Chiropractors can help people suffering from TMJD by finding the causes, by making gentle adjustments to the neck and jaw and by performing exercises and therapies to balance and re-train the muscles for proper movement.

What does TMJD stand for?

Dr. Dale Smith: Temporomandibular Joint Disorder, and so let me explain where that’s located. If you can take your index finger of both hands and stick it right to where your ear hole is. Not in your ear though, but right to where the ear hole is and you move your finger forward and start to open and close your mouth, you can feel that joint move.

What are the symptoms people experience and how is TMJD diagnosed?

Dr. Dale Smith: Well there’s a lot of different symptoms. For example, migraine headaches, a radiating pain to the face, neck, shoulder, limited movement or locking of the jaw, painful clicking or grinding when you’re opening and closing your mouth, significant changes in the way your upper and your lower teeth fit together, ear aches, dizziness, hearing problems, and difficulty swallowing just to name a few.

Could you tell us what causes TMJD?

Dr. Dale Smith: Injuries to the jaw, for example, from sporting accidents, automobile accidents, falls, grinding your teeth, that’s commonly called bruxism. Usually, it’s related to people that are under a lot of stress, and even certain medications can cause you to grind your teeth. According to the Journal of Oral Rehabilitation and the Journal of Cranial and Clinical Oral Investigation, the position of your head and your neck are intricately connected to the TMJD.

Let me explain what I’m talking about, Liz. I like to give an analogy when I do things.  So Liz, if you can sit up straight, and what I want you to do is just to open and close your mouth and just notice where your teeth fit together when you do that.

RC: Okay, got it.

Dr. Dale Smith: Have you done that yet?

RC: Yes.

Dr. Dale Smith: All right, now what I want you to do is I want you to extend your neck backwards, and I want you to open and close your mouth. Now you notice how your jaw pushes backwards?

RC: Right.

Dr. Dale Smith: The lower jaw. Yeah, so if you take your hand, and I want you to flex it down, your chin down to your chest. Now open and close again.

RC: Okay, yes.

Dr. Dale Smith: You see how the jaw goes forward now?

RC: Right. Huh!

Dr. Dale Smith: I mean what are most people doing these days. They’re sitting at a computer, day in and day out. They’re on their cell phones, text messaging, playing games, playing video games at home a lot of these kids, you know, or even reading books, so most of the life during the day is spent with your head down forward and doing this over periods of time can create problems with the way that the jaw functions. Does that make sense?

How is TMJD treated by chiropractors?

Dr. Dale Smith: Liz, that’s a great question. The first that we need to do is a full examination of the head, neck, and jaw before we determine treatment. All of our treatment plans are individualized depending on what’s going on with the particular patient. The exam, it includes an exam of the neck and the jaw. What we do is, we measure certain things such as the opening of the mouth. Your mouth should be able to open forty millimeters when you open it as wide as you can. You should also be able to, the lower jaw which is called the mandible, it should go from side to side, from right to left, ten millimeters in each direction.

We also check the muscles of the face and jaw for adhesions. Adhesions are like scar tissue. Have you ever cut your arm or leg or something Liz, and got a scab on it?

RC: Oh sure. Definitely.

Dr. Dale Smith: Yeah, I mean we’ve all done that. That’s an adhesion. That same thing happens actually on your muscles any time you injure them, or they’re stretched or pulled in certain directions more than they should, and so we check for those adhesions.

We also do pre- and post x-rays of the neck. We will do multiple progress reports to make sure that we’re making the progress that we should be making. If we need to change things, we change them. We also do gentle and safe adjustments of the neck and the jaw. We do exercises to strengthen and to stabilize the jaw and the neck. We’ll do therapies to re-train the muscles for proper movement of the jaw. We also do therapies that balance the muscles for proper function, and we’ll co-manage those treatment programs with the patient’s oral care provider.

What preventative measures can people take to avoid getting TMJD?

Dr. Dale Smith: Well there’s several measures to take actually to prevent getting it, under care and even after care in our clinics. There’s some dietary measures that people can do. For example, not chewing gum, hard candy. If you cut your apples in slices, it’s better for you that way. No large sandwiches. You know you get these triple decker sandwiches and trying to open the mouth wider than it should be normally will also create problems. No nuts and/or chewing ice. Chew softer foods in the beginning of care, so most people when they initially come in, we ask them to start with some soft foods. Take smaller bites. Decrease stimulants, things such as soda with caffeine, coffee, tea, energy drinks. No red meat or wild game. That doesn’t mean you can never eat it, but especially when you’re starting to have these problems, it’s a little tougher meat to chew. Maybe chew more of like a fish or chicken.

When a patient first comes in, sometimes we’ll put them on a liquid diet, and that’s because their joint is so fired up that they need to let it calm down in order to start the healing process. Posture. That’s you know with the forward head posture we talked about earlier you know sitting at your desk, phones, texting, email, social media, even while you’re driving in your car and sleeping. It’s best to sleep on your back, rather than sleeping on your side because when you sleep on your side, you’re going to put stress and pressure on that jaw, and it can aggravate it. That doesn’t mean you can’t ever sleep on your side, just during the initial phases of care when everything is all fired up, and also medications.

Often times, the side effects of a lot of these medications, they create bruxism or the grinding of the teeth. If you’re on medications, I would suggest that you look up the side effects, and if that’s one of the side effects, consult your medical doctor and let them know that you’re having this problem. Can they alter the medications, change it anyway, or you know, maybe reducing the dosage or something to reduce that grinding of the teeth.

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