Temporo-Mandibular Dysfunction

TMD

Temporo-Mandibular Joint Dysfunction (TMD) is a condition of the Temporo-Mandibular Joint (TMJ) which presents as a painful, uncomfortable or otherwise abnormal behaviour of the jaw.  Not all patients present with pain, and other symptoms can include:

  • Clicking or locking of the jaw
  • Pain in the side of the face which can mimic toothache
  • Headaches
  • Pain on opening or closing the mouth or on chewing

 

What Are The Causes of TMD?

TMD can be caused by a combination of:

  • Arthritis to the joint
  • Damage to the joint cartilage
  • Trauma to the joint itself or due to a blow to the jaw
  • Abnormal muscle loading of the muscles of the face
  • General muscle tenderness secondary to over-activity of the muscles of the face

 

What Are The Aims of Jaw Excercises?

Jaw exercises aim to provide relief from pain and other symptoms associated with TMD, and to restore normal function of the jaw and joint

 

Do

  • Cold Packs

    Apply cold packs onto the area of the joint and associated muscles. Ideally, get a gel pack that goes in a freezer. Wrap it up in a tea towel and hold it against one side of the face, then the other, for around 20 minutes, twice a day, at lunchtime and bedtime.

  • Soft Diet

    Try to eat a softer diet for around 3 weeks. This does not imply mashed or liquidised foods, rather have your food cooked in such a way as to minimize chewing (e.g. boiled potatoes, not roasted)

  • Jaw Exercises

    Try the jaw exercises as advised by your dentist. Resolution of symptoms typically takes up to 3 weeks

  • Mouthguard

    If your symptoms do not resolve in 3 weeks, call your dentist and ask for a review. In some cases, you may need a mouthguard (similar to a sports guard) to help alleviate your symptoms. Wear it reguarly, as advised

Avoid

  • Excessive Mouth Opening

    Avoid excessive mouth opening (e.g. large yawns)

  • Abnormal Loading

    Avoid any habits like chewing a pencil, chewing gum and clenching your teeth while awake

  • Sleeping Habits

    Avoid sleeping face down, as this could exacerbate your TMD

  • Relaxation

    1. Allow your tongue to come to rest on the roof of your mouth, with your teeth apart, thus relaxing your jaw muscles
    2. Proceed to tense and then relax, the muscles of your body, starting with the ones in your feet and hands and working your way up, until you are completely relaxed
    3. Maintain this position for a few minutes
  • Exercise 1

    1. Keep your tongue on the roof of the mouth
    2. Place one finger on your TMJ and one finger on the recess of your chin
    3. Gently open and close your jaw in a straight up-and-down fashion with help from your index finger.
    4. Repeat 6 times, 6 times per day
  • Exercise 2

    1. Keep your tongue on the roof of the mouth
    2. Place both fingers on your TMJs
    3. Gently allow your jaw to drop, then pull your chin backwards (towards the throat) in a straight line
    4. Repeat 6 times, 6 times per day
  • Jaw Stabilisation Exercise 1

    1. Keep your jaw in a relaxed state
    2. Gently apply pressure with your thumb: vertically upwards then left and right
    3. Counter the pressure of your thumb by moving your jaw against resistance
    4. Hold for 2 seconds, repeat 5 times, 5 times per day
  • Jaw Stabilisation Exercise 2

    1. Place the knuckle of your index finger between your teeth
    2. Remove your knuckle and keep your teeth the knucle-space apart
    3. Gently apply pressure with your thumb: vertically upwards then left and right
    4. Counter the pressure of your thumb by moving your jaw against resistance
    5. Hold for 2 seconds, repeat 5 times, 5 times per day