What does jaw therapy mean?
Jaw therapy essentially refers to temporomandibular joint (TMJ) physiotherapy, which focuses on restoring muscle- and joint-related changes in the jaw joint and the resulting functional disorders, thereby reducing local and referred pain.
According to current professional guidelines, conservative treatment is primarily recommended for TMJ dysfunction and pain, with TMJ physiotherapy being the cornerstone. The first step is to restore the resting position of the jaw joint, which includes eliminating harmful oral habits and relaxing the masticatory muscles, both of which require physiotherapy exercises.
TMJ physiotherapy is a specialised therapy. It aims to treat complaints localised in and around the jaw joint and also addresses head, neck, and facial pain, commonly referred to as orofacial pain syndrome.
The masticatory muscles play a major role in the development of temporomandibular joint complaints. The most effective method for treating them is soft tissue mobilization applied both externally and intraorally. Its execution requires precise anatomical and manual knowledge. It is necessary to distinguish between different types of soft tissues. We can treat muscle fascia, muscle fibers, tendinous origins, tendinous insertions, or the muscle-tendon transition. In some cases, connective tissue structures adhere to one another, causing joint movement restrictions or contractures. During soft tissue mobilization, we ensure optimal mobility of the soft tissues, which forms the basis for joint mobility.
In temporomandibular therapy, soft tissue mobilization combined with jaw physiotherapy exercises gradually reduces established muscle spasms and prevents further excessive tension in the masticatory muscles, thereby alleviating local or referred pain in and around the jaw joint.
When might jaw therapy be needed?
Approximately 33% of adults and 11% of children are affected, and 5–12% of them require treatment. In Hungary, this corresponds to about 3,300,000 people with symptoms of temporomandibular joint dysfunction, and around a quarter of a million of them need treatment.
Temporomandibular therapy is necessary in the presence of TMJ dysfunction. TMJ dysfunction refers to altered, abnormal function of the joint. Its main symptom is pain in the jaw joint, masticatory muscles, or the area in front of the ear, which usually increases with chewing or jaw movements. Jaw movements may become irregular, restricted, or asymmetrical. Joint sounds may also occur: clicking, crepitus, or popping.
Jaw therapy provides effective treatment in the following cases:
- jaw pain
- lockjaw or limited mouth opening following dental treatment
- spontaneously occurring lockjaw or limited mouth opening
- lockjaw or limited mouth opening after traumatic injury
- lockjaw or limited mouth opening after radiation therapy
- prolonged difficult mouth opening (e.g., during dental treatment)
- jaw clicking (especially if painful and/or related to orthodontic treatment)
- jaw crepitus, popping (TMJ osteoarthritis)
- teeth clenching or grinding during sleep or awake
- difficulty chewing
- difficulty swallowing
- lump sensation or tight throat
- after traumatic injury to the jaw joint
- painful, tense masticatory muscles due to tongue thrust swallowing
- neck tension, neck pain
- tooth pain of unknown origin
- ear problems of unknown origin (e.g., tinnitus, ringing, popping, blocked ears)
- frequent headaches or pain at the top of the head of unknown origin
- sinus-related facial pain of unknown origin
- facial numbness of unknown origin
- dizziness of unknown origin
How does jaw therapy take place?
Comprehensive jaw therapy begins after the first consultation, although the first consultation already includes treatment.
Each session starts with a physical examination. During the joint movement assessment, we evaluate the range of mouth opening and forward, right, and left movements of the jaw joint. We check whether the movement is accompanied by pain or joint sounds. This is followed by palpation of the joint and muscles, where we look for tender points around the jaw joint, as well as in the masticatory and neck muscles. We also examine whether these painful points cause referred symptoms.
We review the patient’s feedback regarding home exercises. We assess to what extent they were able to follow the previously assigned home program, whether it caused pain, muscle soreness, or whether they noticed improvement or worsening. Next, we check the execution of the physiotherapy exercises. The results of the physical examination are compared with the patient’s feedback and exercise performance. Every detail is evaluated together, and based on this, the exercises are continued or adjusted if necessary. Patient education is emphasized throughout the therapy. Every jaw exercise has a purpose, and understanding the origin of the complaints helps the patient engage with the exercises more effectively. The home program is complemented with additional jaw exercises and lifestyle advice. If needed, manual techniques to be performed at home are reviewed. Each session includes masticatory muscle relaxation using soft tissue mobilization techniques. Additional therapies and involvement of other specialists may be recommended if necessary, with specific professionals suggested.
Results of jaw therapy
In most cases, the effects of jaw therapy on TMJ complaints can be felt from the very first session, but achieving qualitative improvement depends on the condition and requires time. For muscle-related TMJ issues, treatment typically takes around 3 months. For acute joint or cartilage-related problems, 1–2 sessions of TMJ physiotherapy may be sufficient, whereas chronic cases require multiple sessions.
Results achievable with regular and professional jaw therapy:
- reduction of jaw pain
- reduction of chewing pain
- decrease in teeth clenching and grinding during wakefulness and sleep
- improved sleep quality
- resolution of lockjaw and limited mouth opening
- pain-free mouth opening, yawning, speaking, laughing, and singing
- relief from tinnitus (reduced frequency and volume)
- elimination of neck pain
- increased awareness of proper posture
- complication-free dental treatment
- improvement in psychological well-being
Research results:
At the Department of Prosthodontics, Semmelweis University, during a study in the first half of 2019 involving 155 participants, we found that among patients with temporomandibular dysfunction, the most common symptom was jaw joint pain (90.97%), followed by nocturnal (62.58%) and daytime (63.87%) teeth grinding. Other frequent symptoms included jaw clicking (53.55%), tinnitus (41.29%), and limited mouth opening (36.13%).
Participants attended an average of 2.7 jaw physiotherapy sessions to achieve improvement. The most significant results of temporomandibular therapy were observed in reducing tinnitus (82.81%), daytime teeth grinding (81.82%), and jaw pain (65.95%). Substantial improvements were also seen in limited mouth opening (60.61%), nocturnal teeth grinding (49.48%), and jaw clicking (43.99%).
How many sessions are needed?
For simple cases, jaw therapy typically lasts around 8 weeks. Initially, sessions are weekly, then every two weeks. Personalized home exercises are gradually introduced during therapy. Creating the final exercise program in simple cases usually requires 2–3 in-clinic sessions. Exercises should be performed 2–3 times daily at home until symptoms resolve. Once a symptom-free state is achieved, a personalized jaw therapy exit program is provided, gradually tapering the previously daily exercises. Once the exit program is underway, in-clinic sessions are no longer necessary.
Jaw therapy exit exercises
The jaw therapy exit program is a personalized 4-week physiotherapy plan designed to gradually reduce daily exercises once near symptom-free status is achieved. The jaw-specialist physiotherapist determines when to begin the exit program, based on the patient’s physical condition and feedback. The program also includes guidance on exercises to perform if previous symptoms return.
Book an appointment for jaw therapy!
Do you have long-standing temporomandibular joint complaints? Have you already had a first consultation with us? If yes, book a jaw therapy session; if not, book a first consultation! Our empathetic jaw-specialist physiotherapists have extensive expertise and experience. We look forward to helping you get relief from jaw joint complaints! You can book online by clicking the Book Now button or call us at +36 70 555 75 33 to find the most suitable appointment.
