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Myofunctional Therapy for TMJ: How it Helps? Written By: Dr. Ankita Shah, January 2022

Tongue Tie

TMJ pain is a common problem affecting many individuals - adults and children alike. TMJ refers to Temporomandibular Joint that connects the lower jawbone to the skull. The conditions that affect the TMJ (leading to discomfort and pain) are broadly classified as Temporomandibular Disorders (TMD).

TMD is viewed as a repetitive motion disorder that eventually breaks down the jaw joint and surrounding muscles, which is vital for supporting the TMJ. Any problem in these areas (bone, muscle, nerve and cartilage) can cause orofacial/craniofacial pain, leading to varied symptoms across the body.

When it comes to treatments for TMJ disorders, myofunctional therapy for TMJ is often used as one of the most non-invasive, inexpensive and effective option to treat the various symptoms of TMJ/TMD. This therapy helps treat the root cause by strengthening the tongue and orofacial muscles, thereby helping establish nasal breathing, correct tongue posture and correct swallowing. Oral myofunctional therapy can significantly reduce TMJ pain and increase mandibular mobility while reducing the severity of TMD symptoms. Overall, it helps improve the functioning of the jaw joints and relieves pain, thereby enhancing an individuals’ life.

A] WHAT IS TMJ?

Temporomandibular Joint (TMJ), the Jaw Joint, is one of the most complex joints in the body located on either side of the face (in front of the ears) that connects the lower jawbone to the skull. This joint also has a disc of cartilage that serves as a cushion, protecting the condyle (top end of the jaw) and the socket (in the skull) from hitting each other. Moreover, the temporomandibular joint is connected to several nerves (like the trigeminal nerve) and the head & facial muscles.

Any TMJ-related pain and dysfunction is always the result of an underlying temporomandibular disorder (TMD). Pinpointing the exact cause of TMD is hard as there are several factors involved. Some of them include:

Genetic

Physical Injury and Trauma

Habitual Mouth Breathing

Age-related Degeneration

Teeth Grinding and Clenching

Arthritis and Rheumatoid Arthritis

Obstructive Sleep Apnea

Malocclusions and Improper Bite

Chronic Stress and Anxiety

Tongue Ties

Improper Chewing or Swallowing Patterns

Narrow Airways

Postural and Structural Issues

Simply put, if any of this affects the structure and functionality of the temporomandibular joint, it can result in TMJ pain, jaw tension, dysfunction and other symptoms.

B] SYMPTOMS OF TMJ/TMD

Some of the primary symptoms of TMJ and TMD are:

Jaw and facial pain

Jaw tension and stiffness

Jaw clicking and popping

Difficulty chewing or swallowing

Difficulty in opening the mouth wide and yawning

Lopsided jaw opening or limited jaw opening

Pain & tension in the neck, shoulders, and upper body

Pain/pressure behind the eyes

Dry eyes and tingling of eyes

Sensitive teeth, toothaches, or misaligned teeth

Teeth grinding and clenching

Ear pain or hearing difficulties

Ringing, tinnitus, and fullness in ears

Headaches and migraines

Dizziness and vertigo

Tingling or numbness in the arm

C] Myofunctional Therapy for TMJ

What is OMT/MFA play icon play icon

One of the non-invasive treatments for TMD/TMJ pain is Oral Myofunctional Therapy (OMT). OMT is especially helpful if the TMJ pain and other TMD symptoms are caused by oral myofunctional disorders (OMDs). OMT is a highly effective physical therapy exercise program that helps improve nasal breathing, strengthens the tongue and orofacial muscles, helps with jaw & joint stabilisation, corrects swallowing and corrects oral and forward neck posture.

This is achieved by toning and re-patterning the head, face, tongue and neck muscles. Therapeutic approaches are used to tone the muscles, which re-patterning involves re-creating strong pathways between the brain and the muscles. By creating this harmonious muscle balance, we can correct articular and muscular TMD.

Some of the other benefits of myofunctional therapy include:

Corrects temporomandibular joint functionality and reduces pain

Improved biting, chewing and swallowing

Continuous nasal breathing

Stabilised TMJ and jaw joint

Correct tongue position and oral rest posture

Increased mandibular range of motion

Improved articulation and speech

Stronger orofacial muscles

D] Orofacial Pain and TMJ

Orofacial/Craniofacial is a field of dentistry that helps with the diagnosis and care of non-dental pain like TMDs. An orofacial/craniofacial pain specialist can help you treat the persistent pain from TMJ, helping discern the root cause of the problem and treating TMD/TMJ with comprehensive and minimally-invasive approaches.

