Jaw problems, such as TMD (or TMJD), affect many people. Actions performed involuntarily and unknowingly 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 joint will develop problems that are a result of grinding the teeth, clenching the jaw, injuries, dislocation, or stress. This might 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, defects in the jaw at birth, 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 the patients try cold and heat packs, eating soft foods, and reducing extreme jaw movements and gum chewing are not enough, doctors may recommend NSAID medications (such as Advil or Aleve), as well as muscle relaxants, antidepressants, or antianxiety medications. Low-level laser therapy could be incorporated into treatment. Dentists might fit patients for night guards (overnight use) or splints (to be worn all of the time), which fit over the teeth and would prevent the patient from clenching and grinding. Dental treatments may include crowns, bridges, and braces.3 Other treatments could 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 might 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 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”. Opting to go through with a surgery is a very serious decision that many patients make without considering alternative treatment options. Surgery, unless all other treatment options have been exhausted and it becomes absolutely necessary, should be the last type of treatment that a patient pursues.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 may 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.
Massage for TMJ Pain
Massage is a treatment option that complements chiropractic care really well. Chiropractors often work with a patient’s massage therapist or the chiropractic office itself will devote some of their own rooms to massage for their own office therapist. Massage works because it targets trigger points, or knots, in the body and puts pressure on these points to relieve pain. The trigger point to target in the case of TMJ pain is the masseter muscle, which is the muscle primarily used for chewing and is located on both sides of the face. A tight masseter muscle contributes to TMJ pain and the grinding of the teeth. Massage therapy can release the tension in this muscle to alleviate the painful symptoms. Additionally, self-massage may be applied to the area to supplement treatment. To put pressure on the trigger point in the masseter muscle, the patient should place a loose fist under their jaw, apply light pressure by gently opening their mouth, silently count to seven, relax the jaw for a count of three, and then repeat this process three times. This self-massage is a temporary fix until the patient is able to seek care from a massage therapist or chiropractor.8