The basic home-protocol for TMD
Contribution by Nadia Gomez.
What can I do to help my jaw pain?
Temporomandibular disorders affect the temporomandibular joint, and muscles of mastication. The cause of this phenomenon is multifactorial, and can be associated with occlusal conditions, stress, trauma, and parafunction. Unfortunately, this disorder is irreversible; however, on the day-to-day basis, by restricting behaviors, any pain associated to the inflammation of the joints and surrounding muscles can decrease, as well as intercept further degeneration.
Basic in-home treatment:
- Diet: soft and in small bites, slow chewing; avoid gum.
- Teeth contact: disengage if in contact during other situations that do not involve chewing or speaking.
- Tip: release a small puff of air and retain position.
- Avoid wide mouth-opening (cut food into pieces, press any food that requires large bites; yawn with limitation: place hand under chin, or move chin towards neck to limit opening.
- Find awareness of parafunctions: biting objects, clenching, grinding, and stop.
- Massage therapy: circular movements and pressure against the muscles until producing warmth, enhancing the blood flow in soft tissues – twice a week, 30 minutes per session.
- Thermotherapy: moist heat for 20 minutes a day in the affected regions.
- N-stretching exercises: tip of the tongue against palate (simulating letter “n”), open wide without removing tongue from the original position and hold for 6 seconds. This should be six times per session, and six times a day.
The purpose of general avoidance is to lessen joint pressure, regain muscle length, and decrease muscle activity.
Simple rule to follow: “if it hurts, don’t do it.”
- Liu F, Steinkeler A. Epidemiology, Diagnosis, and Treatment of Temporomandibular Disorders. The Dental clinics of North America. 2013;57(3):465-479. doi: 10.1016/j.cden.2013.04.006
- Okeson, Jeffrey P., Management of Temporomandibular disorders, and occlusion, eighth edition, Elsevier, 2020.
- Wieckiewicz M, Boening K, Wiland P, Shiau YY, Paradowska-Stolarz A. Reported concepts for the treatment modalities and pain management of temporomandibular disorders. J Headache Pain. 2015; 16:106. doi: 10.1186/s10194-015-0586-5. Epub 2015 Dec 7. PMID: 26644030; PMCID: PMC4671990.
- Kraaijenga S, van der Molen L, van Tinteren H, Hilgers F, Smeele L. Treatment of myogenic temporomandibular disorder: a prospective randomized clinical trial, comparing a mechanical stretching device (TheraBite®) with standard physical therapy exercise. Cranio. 2014;32(3):208-216.