Many people suffer from chronic facial and neck pain as well as severe, recurring headaches. In some cases, this pain is due to Temporomandibular Joint Disorder, also known as TMD or TMJ.
Frequently asked questions about TMJ
If you are having TMJ problems, eating softer foods will certainly help. This change in diet provides less stress on the muscles that you use to chew and less discomfort around the joint. Avoid certain foods like bagels, steak or taffy-type candy that can require a lot of work to chew. If you sprained your ankle, you wouldn’t go run a race. The same rules apply here. When possible, cut fruits into small pieces and steam vegetables. Severe cases of TMJ discomfort may even require a liquid diet for a period of time, or at least restricting diet to soups and milkshakes for a while.
There are some things to think about when chewing when you are having TMJ discomfort. First of all, try to chew gently with your back teeth rather than biting with your front teeth. Don’t take big bites or open your mouth wider than 1-2 inches (i.e., don’t order the double cheeseburger). Don’t eat any foods that require prolonged chewing, like bagels, taffy-like candy, or your mother-in-law’s brisket. Try to be intentional to chew evenly, left vs. right, so you do not concentrate all the chewing force on one side of your jaw.
DO NOT PUT PRESSURE ON CHIN. Pressure on the chin can immobilize the joint, and reduce the effect of the lubricating fluid. Do not rest your chin on your hand while reading, working, or watching TV. Try to sleep preferably on your back, or at least on your side. Avoid stomach sleeping.
DO NOT OPEN WIDELY. Avoid extreme jaw movements (such as wide yawning, loud singing, and gum chewing). Cut food into smaller bites. Do not stretch to eat large sandwiches, etc. Avoid activities that involve prolonged opening (i.e., long dental treatment) until the pain is reduced.
AVOID STRESS. Easy to say, hard to do. But stress is a major contributor to TMJ symptoms. We see this a lot when there are major transitions in the life of our patients whether it be with work, relationships, or school. These cannot always be avoided, but being aware that this can play a role is a start.
Don’t do it. We see lots of patients with TMJ discomfort that make it a lot worse by chewing gum. Chewing gum increases the wear and tear on the joint and gives little opportunity for your jaw to recover between meals.
Million dollar question. This is much easier said than done but it is a huge contributor to TMJ problems. Dr. Hodges may recommend that you wear a splint (nightguard) at night to help with this when you’re sleeping, but when you are awake, try to be very aware of the position of your teeth. Try to be intentional to keep your tongue up and teeth apart. Closely monitor your jaw position during the day in order to maintain a relaxed and comfortable position. Avoid oral habits that put strain on the jaw muscles and joints, including clenching, grinding, and jaw tensing. The teeth should never be touching (except occasionally during swallowing).
‘Lips together teeth apart’ is a technique to keep the jaw in neutral relaxed position. Practice this
technique during the day and before falling asleep. This involves placing the tongue lightly on the roof of your mouth behind your upper front teeth, allowing the teeth to come apart and relax the jaw muscles. Saying the letter ‘N” throughout the day can remind you of the proper position
HOT/COLD TREATMENT. Applying heat to a sore area for 5-10 minutes 2 to 4 times daily can help some of your TMJ discomfort. Microwave a wet towel for approximately 1 minute or until the towel is warm. You can also wrap the moist hot towel around a hot water bottle to keep it warm longer. This will increase circulation and relax the involved muscles. For cold compresses, use ice wrapped in a thin washcloth for 5-10 minutes, 4 times daily. Heat or ice can reduce
joint or muscle pain and relax the muscles. Alternating hot and cold may be beneficial. For acute
injuries, only a cold is recommended.
MASSAGE/STRETCH SORE MUSCLES. Use two fingers to massage in a circular motion along the tender chewing muscles, usually in the temple area, side of the cheek, in front of the ear, and jawline. Stop the massage, then stretch your mouth only to the point that it is comfortable, and hold for 5-10 seconds. Repeat.
ANTI-INFLAMMATORY DRUGS. Over-the-counter ibuprofen (generic, Motrin(r) or Advil (r)) may be useful for short-term use in reducing inflammation in joints and is recommended before bed and upon waking for no more than 7-10 days. Long-term use is not recommended and if necessary consult a doctor.