Snap, crackle, pop…lock!
   These are not only the sounds of your favorite breakfast cereal but could be the symptoms of a disorder called Temporomandibular Joint (TMJ) Dysfunction. TMJ dysfunction is a multifaceted problem which may involve the jaw, neck, temple or ear.

   We use our jaw muscles continually throughout the day to chew, talk, laugh or yawn. Pain in the jaw or face region can be severely disabling and limit these daily functions. The varied symptoms of TMJ include headaches, ringing or throbbing in the ear and teeth clenching, also call bruxism. Limitation in mobility of the jaw, either with opening or closing all the way, may occur. A thorough evaluation by your dentist can help identify occlusal problems (how your teeth fit together). In some cases, a positioning splint may be necessary to place the condyle or end of the mandible in its most neutral position in the joint. In a more advanced case, the disc may be dislocated.  Physical therapists work carefully with dentists and doctors to alleviate symptoms.  Therapy may be beneficial to decrease soft tissue tightness and swelling, improve muscle relaxation, normalize joint mechanics and improve the function of your jaw.

   Patients can take steps to help in the healing process of TMJ by being aware of posture, clenching of teeth, diet, use of heat/ice and massage.  Poor posture can contribute to pain by causing misalignment in the teeth.  Sitting with your head positioned too far forward such as looking at your computer through bifocals can shift your jaw as well.  Reading in bed with only your head propped can also push your head forward and change your teeth position.  Good head and neck alignment positions your ears over your shoulders and, therefore, shoulders over your hips.  Standing tall and looking forward rather than down at your feet promotes good posture.  Sitting upright instead of slouching also helps with good head positioning.  Sleeping with a pillow that has good neck support helps the jaw muscle relax.  Sleeping on your stomach may push your jaw out of place.  Be aware of how you sit, how you carry yourself when you walk and how you sleep.

   Whether clenching your teeth is how you carry your stress or a habit, jaw muscles can be overworked.  In some cases, clenching may be more neurologically based, and you may need neuromuscular re-education of the muscles.  A splint may be necessary to keep your teeth apart and in a more relaxed state.  Awareness is the key.  The first step is to notice if your teeth are constantly in contact.  For your jaw to be relaxed, your teeth should be apart.  Keep your lips together but teeth apart to keep the jaw muscles from firing too much.

   Another way of influencing your clenching is a technique called Pain Reflex Release Technique (PRRT). PRRT down regulates the protective reflexes which may be keeping you in a painful state. Simple techniques of neuromuscular re-education can quiet the trigeminal system (a part of the nerve system) which may be over firing the muscles used for chewing.

   Being aware of jaw placement and not clenching can also be enhanced by what you chew.  The TMJ sufferer should be aware of diet.  For once, you do have to pay attention to your mother and eat your cooked carrots.  Avoid chewing gum, chewing on ice or raw crunchy vegetables, chips, nuts or hard candies.  These may cause you to use your muscles more intensely.  Cutting food into smaller pieces and eating a variety of softer or blended foods can help keep your muscles from overworking.

   Massage is the last important component in TMJ.  It may be significant in improving circulation and decreasing muscle tightness.  Extreme symptoms of neck and jaw pain, unrelenting headaches and locking of the jaw may be indicative of more serious joint changes.  An evaluation by a TMJ specialist may be necessary to alleviate symptoms.  In the meantime, be aware of your posture, diet and clenching.  While it is important not to chew ice, it can be used to decrease swelling and inhibit pain.  Moist heat can be helpful to improve circulation and decrease muscle tightness.  These few tips may get you on the way to improved function and healing of your jaw.