Temporomandibular dysfunction refers to any disorder affecting the temporomandibular joint (TMJ) and its surrounding muscles. This can include pain in the jaw or head region, clicking/locking of the jaw as well as abnormalities of opening and closing the jaw. At Pinnacle we have a number of physiotherapists that are trained in the management of TMD
There are a multitude of factors that can lead to TMD such as:
- Bruxism (clenching/ grinding of the teeth) which is typically but not always related to stress. The muscles that perform this action get overused and tight (often leading to muscle pain).
- Neck and postural dysfunction. Tightness in certain muscles that connect the neck/trunk to the jaw (eg platysma) mean that neck and jaw dysfunction are closely related. Certain postures have typical effects on the way the jaw rests as well as opens and closes.
- Certain behaviors such as chewing gum, side sleeping with your arm under your jaw can have a significant impact on jaw function.
- Dental issues such as missing teeth or malalignment of teeth can change the way you eat causing certain imbalances in muscle strength/length and joint mobility.
- Trauma, for example motor vehicle accidents and direct blows to the jaw can damage the TMJ.
- Medical/dental procedures such as those involving the jaw needing to be stretched open or directly operated. Radiation therapy for cancer treatment of the facial region is also a well known potential cause of TMD.
The outcome of this dysfunction may be signs and symptoms such as:
- Jaw pain due to muscle/tendon pain, joint pain or disc pain.
- Headaches as some muscles, such as temporalis, function to move the jaw but are actually located predominantly in the head rather than jaw region.
- Movement disorders: clicking, grinding, subluxing/dislocating, asymmetrical opening. Normal opening and closing of the mouth involves the symmetrical movement of TMJ on both side. Muscle length/strength differences as well as joint stiffness/hypermobility can lead to asymmetry. Sometimes the disc within the TMJ is moving abnormally which can be quite distressing.
At Pinnacle Physiotherapy your physio will thoroughly assess your jaw as well as consider other factors such as those listed above. Treatment options may include things such as:
- Soft tissue massage of muscles such as masseter, temporalis, pterygoids, digastric, etc.
- Joint mobilization of the TMJ
- Prescribed stretches to create more symmetry in the muscles controlling jaw function.
- Prescribed strengthening exercises to stabilise a lax joint or work towards more symmetry in the jaw function.
- Liaising with your dentist with respect to splint therapy, botox, dental implants and other dental procedures to provide a wholistic approach to your management.
- Discuss and make recommendations on sleep hygiene, bruxing and other behaviours that may be contributing to your TMD.
- Assess your neck and posture and address any issues that me be contributing to your TMD. This may involve muscle or joint mobilization of the neck or thoracic spine (upper back). There may be exercise prescribed to improve posture in sitting, standing or specific work or daily life situations.