Learning with laughter

TMD Tips: Tongue Tips, Teeth Grinders and More

November 08th, 2009

Tongue tips – The tip of tongue should always be on the roof of mouth. Test it by saying the letter “m” or “n”.  Ask your patients, “Where is your tongue rest in your mouth. “  Many TMD patients are unaware that their tongue is sitting the wrong place and in a low lingual position. The partial vacuum that exists when the tongue is sitting in the “n” position and the palate is critical in supporting the jaw.  Extra bonus it also facilitates deep diaphragmatic breathing.

Teeth grinders – In these tough economic times, people are taking it out on their teeth, and therefore jaws more and more.  Most people are unaware until they break a tooth or an implant, have morning headaches and have stuffy noses.  Some nocturnal grinders will grind up to 40 minutes and can exert up to as much as 200 pounds per square inch on their teeth.

As we enter the cold season it may be of interest to note a little known side effect of all this clenching, ie a sore throat or sinusitis or stuffiness in the ears.  If clients not feeling other cold like symptoms It may not be a virus. Instead could be due to over activity in the clenching muscles.

Side effects of Masseter overuse. Patient will complain of:

1.      Pain and restricted opening to two thirds. or less of normal aperture (at least 45mm for women and 55mm for men) Quick test –  ask patient if they can get three knuckles between teeth.  If two has restricted movement.

2.       Pain in upper molar teeth, adjacent gums and maxilla.

3.       Maxillary pain is often described as “sinusitis”

4.       Unilateral tinnitus. If tinnitus is bilateral suspect a systemic rather than myofascial cause. However deep layers of master can become involved bilaterally in this case unilaterally it can fluctuate in its intensity

Side effects of Temporalis overuse. Patient will complain of:

1.        Headache throughout the temples, along eyebrow, and behind the eye

2.        Hypersensitivity and aching of upper teeth

3.        Premature tooth contact

Side effect of the medial pterygoid (which can be can be palpated below the inner aspect of the angle of the jaw).

1.        Sore throat with no infection

Try to remind your patients that tongue should be on the roof of mouth, with teeth apart and lips together and breathe slow!

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