TMJ/TMD

The "Temporomandibular Joint," more commonly referred to as the "jaw joint," assists in the basic opening and closing movements of the jaw. Unfortunately, this joint is a common area for recurring pain. Although conventional wisdom suggests that "popping" sounds in the jaw indicates a TMJ dysfunction, this is not always true. Many times, your jaw is functioning properly even if a "popping" sound is present when chewing or talking.

We offer a TMJ exam that evaluates the joint tissue in the "hinge" of the jaw. Possible problems include swelling, deterioration of the joint tissue or damaged joint tissue (which cushions the jaw bones during the opening and closing movement of the mouth). Common pain relievers and cold compresses can provide temporary relief for most cases of TMJ.

For more serious cases of TMJ, we will recommend alternate treatments. Often, we will suggest using a mouth guard to relieve teeth grinding. In some cases, we will instruct you to use orthodontic appliances or retainers to alleviate discomfort or redirect positioning of the TMJ joint. For the most severe cases of TMJ, we may recommend certain invasive procedures.

SELF MANAGEMENT FOR TMJ AND JAW PAIN

We use our mouths for many activities: talking, eating, yawning, laughing. When we are not engaged in these, we need to allow our jaw muscles and joints to relax. Many people have developed habits that do not permit their jaw muscles or joints to relax sufficiently. The steps listed below will help you learn how to relax these muscles and joints—and reduce the jaw pain you are experiencing.

1. Use hot or cold packs. Apply moist heat, ice or a combination of the two to the painful area(s). Most people prefer heat, but if that increases your pain, use either the combination or the ice alone.

• Apply moist heat for 20 minutes two to four times each day. Wet a towel with very warm water, keeping it warm by wrapping it around a hot water bottle or by placing a piece of plastic wrap and a heating pud over it. The towel also can be rewarmed in a microwave oven or under very warm tap water.
  
• Use the combination of heat and ice two to four times each day. Apply the heat as recommended above for 10 minutes, then lightly brush the painful area with an ice cube wrapped in a thin washcloth. Repeat this sequence four or five times.
  
• Apply ice wrapped in a thin washcloth to the painful area until you begin to feel some numbness (usually in about 10 minutes), then remove it.
  

2. Eat soft foods. Confine your diet to soft foods such as casseroles, canned fruit, soups, eggs and yogurt. Do not chew gum or eat hard foods (such as raw carrots) or chewy foods (such as caramels, steak or bagels). Cut other food into small pieces, and chew on both sides of your mouth to reduce the strain on one side.

3. Rest your jaw muscles. Keep your teeth apart and practice good posture.

• When you're not chewing, your teeth should never touch (except occasionally when you swallow). Closely monitor your jaw position for signs of clenching. Try placing your tongue lightly on the top of your mouth behind your upper front teeth, allowing the teeth to come apart and relaxing the jaw muscles.
• Good head, neck and back posture help you maintain good jaw posture. Try to hold your head up straight, and use a small pillow or rolled towel to support your lower back. Avoid habits such as resting your jaw on your hand or cradling the telephone against your shoulder.

4. Avoid caffeine. Caffeine stimulates your muscles to contract and, therefore, become more tense. Caffeine or caffeinelike drugs are in coffee, tea, most sodas and chocolate. Decaffeinated coffee also has some caffeine.

5. Watch your habits. Avoid oral habits that put strain on the jaw muscles and joints. These include, among others, clenching the teeth; grinding the teeth (bruxism); touching or resting the teeth together; biting your cheeks, your lips or objects you put in your mouth; pushing the tongue against the toeth; and tensing the jaw.

6. Sleep smart. Avoid sleeping habits that strain your jaw muscles or joints. Don't sleep on your stomach, and il'you sleep on your side, keep your neck and jaw aligned.

7. Don't open wide. Until the pain has been reduced, avoid activities that involve opening the jaw wide—yawning, yelling, prolonged dental treatments.

8. Use medications. Use anti-inflammatory and pain-reducing medications like Aleve (Syntex Laboratories), ibuprofen, Tylenol (McNeil Laboratories), aspirin (without caffeine) and Percogesic (Procter & Gamble) to reduce joint and muscle pain. Avoid medications with caffeine, such as Anacin 'Whitehall), Kxcedrin (Bristol-Myers Squibb Company) or Vanquish (Glenbrook).