Temporomandibular Joint (TMJ) Dysfunction & Bruxism Treatment Optimization
To optimize therapeutic botulinum neurotoxin-A injection treatment, non-pharmacologic strategies should also be used. It takes time to develop these habits and nobody is perfect! However, it may help decrease the severity of your symptoms and prolong duration of neuromodulator effects.
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Bruxism refers to tooth clenching that can cause jaw pain, headaches, tooth sensitivity, dental fractures, and TMJ dysfunction.
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TMJ Disorder refers to over 30 causes of restricted range of motion and jaw pain. The most common causes include bruxism, osteoarthritis, malocclusion, and jaw injury.
Awareness of habits or jaw use patterns
• The teeth are supposed to make contact during eating and swallowing, but at no other time.
When the jaw is not working, the teeth should be apart and the jaw should be at rest.
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• Be aware of:
o Any positions your jaw continually returns to and any contact your teeth make.
o Any clenching, grinding, gritting, tapping of teeth or tensing of jaw muscles.
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• Take notice of when the above most often occurs such as when driving, studying, reading, social situations, fatigue, conversation, overwork, emotional upset, stress, or sports.
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• Be aware of whether you are able to eat on both sides.
Position the jaw to avoid tooth contacting habits
Place the tip of the tongue just behind the top front teeth and keep the teeth slightly apart.
Try to maintain this position whenever the jaw is not being used.
Avoid wide jaw opening
• Excessive movements of the jaw will place stress on the joint and the muscles.
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• Support the jaw during yawning.
o Place your index finger and thumb on your chin to provide some extra stability to the
lower jaw during yawning.
Diet modifications
• Avoid eating coarse, hard foods that require you to bite into them with the front teeth, such as apples or sandwiches if your jaw pain is active.
o Cut these foods up into small pieces and eat them with the back teeth.
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• Do not chew gum or soft chewy foods that require excessive jaw movements.
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• Softer foods place less stress on the jaw muscles and joints than coarser food.
Sleep patterns
• Avoid sleeping positions where the jaw is rested upon a hand or arm as this applies
considerable pressure to the jaw.
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• Avoid sleeping on your stomach, which places the jaw in a position where considerable pressure is placed upon either side.
o This is a very challenging habit to break! Propping pillows beside you may be helpful in
avoiding unconsciously moving to your stomach.
Leaning
• Avoid leaning on your chin or jaw anytime.
o This applies to posturing your head to press a telephone against your shoulder or
leaning on your hand at a desk.