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TMJ RoundTable Update - June 2017

From the time of the June 16, 2016 meeting, until last month, progress has been slow. However, over the past couple of months we have the following accomplishments to share with you.

Pain Drawings: An Important Tool for Health Care Practitioners

Last year we shared with you a study in which investigators found patients with more severe and chronic TMD are likely to experience other persistent pain conditions in other parts of the body, seemingly unrelated to problems in the jaw or face. Yet patients often do not mention these "overlapping" or "comorbid" pain conditions when they see a dentist or health care provider.

Primary Temporomandibular Disorders and Comorbid Conditions

The aim of this study is to evaluate the distribution of the most common comorbid conditions associated with chronic temporomandibular disorders, and the pharmacological agents which play an integral role in the overall management of temporomandibular joint disorders. Abstract: INTROD

Overdiagnosis and Unnecessary Therapy

Many dental practitioners continue to use radiographic or magnetic resonance imaging (MRI) findings in the temporomandibular joint (TMJ) as the sole means of establishing that there is a pathology present that requires treatment.

TMD Self-Management Programs

Self-management (SM) programs in temporomandibular disease (TMD) are a core component of pain management of TMD throughout its course and are often given to patients as a first essential step after diagnosis.

TMJ Home Remedies

  • Jan 27, 2017

These useful tips for treating temporomandibualr disorders were recently featured in Reader's Digest's book of 1,801 Home Remedies as well as on-line.  

Treating Temporomandibular Disorder

If you have pain when you chew or yawn — or even when you say “temporomandibular disorder” — you know the discomfort of TMD. Your first lines of defense are heat, cold, and an over-the-counter anti-inflammatory drug such as ibuprofen. And try the other approaches below. No matter which avenue you take, you’ll also need to give your mouth a rest (that means no more biting pencils, gnawing on beef jerky, or chewing gum). Use it as an excuse not to answer the phone!

1. Global Cooling and Warming

When you feel occasional sharp pain in your jaw joints, apply a pair of cold packs. The cold numbs your nerves, dulling pain messages that go to your brain. Wrap a couple of soft packs in thin towels and hold them on both sides of your face for about 10 minutes or so (not longer than 20 minutes, though, or you could cause mild frostbite). Repeat every two hours as needed. If you’re experiencing a dull, steady ache rather than sharp pain, heat is better than cold. It increases blood circulation to the area and relaxes jaw muscles. Soak a couple of washcloths in warm water and hold them to your face for 20 minutes or so. (You’ll want to run them under hot water a few times to keep them hot.)

2.Go Ahead -- Rub It In

Massage the areas around your jaws to relieve muscle tightness and enhance blood flow to the area. Several times a day, open your mouth, then rub the muscles by the ears near your temporomandibular joints. Place your forefingers on the sore areas, and swirl them around, pressing gently, until the muscle relaxes. Close your mouth and repeat the massage.

With a clean forefinger, reach in your mouth until you can feel the sore muscles that are inside. Pressing firmly with your forefinger, massage one side, then the other, getting as close to the joints as you can.

Finally, massage the muscles on the sides of your neck. Those muscles don’t directly control your jaw, but by massaging them you help to reduce tension that contributes to jaw pain.

3. Don't Be Inclined

When you’re sitting in a chair most of the day, it’s especially important to sit up straight rather than lean forward. Your back should be well supported. Make sure your chin doesn’t jut out in front of your body. If you are angled forward, you’re putting strain on your neck and back, and that creates jaw pain.

Use a document holder when you type so you don’t have to crane your neck or lean forward to read the text.

If you spend a lot of time on the telephone while you’re using your hands for other tasks, get a headset. Cradling the telephone receiver between your shoulder and cheek puts a lot of strain on your neck and jaw.

4. Put Your Guard Up

If nightly teeth grinding or clenching is contributing to your TMD, try wearing the type of inexpensive mouth guard that can be found in any sports store. This isn’t as good as a custom-designed mouth guard that dentists can provide. But even a sports-store product can be molded for a good fit. Follow package directions to make it fit your mouth.

5.Table Matters and Manners

Try to steer clear of extremely crunchy and chewy foods, such as apples, carrots, beef jerky, and hard dinner rolls. You want to spare your jaws from overwork, particularly when the aching and clicking are severe. What you want are soups, pastas, and other easy-to-eat foods.

Don’t take big bites. Cut your food into smaller portions, so you don’t have to overwork your jaw.

Skip tea and coffee. Caffeine and TMD don’t go well together, since caffeine can increase muscle tension. Switch to decaffeinated drinks.

6.Put Some Teeth in Your OJ

Add 500 milligrams of powdered calcium and 250 milligrams of powdered magnesium to your morning orange juice. These minerals work together to promote muscle relaxation, which can help reduce tension in your jaw muscles. You can take capsules if you can’t find the powders, but the powdered form — which dissolves quickly — is more easily absorbed by your body.

7. A Yawning Trap

If you see someone yawning, resist the temptation to join in. Under those circumstances, it’s extremely difficult to stifle a yawn, but that’s exactly what you want to do if you have TMD. A big, wide yawn is sure to cause pain. If you can’t stop a yawn, try to suppress it by opening your mouth as little as possible.

8. Give Your Jaw a Rest

  • Avoid chewing gum. Every time you chew, you tense your jaw muscles and give your temporomandibular joints an exhausting workout.

  • Avoid biting your fingernails or chewing on a pencil. Instead, find a non-jaw-related way to get rid of your nervous energy — such as fiddling with “worry beads” or twisting a paperclip.

  • Sleep on your back or side. If you’re on your stomach, with your head turned to one side, the misalignment produces neck strain that’s transferred to your jaw.

  • If you put in a lot of desk time, take a few minutes to hide out and meditate. Focus on the muscles in your face and neck, allowing them to relax and grow slack.

  • Get 20 to 30 minutes of aerobic exercise at least three or four times a week. Not only does exercise reduce stress, it helps your body produce endorphins, which are its natural painkilling chemicals.

  • When you’re under stress, make a point to not respond by grinding your teeth or clenching your jaw. If it helps, hold your tongue between your teeth to ensure that you don’t grind your teeth together.

  • If you often carry a monstrous purse or briefcase on one shoulder, lighten your load. The weight throws your spine and neck out of alignment — indirectly contributing to jaw pain. If you absolutely need the heavy tote, move it from shoulder to shoulder as you’re walking along.

What’s Wrong?

A pair of hinges — temporomandibular joints — attach your jawbone to your skull. These structures are surrounded by muscles and ligaments. In temporomandibular disorder, or TMD, the muscles around the joints become tight and inflamed. TMD is marked by pain in the joints, a clicking or popping noise when using your mouth, headaches, and aching in your neck and shoulders. Common triggers include emotional stress, chewing tough foods, and jaw clenching or teeth grinding. Less often, people get TMD as a result of arthritis or a blow to the jaw.

Should I Call the Doctor?

If you have symptoms after two weeks of self-help remedies, call your doctor. And you’ll want prompt medical attention if it’s too painful to open your mouth or brush your teeth. For severe TMD doctors may prescribe muscle-relaxing drugs or, if you have inflammation, inject corticosteroids into the joints. A dentist can prescribe a customized mouth guard to wear at night to reduce clenching or grinding if that’s contributing to TMD pain.

Did You Know?

The temporomandibular joint is so named because it connects the mandible (or lower jaw) to the temporal bone at the side of the head.


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http://www.rd.com/health/7-tips-for-treating-temporomandibular-disorder/

TMJ Disorders

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