Post Treatment Care
- Apply moist heat or cold to the joint or muscles that are sore. Heat or ice applications used up to four times per day can reduce pain and relax the muscles. For heat, microwave a wet towel for about 1 minute or until towel is warm. Then wrap the warm towel around a hot water bottle or heated gel pack to keep it warm longer. Apply it to the affected area for 15-20 minutes. For cold, use ice wrapped in a thin cloth. At first, you may feel a burning sensation and this is normal. Keep ice on the painful area only until you first feel some numbness, but not more than 5 minutes. Use what feels best but in general, heat is used for more chronic pain conditions and cold for acute conditions. Never use heat on a tooth ache, only on joint pain.
- Eat a pain free diet. Avoid hard foods such as French bread or bagels. Avoid chewy foods, such as steak or candy. Cut fruits and steam vegetables into small pieces. DO NOT chew gum!
- Chew food on both sides of your teeth at the same time or alternate sides. This will reduce strain to the muscles and joints. If biting into food with your front teeth is painful, then cut up your food with a fork and knife and chew with your back teeth.
- Keep your tongue up, teeth apart and jaw muscles relaxed. Closely monitor your jaw position during waking hours so that you maintain your jaw in a relaxed, comfortable position. This often involves placing your tongue lightly on the palate behind your upper front teeth (you can find this position by saying “n”). This allows the teeth to come apart while relaxing the jaw muscles.
- Avoid caffeine. Caffeine can interfere with sleep and increase muscle tension. Caffeine or caffeine like drugs are in coffee, tea, soda, power drinks, and chocolate. Note that some decaffeinated coffee has up to half as much caffeine as regular coffee.
- Avoid oral habits and activities that put strain on the jaw muscles and joints. Oral habits such as teeth clenching, grinding (bruxism), teeth touching or resting together, biting cheeks or lips, tongue pushing against teeth, jaw tensing, biting objects, shoulder shrugging, neck tensing, and other activities such as overextending yawning, prolonged dental treatments, resting your jaw on your hand, over chewing, excessive singing, or use of musical instruments can strain the jaw. Remind yourself to check regularly to see if these activities are present through reminders such as stickers or timers. If noticed, these habits should be replaced with positive habits such as tongue up and teeth apart. Use your own good judgment to minimize activities that cause discomfort.
- Keep head up, chin in and shoulders down and back. Closely monitor your head position over your shoulders to maintain a balanced relaxed head, neck and shoulder muscles with a forward head posture. This will help in reducing strain to jaw, neck and shoulder muscles.
- Learn and practice relaxation and abdominal breathing. This will help reduce your reactions to stressful life events and decrease tension in the jaw and neck.
- Avoid events that trigger the pain. Use a pain diary to review daily activities that aggravate the pain and modify your behavior accordingly.
- Get a good night’s sleep. Manage your sleep environment. Reduce light and noise and lie on a comfortable mattress. Reduce stimulating activities in late evening including computer work and exercising. Avoid stomach sleeping since this puts adverse forces on the jaw and neck muscles.
- Use anti-inflammatory and pain reducing medications. Short term use of over the counter ibuprofen, naproxen, acetaminophen or aspirin (without caffeine) can reduce joint and muscle pain. If compatible with patient conditions and lifestyle, consider use of combination of analgesic and muscle relaxant in the evening.
Self-care is often a first step in the management of TMJ. Recognize that this is not a life-threatening situation, even though it can be very uncomfortable. Injury to the TMJ and jaw muscles is extremely common and joint noises (clicks, pops) and locking of the jaw is also not uncommon. Most often these symptoms are transient, or will come and go. Changing habits, relaxing the area and avoiding additional strain or injury will better manage your pain.