Problems with the neck can lead to TMJ dysfunction. A common and often overlooked cause of this is poor posture. A slouched, slumped posture with rounded shoulders and forward head position can put stress on the jaw and affect proper range of movement. Long-term forward head posture in children and adolescents may create altered cranial bone development and movement. This may mean that the jaw bone needs to retract which will result in long- term TMJ stress and may even result in breathing difficulties like sleep apnoea. Previous whiplash injuries may lead to abnormal jaw movement too.
Any direct or indirect trauma to the jaw and/or head and neck region may not necessarily cause a fracture or dislocation, but may stretch or compress the joint itself and affect supporting ligaments.
Tension in supporting muscles of the jaw and temple can contribute to TMJ issues. This is common in people who grind their teeth or are constantly chewing gum. Headaches may also arise due to the tension in these muscles.
Bruxism (grinding or clenching teeth) may lead to micro trauma over a long period. It is important to be aware that this may occur at night while a person is asleep and they may be completely unaware of it. Teeth are not supposed to be in contact all the time, and an improperly functioning jaw resulting in tightness and the teeth in constant contact can actually lead to wearing of the tooth enamel.
TMJ disorders may not necessarily cause pain. An audible or palpable click or pop on opening or closing the mouth usually indicates a TMJ disorder as well.
What can complicate correct diagnosis is dental abnormalities and pathologies. Ear problems such as infection may also lead to pain in the jaw.
There are specific ways that a chiropractor might measure and assess jaw joint function, however a simple method for someone to determine if they may have a problem with TMJ movement is to measure how far you can open your mouth by using the knuckles of your hand as a guide. The general rule is if you can insert two or two and a half knuckles into your open mouth it is considered normal range of motion. Less than two knuckles may indicate restricted movement and more than three may indicate hypermobility or ligament laxity.
Many TMJ disorders can be assessed and managed with chiropractic care. Techniques may involve massage and trigger point therapy to tight muscles involved with chewing, and stretching of related tissues. Gentle manipulation to the joint itself is sometimes helpful at restoring correct movement. Gentle restoration of cranial bone movement may also help.
Proper assessment and diagnosis is essential in determining the cause and best treatment method to take.
by Dr Emma Wilkinson
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