To treat non-dental pain caused by TMDs, determining the various types of TMD pain is important. This includes:

TMD Pain: Myofascial Pain - Since the face is made up of a combination of muscles, nerves, fascia, bones and cartilage, any dysfunction in these structures can lead to non-dental pain in the face, neck, head and inside the mouth. It may lead to headaches and migraines. In severe cases, it can cause pain and burning/tingling sensations in the face, neck, mouth, teeth and shoulder.

TMD Pain: Articular Pain - This is caused due to a dislocated jaw or displaced disk. An injury to the condyle can also cause articular pain. Displacement of the disk can be of two types - with reduction and without reduction.

TMD Pain: Degenerative Joint Disease - This primarily includes osteoarthritis or rheumatoid arthritis in the jaw joint.

Trigeminal Neuralgia Pain - Trigeminal Neuralgia can trigger brief, sharp, shooting or severe pain when chewing, talking, brushing or lightly touching the face.

By understanding what is causing the pain, an Orofacial Pain Specialist can help recommend effective treatment for temporomandibular joint pain.

TMJ and TMD FAQs

Pay attention to the TMJ symptoms like pain/pressure behind the eyes, ear pain, jaw pain, difficulty chewing or swallowing, headaches and migraines, misaligned teeth, tenderness in jaw muscles, neck pain and shoulder stiffness. Experiencing feelings similar to lockjaw and unusual clicking or popping sounds while speaking or chewing are a few other signs to watch out for. Just remember, when functioning, the jaw shouldn’t make any sound. If it does, it is an indication of a TMJ disorder.

Upon consultation with a professional, they will suggest TMD/TMJ exercises and stretches that can help alleviate the TMD pain. Remember, to treat TMD pain or TMJ disorder, a combination of specialists (airway focused dentist, physiotherapist, ENT specialist) will have to work together to achieve the best results. Oral Myofunctional Therapy (an exercise program) is also used to create a harmonious muscle balance while correcting articular and muscular TMD.

Some of the exercises to alleviate TMD pain includes:

Place the tongue just behind the upper teeth on the roof of your mouth and gently try opening your mouth/jaw without moving the tongue.

Place the thumb below your chin, gently open your mouth as you work against the resistance from your thumb.

Cross your arms across your chest (one hand on each shoulder). Slowly stretch your neck backwards. Now, move your neck to the left, hold the position for a few seconds and switch sides.

TMD/ TMJ can be difficult to diagnose and treat. This is the reason why consulting with a specialist is important. An airway focused dentist specifically trained & experienced in temporomandibular joint disorders will screen, diagnose and treat the symptoms. Through a comprehensive oral exam, the specialist will create a custom treatment plan that works best for you depending on the nature of your TMJ disorder and its severity.

Since teeth grinding or teeth clenching is prevalent in children, they can be diagnosed with TMD. This is why biannual dental exams are important. It will prevent the children from developing TMD.

Some of the preventative measures to lower the risk of TMD is practising good posture and relaxing the jaw muscles to reduce jaw stress & tension. Consulting with a specialist will also help you discern whether any jaw or bite issues need to be rectified.

Avoid activities that contribute to TMD:

Chronic gum chewing

Clenching your jaw

Chewing on ice or pens

Poor posture

Grinding teeth

Also, be mindful of excessive stress and anxiety, as they can contribute to the above activities.

Below is a list of foods to avoid while experiencing TMJ pain:

Chewy Foods: These types of food often require continuous chewing motion of the jaw, which can cause TMJ pain. The foods include chewing gum, caramel, chewy pieces of meat and sticky candies.

Crunchy Foods: These types of food often require high-intensity pressure to chew. Crunchy foods include popcorn, chips, hard nuts, ice, carrots, crusty bread, apples, and other hard fruits & vegetables.

Fatty Foods: Foods like red meat, fried foods, trans-fat, and pastries can increase inflammation in the body, causing TMJ pain. Also, avoid large chunks of food, which can overwork your jaw.

Some types of foods to include in your diet to lower the risk of TMD are:

Soft foods: This includes scrambled eggs, hummus, baked salmon, baked sweet potatoes, legumes, spinach, kale, yoghurt, tuna salad, bananas, watermelon, cucumber, and meatballs. Any food item that is well-cooked and provides nutrition can help ease the pain, relax the jaw, and speed up the healing process.

Fluids: Chicken soup, milk, broth, vegetable soups are a few foods that should be a part of your diet as they provide wholesome nutrients.

Anti-inflammatory foods: A rich diet of anti-inflammatory foods like beans, fruits, vegetables, whole grains, healthy fats, and fish can lower the risk of TMD. Ginger, garlic, turmeric and onions are a few other anti-inflammatory foods. Also, dairy-free diets can reduce inflammation.