What to know when seeking manual therapy for jaw tension/pain

So far, in five years of practice, I’ve had two clients come in for TMJ relief sessions who had previously seen multiple practitioners who worked inside their mouths to try to relieve their TMJ symptoms.

They had seen chiropractors, chiropractic neurologists, Rolfers, dentists trained by the Las Vegas Institute (LVI), and/or other massage therapists.

These two clients both told me, “No one has ever touched me there,” after I worked on their lateral pterygoids.

These are small, hard to access muscles, and in my opinion, they are most often the key muscles to address to release jaw tension.

anatomy of the jaw muscles

It’s not that the other jaw muscles don’t contribute. They do, and in roughly 10% of the TMD cases I’ve worked on so far, one of the medial pterygoids is “the problem child” creating the most pain and dysfunction in the jaws.

The external jaw muscles — the masseters and temporalises — also play a role in jaw tension but are never (that I’ve seen so far) the biggest contributors.

In other words, about 90% of the time when people have jaw pain from muscle tension, the lateral pterygoids are the main source.

It’s not that these other intra-oral practitioners have nothing to offer. Chiropractors, Rolfers, and massage therapists have definitely helped me, and I’m not familiar with the others. Also, some LVI-trained dentists do receive specific training in treating TMJ issues — and I’m sure they can help with more complex or advanced problems.

The only complaint I’ve heard about going to a physical therapist for TMJ relief is that they work aggressively, with little concern for patient comfort. I’m pretty sure that is because they are restricted by insurance companies to the amount of time allowed to address a given problem. If you can handle it, they probably will work on your lateral pterygoids.

You can always talk to them first about what to expect.

I don’t work with insurance, but even people living on a budget who are determined to get gentle, lasting TMJ relief have found a way to pay my reasonable rates.

I’ve learned through trial and error that one 75-minute session provides relief, but it may not be lasting. For longer-lasting relief, 5 sessions in 4 weeks with support for habit change and self-care help retrain the jaw muscles to lengthen and relax.

If jaw tension or pain resulting from jaw tension is your major complaint, and you’d like a sense of spaciousness in your TMJs (if you can even imagine how great that would feel), please seek a practitioner that works on the lateral pterygoids.

Click here to book a free 30-minute consultation. (My practice is in Austin, Texas.)

Things that distinguish my work:

  • I work as gently as possible. 
  • I never make any sudden moves. 
  • My sessions start with full body alignment to get you relaxed and progress toward the intra-oral work near the end. 
  • My referral partners include dentists, chiropractors, doctors, and massage therapists.

I started a Facebook group, Word of Mouth: Resources for Jaw Pain/Dysfunction, for people who want to work on their jaw issues. You can ask questions and learn more there.

I hope this information helps you ask informed questions when choosing a practitioner to relieve your jaw tension and pain. 

Healing a deep dental pocket

I went to the dentist yesterday for an exam and cleaning, five months after my previous visit. The best news is that the pockets that had deepened from using the Waterpik on too high a setting and too much angle have returned to 2s, 3s, and a couple of 4s.

Since that appointment, I returned to flossing and using dental picks, as described in a previous post, Rebuilding tooth enamel after drinking water with lemon. I continued to gently brush my gumlines at a 90 degree angle.

That did the job, except for one tooth. The back part of my upper right back molar has pockets measuring 7 and 8 mm (3 or lower is healthy). It was painful when the hygienist was probing with her tool. On earlier visits it’s been 4 or 5 mm deep, concerning but not dire. Now it’s dire.

I’ve never had any pockets this deep, and of course they want me to see a periodontist. (Beyond that, the hygienist didn’t have much scraping to do, so my plaque levels are down.)

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Image from Brandywine Dental Services

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Floss regularly for longevity, plus floss recommendations

Not kidding! Flossing regularly is an indicator of longevity. Of course it’s not a guarantee. It’s just that people who are knowledgeable about the benefits of flossing and who are motivated to get/keep their mouth in great shape floss — and are more likely to take care of their health in other ways.

Plus, flossing has been found to prevent heart disease.

Face it, flossing isn’t very much fun. About the most I’ve been able to get out of it is (1) being mindful about doing it daily and seeing improvements in gum health (no tenderness and bleeding is the goal), and (2) going to the dental hygienist and her barely needing to do any scraping. In fact, last time I went, I got to skip a scaling procedure, which would have been unpleasant. It also saved me $60. Continue reading

Healing bleeding, tender gums

I skipped going to the dentist for three years, and when I finally went, I had a few molar fillings that had decay underneath. They were old, from back when I was a teenager.

I also had several deep pockets. The worst one measured 6. One or 2 is considered good.

I got a couple of crowns to replace those decayed molars, and I got my teeth cleaned. My next appointment for cleaning was in 4 months. I was told to floss once daily and brush twice daily.

I vowed that I would floss every day. And I did. (I still usually just brush once, and again only if needed.)

Working with nutritionist/acupuncturist Olivia Honeycutt at Merritt Wellness, who was having me take Organically Bound Minerals, I also tightened my diet up — no grain, dairy,  or sugar.

When I went back four months later, the hygienist barely had any scraping to do because I had hardly any tartar.
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