Continued Tooth and Jaw Pain After Antibiotics

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The temporomandibular joint (TMJ) is the point where two bones meet on each side of your jaw. It connects the lower jaw to the bone at the side and base of your skull, called the temporal bone. The TMJ acts like a sliding hinge, allowing the jaw to move up and down and to the sides when you eat, talk and yawn. You can locate it by placing your fingers just in front of your ears and opening your mouth.

TMJ problems can be painful and disruptive — so if you have TMJ pain, talk with your doctor right away. Your doctor can talk with you about treatments for TMJ disorders, including simple exercises you can try at home.

TMJ disorders are conditions that affect the joints and muscles that control movement of your jaw. These disorders are common — researchers estimate that at least 10 million Americans have TMJ problems, and the number may be much higher.

Symptoms of TMJ disorders may include:

• Pain or tenderness in your face, especially around your jaw, ears and temple
• Trouble chewing or pain while chewing
• Trouble opening your mouth all the way
• Locking of your jaw in the open or closed position
• Clicking, popping or grinding sounds when you move your jaw
• Headaches, toothaches or changes in the way your teeth fit together
• Earaches or ringing in your ears (also called tinnitus)

In many cases, the exact cause isn't clear. TMJ disorders may be linked to a combination of factors including:

• Genes
• Other health conditions, like arthritis
• Trauma or injuries to the jaw or face

General wear and tear and stress on the joint can also play a part.

What Are the Treatments for TMJ Disorders?

Treatments for TMJ depend on how severe your symptoms are. To start, your doctor will probably recommend simple self-management techniques, such as:

• Avoiding habits that put tension on your TMJ, like clenching your jaw, resting your chin in your hand when sitting down or grinding your teeth
• Avoiding hard or sticky foods that put strain on your jaw muscles — and switching to soft foods like soup or pasta
• Applying a heat or cold pack to the side of your face
• Taking pain relievers like ibuprofen
• Gently exercising or massaging the muscles around your jaw

If you want to try TMJ physical therapy exercises, your doctor or a physical therapist can show you how.

If you have severe symptoms, your doctor may recommend other treatments, including muscle relaxants, cognitive behavioral therapy or injections. But thankfully, TMJ symptoms usually get better on their own or with gentle, non-invasive treatments.

How Do TMJ Physical Therapy Exercises Work?

Doctors often recommend physical therapy exercises as a first-line treatment for TMJ disorders. Further research is still needed on the effectiveness of physical therapy as a treatment for TMJ. But some studies have shown that exercises and manual therapy can reduce pain and increase function in people with TMJ disorders.

The overall goals of physical therapy for TMJ are to relieve pain, increase motion in your jaw and get you back to normal functioning again. Exercises that may be effective include:

• Stretching the soft tissue around your jaw and neck muscles to slowly increase how wide you can open your jaw
• Strengthening the muscles that pull your jaw backwards (to take strain off the muscles that pull your jaw forwards and side-to-side)
• Massaging the soft tissue and muscles around your TMJ, temples and neck to relieve tension and improve motion
• Training to improve your posture

In most cases, symptoms improve after a few weeks of working with a physical therapist and following instructions for self-management at home.

Can I Do TMJ Treatment Exercises at Home?

Your doctor, dentist or physical therapist can show you how to massage your TMJ. They can also teach you exercises to stretch and strengthen your jaw muscles. You can do these exercises at home a couple of times a day, at a time when you're relaxed and have a few moments to yourself.

Common massage techniques and exercises that you can do at home include:

• Masseter massage — You'll use your fingers to apply a small amount of pressure to the side of your cheek just beneath your cheek bone. Then move them in a downward motion on repeat for about a minute.
• Temporalis massage — You'll place your fingers on your temples (next to your eyebrows) and pull down slightly until your fingers reach the top of your cheekbones. Repeat this for about a minute.
• Mouth opening movement — You'll open and close your mouth for about 30 seconds while trying to keep your top and bottom teeth in line.
• Mouth opening in alignment — You'll place the tip of your tongue onto the roof of your mouth, then open your mouth as far as you can. Then close your mouth again with your tongue still on the roof of your mouth. Repeat this action for about 30 seconds.
• Sideways movement — You'll open your mouth very slightly (less than half an inch wide) and slowly move your jaw side-to-side for 30 seconds. Don't force this movement if you feel resistance.

Remember, it's very important to talk with your doctor before you start doing TMJ exercises. Doing these exercises incorrectly or too often may make your joint problems worse.

How Can I Prevent TMJ Problems?

You can't always prevent TMJ, since causes may include genes or other health conditions you can't control. But in most cases, you can lower your risk of TMJ problems by making a few changes to your regular routine. Follow these tips:

• Consider your posture – Try to maintain good posture throughout the day, especially if you're sitting for long periods of time at work. Take frequent breaks to change your position. Avoid resting your head in your hand while sitting.
• Relax and manage stress — Try to reduce your overall stress levels by taking some time out of your day to do something that relaxes you and relieves muscle tension.
• Protect your mouth and teeth — Use a mouthguard when playing contact sports to reduce your risk of fractures and dislocations. Use a mouthguard at night if you grind your teeth.
• Reduce chewing — Avoid chewing gum or eating foods that need a lot of repetitive chewing.

Resource Links:

• "TMJ Disorders" via Mayo Clinic
• "Temporomandibular Disorder" via NHS
• "Temporomandibular Joint (TMJ) Disorders" via Cleveland Clinic
• "TMJ Disorders" via MedlinePlus Medical Encyclopedia
• "Other Treatments" via The TMJ Association
• "TMJ Disorders" via National Institutes of Health
• "TMJ Exercises" via National Health Service

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