TEMPOROMANDIBULAR  JOINT/MUSCLE DYSFUNCTION

Many patients experience pain or limitation of movement in their jaw joint (TMJ) at different times of their lives. The following instructions will the healing for a sore jaw joint.

I. Activities

• Do NOT chew gum.

• During the initial phase of treatment, particularly if symptoms are acute, stay on a definite soft diet (baby food, soups, milkshakes, eggs, hamburger, etc.)

• For the next few months, be sure to cut all foods into small, bite sized pieces and try to avoid opening your mouth any wider than the thickness of your thumb. (1-2 inch).

• Do not eat hard crusts of bread, rough meat, raw vegetables, or any other food that will require prolonged chewing.

• Do not chew peanuts, ice cubes or any other substance that is repeatedly milled between your back teeth.

• Do not chew gum, bite your lips, clench your teeth or habitually chew the insides of your cheeks.

• Do not thrust your lower jaw forward, as when biting off a piece of thread, applying lipstick, smoking, or through force of habit.

• Do not bite any food with your front teeth.

• If you must yawn, limit the distance your mouth opens by pulling your lower lip up over the edges of your lower teeth.

• Make every effort not to strain your jaw joints unnecessarily by such activities as talking excessively, deliberately popping your jaw joint as one would pop the knuckles of his hand, leaning on the palm of your hand while reading or watching TV, etc.

• Try to sleep on your back. Avoid sleeping on the side of your face or on your fist.

• During all times of occupational, marital or academic stress, and also while waiting to fall asleep at night, say to yourself "lips together, teeth apart" over and over again.

• Try not to do strenuous work or lift items weight more than 10 pounds above your waist because when your jaw muscles and jaw joints are out of balance, your body is out of balance and your pains will probably increase due to this imbalance.

• A low fat diet should be maintained due to the fact that fats produce adds and are hard to digest. Therefore, milk, cream and eggs should be avoided because of their high fat content. IT IS IMPORTANT TO STAY ON A HIGH PROTEIN DIET. It may be advisable to take a multiple vitamin preparation to insure adequate vitamin intake.

• PREPARE FOODS BY: BOILING, BAKING OR PRESSURE COOKING. DO NOT FRY.

II. Aspirin, Motrin or Advil

• Since aspirin is the drug of choice for inflammation of any joint, you should initially take two 5 grain aspirin tablets every four hours. As symptoms improve you may reduce the amount of aspirin you are taking. Please take medication with food to prevent stomach upset.

• If you cannot take aspirin for any reason, you may take any of the aspirin substitutes.

• If you need a stronger drug for pain, we can prescribe a different type of medication.

• Motrin or Advil can also be effective for jaw pain. Take 200-400 mg every 4 to 6 hours as directed.

III. Moist Heat/Ice

• Moist heat applied to the area around a painful joint provides more relief from pain than dry heat.

• Fill a basin with water as hot as the skin can stand and soak two large wash cloths in it. Take one out,wring it out, and apply it to the painful area. When the first towel cools off apply the second towel. Repeat with hot towels for a total of 20 minutes.

• Follow moist heat with ice cubes. Rub on painful area for 30 seconds/wait 30 seconds and repeat for 5 minutes.

• This procedure should be carried out for 25 minutes 3 times a day allowing for at least a 20 minute interval between applications.

IV. Disengagement

• One of the most important steps in breaking the habit of clenching and grinding your teeth is to learn to keep the lips together and teeth apart. You must make a conscious effort to separate the teeth at the same time you keep the lips closed. Repeat to yourself several times a day, "Lips together and teeth apart."

• This simple step will relax the very muscles that become tense and taut, besides permitting a more normal positioning of the jaw joints. Remember, the only time your teeth should normally touch is during swallowing and chewing.

• If you clench or grind your teeth, you will continue to injure your chewing system and thus delay healing and the results of our treatment.

These few simple rules can easily allow you to avoid such jaw movements that might re-injure your joints, muscles or ligaments.