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TMD / TMJ and Head Pains

Even though many of us recognise the importance of a beautiful smile, we often take oral health for granted. Cancelled dentist appointment here, delayed cleaning by approximately six months over there, and before you know it, a substantial amount of time has gone by without a trip to the dentist and when we do go, there are a host of issues that have now manifested In our mouths. Despite this fact ,the majority of the time, our visit to the dentist are pretty successful. A root canal although painful has been performed or a simple cleaning has been given. But due to our own lack of understanding about the musculature overlay of our skulls and the connective tissue around our jaws, many of us wouldn’t even think to inquire during our dentist appointment if the neck pain, back pain, and cluster headaches we’ve been experiencing are even remotely related to our Jaw alignment. Or more specifically, Temporomandibular joint (TMJ) or  Temporomandibular disorder (TMD).

Temporomandibular joint (TMJ) is a joint connecting your lower jaw bone (mandible) to the skull. This joint is involved in all movements of the mouth, including opening, closing, shifting side to side, protruding, and chewing. When there is pain and dysfunction surrounding the joint, it is categorized as Temporomandibular disorder (TMD).  Symptoms of TMD include clicking or locking of the jaw when eating or opening the mouth. Some people may experience headaches as well.

It is important to see your dentist to rule out other possibilities of jaw pain – including tooth decay, infections, and gum disease – and to diagnose your pain as TMD.

Grinding your teeth at night (bruxism) can contribute to TMD as well. A night guard protects your teeth and helps reduce the tension of some muscles of the jaw, but may not completely relieve you of your symptoms. At this point, physiotherapy can assist you in getting more relief and regaining the movement quality and quantity back in your temporomandibular joint.

What physiotherapy can do for you

On your first visit with our physiotherapists, a complete assessment will be done to determine if the pain is due to muscle imbalance of mastication muscles, derangement in the joint, arthritis, or overuse of TMJ muscles. The assessment involves a pain history and objective tests to assess your posture and how your TMJ is moving. Our physiotherapists will also rule out trigeminal nerve impingement or involvement, which can mimic TMJD symptoms.

Depending on your specific condition, physiotherapists at Full Function can do a multitude of treatments to increase jaw mobility, quality of movement, and decrease pain.

  1. Manual Therapy: TMJ traction and mobilizations aim to increase range of motion. You should be able to open your mouth wide enough to fit 3 finger-widths between your top and bottom teeth. Gentle traction can help to decrease pain as well. Manual therapy on the neck can help with reducing pain around the TMJ as well.
  2. Craniosacral Therapy: Craniosacral therapy is a technique aimed at adjusting the flow of the cerebrospinal fluid that creates a rhythm that may shift your cranial bones. This involves very gentle pressure on your cranium and is not painful. Craniosacral therapy can decrease the pressure felt in and around the jaw and minimize headaches.
  3. Myofascial release: Soft tissue or myofascial work is done to correct hypertonicity in the muscles of mastication and neck. This can include intra-oral trigger point muscle releases as well.
  4. Exercises: Physiotherapists will provide you with a repertoire of exercises to assist in your TMD rehab. This may include exercising postural awareness, self-awareness of jaw positioning, strengthening and stretching exercises for muscles in the neck and jaw, and proprioceptive opening and closing exercises of the jaw.
  5. Education: Our physiotherapist will provide you with dietary recommendations to consider when you have TMD, such as no hard foods or chewing gum. They can advise on whether heat or ice will be better for you. They will teach you why it’s important to have a good posture when eating, and can also teach myofascial releases that you can do on your own at home.
  6. Acupuncture: Acupuncture needles may be inserted in the jaw, face, and neck. Acupuncture can reduce pain, normalize your nervous system, reduce inflammation, and correct muscle tone in and around your jaw.

Physiotherapists at Full Function can work together with your family doctor and dentist to build a treatment plan targeted to reduce pain and return full function to your TMJ. Improvements are expected to be observed after 4 treatment sessions. Persistent TMJ pain after recommended physiotherapy sessions is an indication for further consultation with TMJ specialists. Give us a call today to get started.

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