Jaw pain?
How can chiropractic care help your jaw pain? Our chiropractor, Dr. Tannis, explains below!
Have you considered seeing a chiropractor for your jaw pain? Not only can chiropractic care help ease the pain or address that pesky clicking that always happens when you eat- but they can give you strategies to use at home! Chiropractic treatment of the Temporomandibular joint (TMJ) is very gentle and encompasses assessing your jaw to see what might be causing the discomfort you are experiencing. Treatment includes soft tissue work to relax the muscles that are overactive, helping the jaw move more symmetrically through mobilizations and prescribing exercises to increase the activity of muscles that can help take the load off your jaw. Chiropractors are also able to identify when dentistry assessment may be required to relieve jaw pain and will often work collaboratively with your dentist to ensure that you are receiving the best possible care.
Let’s talk about the joint that causes your jaw pain and what leads to TMJ disorders:
You have two temporomandibular joints, one on either side of your face (located right in front of your ear). The joint is formed by the mandible (the bone that forms your jawline) and your temporal bone (the portion of your skull above your ear). This joint is extremely unique in that the surfaces of the bones that form the joint never come into contact with one another- they are separated by an articular disc (a cushion-like structure). This disc is integral to allow your mouth to open and close. To open your jaw, the disc, mandible and muscles attached to the area must work together in tandem. When these structures aren’t functioning as they should- jaw pain can result.
The biomechanics of the joint - how does this joint work!?
At rest/when your jaw is closed, the mandibular condyle sits on the disc (cushion)
Opening- the condyle rolls and slides forwards on the disc
The mandibular condyle remains on the disc during the entire normal jaw opening process (think of them as a working unit)
Temporomandibular Disorder:
Temporomandibular disorder (TMD) is an umbrella term that encompasses jaw pain (which can be caused by the muscles, disc or surrounding structures that allow the joint to operate. TMD is the 2nd most common type of musculoskeletal pain, with 33% of the population experiencing at least one symptom at some point in their lifetime. Overall, females have a higher rate of TMD across all ages with the peak incidence being 25-45 years old. There is a huge association between stress levels and TMJ pain! Research has also shown that mask wearing can provoke jaw pain… aka the last 2 years of incredible stress and mask wearing creates the perfect storm for developing jaw pain!
What causes problems in this joint?
- Direct trauma
- Stress (we tend to clench our jaw or grind out teeth when stressed)
- Sleeping with our mouths open
- Poor posture (leaning over that desk to get closer to your computer)
- Neck muscle tension (think of that shoulders up by ears position you find yourself in after a long day)
- Excessive chewing
- TMJ hypermobility and ligament laxity
- Poor bite mechanics
- Osteoarthritis/break down of the joint from wear and tear
What the heck is that clicking in my jaw?
- If the disc (which as seen above normally sits directly on top of the mandibular condyle) becomes stuck forwards, it becomes an obstacle for the condyle to move over, and as the condyle hops back onto the disc, a clicking noise is produced!
Symptoms of TMD:
- Headaches that are most intensively felt above the ear (around your temples) and eyebrows or over the eyes
- Tooth aches
- Clicking when opening or closing jaw (most often noticed when eating)
- Painful yawning
- Crunching or grinding sounds when using your jaw
- Facial pain
- Pain over the joint (just in front of your tragus)
- The feeling of fullness in the ear
- Dizziness
- Teeth grinding (bruxism)
- Persistent upper neck pain
What can make your jaw pain worse:
- Very dense/chewy foods (think steak)
- Big yawns
- Grinding your teeth
- Stress, anxiety and depression
- Extensive dental work (due to the mouth being forced open for prolonged periods)
- Facial tension
- Poor posture (leaning on your chin all day at work)
- Sleeping on your stomach
What can make your jaw pain better:
- Eating softer foods
- Stress reduction
- Mouth guards from your dentist (if indicated)
- Over the counter pain relief
- Improving your bite- dentists are wonderful at helping with this
- Improving ones posture
- Stretching and exercise
- Botox (if indicated)
- Chiropractic treatment!!!
What I do as a chiropractor to help relieve jaw pain
I will assess both joints to determine which part of your joint’s mechanics need to be addressed- whether that be the disc, the movement of the joint or the muscles that control it. I will also assess your neck to see if your posture or weakness in certain muscles could be contributing to your jaw pain. I can assess whether you could benefit from dentistry and will give you self-management strategies that you can use every day to help relieve the pain and prevent it from coming back in the future! Treatment of this area is incredibly gentle and I utilize a combination of acupuncture, soft tissue release and mobilization of the joint to help relieve that pain and discomfort.
How do I know if I have TMD?
Try the following self-assessment techniques to determine whether you could benefit from TMJ assessment and treatment:
1. Tongue position- does your tongue naturally rest on the roof or bottom of your mouth?
a. What it to be on the roof of your mouth behind your front teeth
b. If it rests on the bottom of your mouth- it means you have increases tone to your genioglossus muscle (tongue muscle)
2. Teeth position- at rest, do your teeth touch or are apart?
a. You want your teeth to be slightly apart at rest (enough that they aren’t overlapping). If they are together, it means that the muscles that control your jaw are too tight.
b. Try to maintain this space at rest if possible
3. Breathing- do you breathe through your nose or mouth?
a. Open mouth breathing requires more jaw muscle activation and increases the stress placed on the jaw.
b. Another way to know if you mouth breathe (during sleep especially) is if you often find your pillow damp from drool in the morning!
4. Swallow test
a. While sitting up straight, place your hand on the front of your neck (location of where the ‘adams’ apple or the pointy bone in the front of your neck is), with the other hand touch the muscles right under the ridge of your skulland swallow.
b. What did you feel? What you should feel is the bone in the front of your neck rise and lower and no movement should be felt at the back of your neck.
c. If you felt the muscles at the base of your skull activate or you noticed your skull fell back slightly towards your spine- the muscles that aid in swallowing are weak
5. Knuckle test
a. Open your mouth and see how many knuckles you can fit in between your upper and lower teeth. Normal is 3.
Want some tips for pain relief or activities you should avoid that can make your pain worse? Book in for an assessment with Dr. Tannis!
Dr. Tannis’ Top tips for pain relief:
o Wear your mouth guard at night if prescribed
o When yawning, support the bottom of your jaw with finger
o Sit up tall, especially when eating.
o Keep teeth apart when resting
o Rest tongue on roof of mouth
o Try nose breathing
o Do jaw massage daily before bed time- bedtime is ideal (use your gua sha or facial cups for added benefit)
Avoid:
o Slouching, poor posture
o Chewing heavy meats, nuts, raw foods
o Taking big bites
o Chewing gum, nailbiting, pencil biting
o Intentionally clicking jaw
o Resting chin on your hand
o Sleeping with your mouth open
o Sleeping on your hand
o Taking large yawns (support your jaw as you yawn)