Dentistry Gym – helping TMJ dysfunction and pain
In this month’s episode of the dentistry gym, Khalil Hussein tries something a little bit different. He takes a look at TMJ dysfunction and pain.
Many of you reading this will see a patient with TMJ issues. Some of you may even have your own TMJ issues. In this video, I will address some of the main ways of managing and dealing with things like pain from clenching and grinding of teeth.
What causes TMJ problems?
When it comes to the jaw, many therapists think that it is somehow a special joint that requires its own special treatment. In actual fact, the TMJ is very much like a knee, hip or shoulder.
Joints and muscles sometimes experience pain when they are forced beyond their capacity or tolerance. Once it has reached this point, either through injury or repetitive microtrauma, it is very difficult to find a way back to feeling normal.
Some things require time to heal, whilst others are cumulative and therefore require ‘de-accumulation’ of stressors.
The TMJ often falls into the latter category. For most people who experience TMJ issues, the underlying cause is often subconscious grinding and clenching. Whilst these issues are mostly centrally mediated (meaning that the brain repeats the action without much conscious thought), there are ways in which we can change the aggravating activity and get better.
Making the unconscious, conscious
Firstly it starts with making the unconscious conscious. This is much easier to do in the case of clenching. Because it is often done in the daytime as well as the nighttime.
Grinding is harder to address, but we will get to that a little later.
When we are under stress, from our environment, and from our thoughts, our bodies aim to seek protection. This is an evolutionary mechanism to help keep us alive.
By creating tension in the jaw, we can activate the sympathetic nervous system and stabilise our bodies much better. And we can also protect our head and neck.
The tension created by the TMJ muscles acts as a stabilising rod against any impact or injury. This is useful if you were about to be punched in the head. It would protect your jaw from damage and make your neck stiffer to absorb the impact.
The issue arises when there is no physical danger to protect yourself from. We inadvertently cause excessive tension of the muscles and if repeated enough, this causes them to become sensitised to even the smallest of stressors.
Once a joint or tissue becomes sensitised, the brain starts to predict danger around every corner. It will often use pain as a way to alter our behaviour.
The pain is our brain’s way of telling us that the joint and tissues could succumb to damage in the future. Our brain is trying to protect us from the outside world. But at the same time it is causing its own problems (much like shooting yourself in the foot…or jaw for this case!)
Nourishing your joints
Once you begin to understand this, you will realise why it’s important to become much more conscious of your jaw throughout the day.
Set reminders on your phone, use post-it notes or even associated certain activities (eg brushing your teeth) with trying to relax your body and jaw.
It is best to do this in combination with some slow relaxed breathing. This helps activate your body’s parasympathetic nervous system. Six to 10 breaths are all you need to make a change.
Repeat this enough times for a few weeks and you will become much more in control of the tension around the TMJ.
Once you have done this we move on to the next step, mobilising the joint.
Joints need movement to be nourished and so we can use this to help keep the jaw healthier and happier.
We start by moving into all ranges of motion possible in a slow and controlled manner. Some clicking and popping is okay, as long as there is not too much discomfort or pain or feeling that the jaw will lock or dislocate. It’s best to do these activities throughout the day when trying to relax. Make the unconscious conscious.
Stretching and strengthening the TMJ
The last portion is about stretching and strengthening. A strong and flexible joint is often a happy, healthy and pain-free joint. Utilising the exercise shown in the video we can start to slowly improve on these factors.
If you’re unable to do much at all, that’s okay. Start with what you can and slowly work your way up over days and weeks.
Remember that the tissues are sensitive and we are trying to ‘de-accumulate’. We don’t want to burn the whole house down when tidying up. We want to start tidying up little by little, moving from room to room until everything is all sorted.
Once you have utilised these steps, you are on your way to being free of that dreaded TMJ and all the issues associated with it!
This class is designed for viewers to carry it out with minimal equipment at home. We don’t use weights so these exercises are quite safe for most people.
However, before conducting any exercises please consult your GP or allied health therapist for guidance and advice about your own circumstances and whether these exercises are the right thing for you.
Always seek medical advice before starting any exercise program.