Understanding TMJ

You may not think about your temporomandibular joints (TMJ) much, but you use them a lot. The
joints connect your jawbone to your skull. Your TMJ springs into action each time you talk, chew,
and swallow.

TMJ disorders occur when something goes wrong with your jaw joints and jaw muscles. Oftentimes,
this happens because of a jaw injury, inflammation such as with arthritis, or overuse.

TMJ disorders may cause mild to debilitating symptoms, such as:

pain while chewing

pain in the ear, face, jaw, and neck

clicking, grating, or popping sounds in the jaw when you open or close your mouth

locking of the jaw joint

headaches

Exercises for TMJ pain relief

It’s unclear exactly how TMJ exercises may relieve pain. They’re thought to help:

strengthen jaw muscles

stretch the jaw

relax the jaw

increase jaw mobility

reduce jaw clicking

promote jaw healing

According to one 2010 study published in the Journal of Dental Research, performing TMJ exercises
increases mouth opening range more than using a mouth guard in people with TMJ disc
displacement.

These nine exercises from the American Academy of Family Physicians (AAFP) and the Royal Surrey
County Hospital may help relieve TMJ pain and improve the movement of your jaw joints. For some
exercises, there are frequency recommendations. For exercises where frequency recommendations
aren’t available, ask your doctor or dentist for guidance.
1. Relaxed jaw exercise

Rest your tongue gently on the top of your mouth behind your upper front teeth. Allow your teeth
to come apart while relaxing your jaw muscles.

2. Goldfish exercises (partial opening)

Place your tongue on the roof of your mouth and one finger in front of your ear where your TMJ is
located. Put your middle or pointer finger on your chin. Drop your lower jaw halfway and then close.
There should be mild resistance but not pain. A variation of this exercise is to place one finger on
each TMJ as you drop your lower jaw halfway and closed again. Do this exercise six times in one set.
You should do one set six times daily.

3. Goldfish exercises (full opening)

Keeping your tongue on the roof of your mouth, place one finger on your TMJ and another finger on
your chin. Drop your lower jaw completely and back. For a variation of this exercise, place one finger
on each TMJ as you completely drop your lower jaw and back. Do this exercise six times to complete
one set. You should complete one set six times daily.

4. Chin tucks

With your shoulders back and chest up, pull your chin straight back, creating a “double chin.” Hold
for three seconds and repeat 10 times.

5. Resisted opening of the mouth

Place your thumb under your chin. Open your mouth slowly, pushing gently against your chin for
resistance. Hold for three to six seconds, and then close your mouth slowly.

6. Resisted closing of the mouth

Squeeze your chin with your index and thumb with one hand. Close your mouth as you place gently
pressure on your chin. This will help strengthen your muscles that help you chew.

7. Tongue up

With your tongue touching the roof of your mouth, slowly open and close your mouth.

8. Side-to-side jaw movement

Put a ¼ inch object, such as stacked tongue depressors, between your front teeth, and slowly move
your jaw from side to side. As the exercise becomes easier, increase the thickness of the object
between your teeth by stacking them one on top of each other.
9. Forward jaw movement

Put a ¼ inch object between your front teeth. Move your bottom jaw forward so your bottom teeth
are in front of your top teeth. As the exercise becomes easier, increase the thickness of the object
between your teeth.

Other ways to manage your TMJ pain

Over-the-counter pain relievers such as ibuprofen and acetaminophen may help relieve TMJ pain.
Muscle relaxers may be prescribed for severe pain. Doctors may also recommend:

mouth guards to prevent teeth grinding and jaw clenching

mouth guards to help realign your jaw

warm towels

ice, no more than 15 minutes per hour and not directly on the skin

stress-relief techniques to help prevent behaviors that cause jaw tension

acupuncture to relieve pressure in the affected area

Severe pain caused by damaged joints may require more invasive treatments, such as corticosteroid
injections into the TMJ. Surgery may be considered as a last resort. There isn’t any scientific evidence
that surgical interventions for TMJ disorders are safe and effective.

TMJ pain may also be managed with simple lifestyle changes. You may wish to:

eat a soft diet to allow the TMJ to relax

avoid chewing gum

avoid biting your nails

avoid biting your lower lip

practice good posture

limit large jaw movements, such as yawning and singing

Tips for relieving pain during dental care

If you have TMJ, it may be painful to practice basic oral hygiene. This includes brushing your teeth,
flossing, and getting routine dental cleanings.
The TMJ Association recommends these tips to reduce pain and help make sure your teeth and gums
stay healthy:

Use a soft-bristle toothbrush or a sonic toothbrush.

Use a rubber tip stimulator or water flosser if you can’t open your mouth to floss.

Add an antiseptic mouth rinse to your daily dental care regimen.

Tell your dental care team if you’re in pain during a dental procedure.

Apply ice or heat after a dental procedure.

Talk to your dentist about ways to remove plaque other than flossing. For example, they may
suggest wiping your teeth with cotton gauze.

The bottom line

In some cases, TMJ disorders go away on their own. If your symptoms persist, TMJ exercises may
help bring pain relief. TMJ exercises shouldn’t be done when you’re in severe pain. The AAFP
recommends waiting until your pain is better before starting a TMJ exercise regimen.

When doing TMJ exercises, start slowly. You may feel some pain at first, but it should be tolerable
and gradually improve. If the pain isn’t tolerable, consult your doctor. You should do TMJ exercises
when you’re relaxed. If you do them when your muscles are tense, it may defeat the purpose.

If your pain worsens after doing TMJ exercises, make an appointment with your doctor.