Temporo-Mandibular Disorder (TMD)
What is TMD?
TMD describes a variety of conditions affecting the jaw joints and muscles. Many people have signs of TMD but only a few have pain or other problems.
What symptoms may I experience?
- Soreness in the jaw joint, particularly on waking.
- Jaw pain when biting, chewing or yawning
- Clicking from the jaw joint
- Stiffness or locking of the jaw joint
- Frequent headaches
- Difficulty opening or closing the mouth
What causes TMD?
We are not entirely sure. Previously, it was thought that TMD was caused by a mis-aligned bite, though recent research has shown this unlikely to be true. The cause of TMD is multi-factorial, and is usually caused by overuse of the joints and muscles. Overuse may be a result of:
- Clenching the teeth together, e.g. when concentrating, anxious or annoyed.
- Grinding the teeth. Many people do this overnight and are unaware of it.
- Biting/chewing habits e.g. biting nails, chewing pencils, chewing gum.
- Altering the natural posture of your joints and muscles, e.g. holding a phone between your neck and shoulder, holding items in your mouth.
Does it get worse over time?
TMD does not usually keep getting worse. In the short to medium term, symptoms may fluctuate, and may be worse at times of stress. Usually TMD will improve as you get older
How is TMD treated?
There is no single cure that works for everybody. Most people will find improvement with simple interventions such as minimising stress on the jaw joint, carrying our simple exercises and/or having a soft bite guard. In non-responding cases, other treatments such as physiotherapy or tooth adjustment may be beneficial. Very rarely are surgery or orthodontics appropriate.
What can I do at home to improve my TMD?
You are the key to successful treatment – without your help, treatment will not be effective.
- Avoid opening your mouth very wide.
- Avoid biting/chewing habits, e.g. biting nails, chewing gum.
- Avoid foods that are particularly crusty or chewy.
- Avoid caffeine and smoking. These are both stimulants that excite nerves and can increase the perception of pain.
- Take time to relax during the day. Even 10-15 minutes can help.
- Try the exercises shown below as shown
Exercises to improve TMD
Try each of these exercises 10 times in the morning and 10 times in the evening.
If the exercises improve your symptoms, you can increase the frequency.
If they make it worse, then you can stop.
1. Jaw opening exercise:
1. Place your fingers on your jaw joints
2. Place the tip of your tongue on the roof of your mouth, as far back as you can reach.
3. Keeping your tongue in place, slowly open and close your mouth 10 times.
4. Watch in a mirror to ensure your chin moves in a straight line. If not, it will come with practice.
2. Muscle strengthening exercise
This helps to strengthen your jaw-opening muscles so addressing the imbalance in strength between jaw-opening and jaw-closing muscles
1. Start with your teeth and lips slightly apart.
2. Place the back of your hand under your chin.
3. Push upwards with your hand, but do not allow your mouth to close.
4. This provides resistance for your jaw-opening muscles to work against.
5. Hold for 5 seconds then relax. Repeat 10 times.
