individuals prefer to have the tongue resting in the floor of the mouth just behind the lower front teeth and others prefer to have the tip of the tongue resting lightly on the roof of the mouth or on the back of the upper front teeth (as in speaking the letter “n”). Either position is acceptable, but do not allow the tongue to press firmly against the palate with suction in the mouth. Some individuals inadvertently stay in this tense, braced position (tongue against palate) for much of the day causing undue stress on the muscles. - Avoid caffeine. Caffeine is a “muscle tensing” drug. Even a small amount of caffeine causes muscles to be stressed, tired and unable to respond to the normal needs placed on them. Caffeine is the most widely used stimulant in our society and is in many pain medications, coffee, tea, soda, chocolate, diet aids, stay-awake drugs and numerous other medications and foods. Even many “decaffeinated” coffees contain caffeine, about ½ the level of regular coffee. Also, regular use of caffeine (as little as 1-2 cups of coffee per day) may lead to persistent headaches.
- Monitor for and avoid habits/activities that add strain to joints and muscles (clenching or grinding the teeth, biting the lips/cheeks, chewing on pens, pencils, toothpicks, biting fingernails, pushing the tongue against the teeth, holding the jaw tense). DO NOT CHEW GUM.
- Avoid stress on the jaw. Do not lean on the jaw. When yawning support the jaw with a hand under the chin to avoid over-stretching. Prolonged dental appointments with the mouth open wide should be avoided, if possible, until the pain has been reduced or eliminated. When having dental treatment ask for frequent breaks to allow the jaw to rest.
- Sleep posture is very important. Avoid positions that strain the jaw and/or neck, such as stomach sleeping. This places pressure on the jaw and neck muscles and jaw joints for many hours. When sleeping on the side, position the pillow as not to push on the jaw and do maintain neck (cervical) alignment.
- Proper diet, exercise, rest and Calcium are all important for the health and healing of the jaw joints and muscles. It is recommended to get up to 900-1200mg of Calcium each day. One glass of milk is about 300-400mg and other foods such as yogurt, cheese and vegetables contain calcium.
- Use anti-inflammatory and pain reducing medications such as ibuprofen (Motrin) and aspirin (without caffeine), per a doctor’s recommendations, to subdue discomfort and inflammation. Over-use of these medications frequently leads to headache disorders, as does regular caffeine use.
- RELAX: It is very important to relax the body’s muscles and joints throughout the day. Patients benefit from sitting in a quiet room, listening to soothing music, a warm bath/shower and slow deep breathing. These techniques also can be used during driving, working, studying or during nearly any activity. Simply allow muscle tension to fade, breathe easy and relax. High stress jobs, legal action, life changes, relationship problems can all be factors that increase or cause jaw pain. You may need to consider a lifestyle change for your health.