Jaw problems, such as TMD (or TMJD), affect many people. Actions performed during sleep, as well as other injuries, can cause headaches and pain during the day, as well as long-term problems that could even lead to serious medical interventions. Chiropractic and other alternative treatments may help ease some of these jaw and mouth problems.
The joint that hinges the lower jaw to the skull is called the temporomandibular joint (TMJ). Sometimes this can have problems resulting from grinding the teeth, clenching the jaw, injuries, dislocation, or stress. This can lead to tenderness, pain, not being able to widely open the mouth, locked jaws that stay open or closed, trouble with chewing, facial swelling, and popping or clicking sounds. Patients often suffer from pain – in the teeth, head, neck, shoulders, and ears.1 The disorders are collectively called TMD or TMJD (temporomandibular joint disorder). The most common cause of TMD is bruxism (teeth clenching and grinding), but it can also come from aging, which causes bite collapse and an “unnatural position of the lower jaw while chewing”. Sports and other accidental injuries, stress/anger jaw clenching, dental procedures (such as restoration and defective crowns), poor orthodontics, gum chewing and nail biting, and excessive mouth opening (such as yawning or eating overly large or hard foods) can also contribute to TMD.2
If cold and heat packs, eating soft foods, and reducing extreme jaw movements and gum chewing aren’t enough, doctors may recommend NSAID medications (such as Advil or Aleve), as well as muscle relaxants, antidepressants, or antianxiety medications. Low-level laser therapy may be incorporated into treatment. Dentists may fit patients for night guards (overnight use) or splints (worn all of the time), which fit over the teeth and prevent clenching and grinding. Dental treatments may include crowns, bridges, and braces.3 Other treatments may be used. Transcutaneous Electrical Nerve Stimulation (TENS) utilizes electrical currents to relax the jaw. Ultrasound treatments apply heat to the TMJ. Some doctors may use radio wave therapy as well, to increase the blood flow. Patients may even be given injections of anesthesia or pain medications to “trigger points”. The most invasive treatments of all include surgery. Surgical solutions are permanent and irreversible. They are performed under general anesthesia, which can be dangerous. Arthrocentesis involves “involves inserting needles inside the affected joint and washing out the joint with sterile fluids”, arthroscopy allows the surgeon to “remove inflamed tissue or realign the disc or condyle”, and open-joint surgery is the most invasive of all: “the entire area around the TMJ is opened”. The latter treatment has the most risk of “scarring and nerve injury”.4
For some patients, TMD can be resolved by practicing good posture, keeping the teeth apart (such as blocking them with the tongue), or relaxation techniques to reduce stress.5 Biofeedback is another alternative treatment option. Patients can use a mirror to help them relax the jaw and reduce symptoms. Some patients may even benefit from a “nighttime biofeedback instrument”, like a headband or other device, that helps retrain jaw habits during sleep.6 Other alternative care can include “chiropractic manipulation, massage, applying heat/ice and special exercises”. Very often, chiropractors will work with dentists so that patients who need splints or night guards can have co-managed care. Chiropractors will also recommend the more conservative treatments, such as heat, ice, avoiding “harmful joint movements”, and special stretching exercises.7 With prevention and alternative treatments, patients may be able to avoid invasive, and potentially dangerous, medical and surgical procedures.