I Have TMJ – What Can I do?

If you are one of the estimated 44 million Americans (child, adolescent or adult) who suffers migraine headaches, chronic recurrent tension-type headaches, jaw joint pains and sore jaw muscles associated with functionally–induced temporomandibular joint pain-dysfunction syndrome, there are only three things you can do: You can obtain 1) Professional help, 2) Self help, or 3) Just plain live with it. For many who suffer terribly from such problems, the third option is totally unacceptable, especially where children are concerned (they’re so easy to cure!

Option 1: Professional Help:

  1. Seek care from a well informed dental practitioner, (general dentist, orthodontist, pedodontist, prosthodontist or generalist) who has experience in some form of orthodontics (metal braces) and certainly knowledge of Functional Jaw Orthopedics (Functional Appliances), or at the very least some one who can use splints of both a “flat plane” and “repositioning” variety. This is critical.
  2. Treatment for less severe or borderline cases of “TMJ” may respond well to several months of night (or day/night) use of a splint or intra-oral removable orthotic (appliance) of some sort to relieve pain and heal the joints. Such treatment is then usually followed by gradual withdrawal of the device allowing the patient to return to their original bite (occlusion). But remember, this limited approach can work for only a select few borderline patients. Most patients in time fail to respond to this limited treatment, due to the severity of their Temporomandibular Joint damage.
  3. Treatment for more advanced cases of “Temporomandibular Joint” in children and/or adolescents requires a special type of orthodontic correction, and that means, yes, maybe metal braces, but for sure removable European-style Functional Appliances of some type (or their equivalent) to realign the offending lower jaw more forward during biting so as to depressurize the battered jaw joints that are the ultimate neurological source of the headaches and jaw muscle pains. The good news is that children and adolescents respond VERY WELL to such techniques and recovery is usually rapid and permanent! Nice huh?
  4. Treatment of more advanced cases of “Temporomandibular Joint” problems in adults may also be treatable with orthodontic technique. Sometimes orthodontic treatment can (or must) begin immediately in efforts to correct the offending bad bite (malocclusion: “mal” = bad, “occlusion” to close). However, some cases might be so severe as to require PhaseI/PhaseII type courses of treatments. “Phase I”, consists of using removable splints, Functional Appliances, and Functional Jaw Orthopedic techniques to first treat the jaw joints and jaw muscles only; relieving the headache and facial pain, healing the damage, and making the jaw mechanisms strong enough to withstand the traumas and difficulties of the second phase of bite correction to permanently solve the problem.

    “Phase II finishing” techniques for bite correction may involve orthodontics, capping of the back teeth, reshaping the teeth, or other devices and techniques to stabilize the new bite in its final, pain free, corrected arrangement. Phase I may take 9 to 12 months to get the patient ready for Phase II finishing. It is long and at times can be somewhat complicated, but it WORKS!!

Option 2: Self Help:

In the “old days” before we truly understood the real nature of the TMJ pain-dysfunction scenario, clinicians depended heavily on Self Help techniques like the following to help control the patients’ pain problems. The reasoning is simple, even though the techniques are varied. The simple part of this is that there are basically two ways to fight any disease or damage in the body. First you can attack the problem from the outside i.e. a doctor can do something for the patient such as cut out a tumor, set a broken bone, administer a drug of some sort, etc. The second way is to somehow bolster the body’s own defense mechanisms from the inside so it can do something for itself. This is called “raising host resistance” and it can really be effective sometimes. It might not “cure” the problem but it may be enough to let the body keep the problem, condition, or disease under control enough so as to hide it from the surface. It’s certainly better than nothing and sometimes it can be pretty good. But then again, sometimes not. Basically the following merely represent TMJ “first aid.”

  1. Jaw Resting: “Lips together, teeth apart; from this rule do not depart”. This old axiom has long echoed down through the halls of early attempts at Temporomandibular Joint treatment. It’s simple, easy, and a direct recognition that biting is bad for the TMJ patient (because the particular malocclusion involved drives the lower jaw too far back in its socket, damaging the nerves in the back side of it). This technique also is a simple reminder to the patient to avoid clenching during the day. But it’s hard to keep this little rule in mind constantly all day. And of course, this technique is useless during sleep at night.
  2. Jaw Exercises: Exercising your jaw, like any form of muscular exercise, can help restore normal range of motion when jaws are stiff and sore, improve flexibility and restore badly needed circulation. The following are a few simple exercises that are common sense ways to help jaw muscles….
    • Looking in a mirror, slowly and gently open and close your mouth straight up and down while keeping your lower jaw protruded just enough so that the upper and lower front teeth stay aligned on top of one another, end to end. Repeat for 2 –3 minutes every morning and evening.
    • For stiff jaws or limited mouth opening, gradually increase your mouth opening by placing one knuckle, or an object of similar size, between your front teeth. Rest on your knuckle for 60 seconds. Do this for 1 to 2 minutes every day. Increase to two knuckles, and then over time eventually to three or until you feel comfortable.
    • Soft foods: Limit your diet to softer, well cooked foods. Do not chew gum or coarse foodstuffs. This temporary measure will help rest sore jaw joints and tired, sore, stiff jaw muscles.
    • Practice good posture. Good head, neck, and back posture helps maintain good jaw posture too. Chiropractic and Physical Therapy adjustments of the neck and upper back and shoulder help reduce pain in the head also. But it is usually only temporary.
    • Heat and Ice: Ice helps reduce Temporomandibular Joint swelling in acute situations. Apply ice packs to the jaw joints for 20-30 minutes several times per day for 2 days. Heat helps relax sore jaw muscles and improve circulation through the area, which may help reduce pain. Apply a hot wet towel to the sore joint or jaw muscles for 10-20 seconds; then lightly rub the painful areas with ice cubes. Repeat this process 4-5 times in the affected area 3 times a day.
    • Aspirin/Ibuprophen (Advil)/Acetomenophen (Tylenol) are also effective. Follow instructions on the label. Do not use more than 2 weeks straight.

Option 3: Learn to live with it!

You’re already doing this, It’s time to take positive action and stop suffering!

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