Temporo-mandibular joint dysfunction describes a variety of conditions which affect the jaws and muscles. Problems occur on one or both sides, it is very common. Many people have some sign of TMJ dysfunction, but only a small number of people experience pain.

What causes TMJ Dysfunction?

We do not know exactly what causes TMJ dysfunction, but latest research indicates it has little to do with your teeth. Most of the discomfort comes from overuse of the joint and muscles. This can be brought on by:

• Clenching your teeth together, this often happens when you are concentrating, busy, worried or annoyed.
• Grinding your teeth together, this often happens at night whilst you are sleeping but can happen during the day.
• Straining the joint muscles by chewing pens, biting nails, holding things in your mouth or holding a phone between the neck and your shoulder.
• Overworking the muscles by constant chewing e.g. chewing gum.
• Faulty movements of the jaw.

Will it get worse?

The problem tends to come and go, often worse at times of stress. Studies demonstrate that is does not get worse with age, often it can get better.

What problems may I experience?

• Soreness of the jaw, worse on waking, biting, chewing or yawning.
• Clicking of the jaw.
• Stiffness or locking of the jaw, difficulty in opening or closing your mouth.
• Earache without an infection.

How is it treated?

There are many methods of simple treatment which help alleviate symptoms. 9 out of 10 patients get better with exercises and the use of a bite guard worn at night. This helps reduce the tension built up in the muscles around the face. Physiotherapy, pain killers, acupuncture and adjustment of the biting surfaces of the teeth can all sometimes be used to help.

What can you do?

YOU ARE THE KEY TO SUCCESSFUL TREATMENT

• Keep teeth apart. Do this when not wearing your bite guard. The normal position of the jaw is teeth slightly apart with your tongue resting gently on the floor of your mouth. This allows your jaw joint and muscles to rest and heal.
• Avoid opening your mouth very wide.
• Do not chew fingernails or chewing gum.
• Avoid straining your neck and shoulders due to posture, this can occur when working at a computer all day.
• Eat nutritious meals that do not require a vast amount of chewing.
• Avoid caffeine and smoking. They are both stimulants which excite the body, which can lead to a greater perception of pain.
• Try to relax for 15-20 minutes each day.

Exercises

The purpose of these exercise is to:

Strengthen the muscles which pull the lower jaw backwards

Relax the muscles which pull the jaw forwards

Set aside two, five minute periods each day to carry out the exercises. Look in a mirror and do the following:

• Close your mouth with the back teeth together.
• Rest the tip of your tongue on your palate just behind the upper front teeth.
• Curl the tip of your tongue backwards over the roof of the mouth as far as you can achieve whilst keeping the teeth together.
• Slowly open your mouth, continuing to curl the tongue backwards and keeping it in contact with the roof of your mouth for as long as you can.
• When you feel the tongue being pulled away from the roof of your mouth (you should feel tension in the muscles at the back of your jaw and under your chin) stop opening further.
• Keep in this position for five seconds and then relax, closing your mouth for five to ten seconds.

Repeat this exercise over the next five minutes. Carry out this exercise as recommended for one week. Initially this may make any painful symptoms seem a little worse, but this will be due predominately to the unaccustomed exercise.

After the initial week, do the exercises as often as you can to strengthen the muscles and ligaments around the joints. Carried out correctly over a three to four week period, you should re-train the muscles so that the jaw opens and closes smoothly without clicks or pain.