The World Health Organization (WHO) describes self-care as the ability of individuals and families to maintain their own health, prevent disease and to cope with illness – with or without the support of a health or care worker.[i]
For patients with chronic conditions, self-care is a bedrock for recovery, getting patients to not just live with a condition, but to try and overcome it where possible.
Temporomandibular joint disorder (TMD) is one such condition, affecting up to 34% of the world’s adult population.[ii] A complex chronic pain disorder, patients with TMD should follow self-care practices to alleviate its symptoms and restore function to the jaw in a non-invasive way. Dental practitioners can empower TMD patients to take charge of their health.
Six steps of self-care
By helping patients identify behaviours that may cause pain, dental practitioners can provide an educational foundation from which the patient can better care for their TMD, focusing on the following:
- Dietary advice and nutrition
- Thermal therapy
- Massage
- Therapeutic exercises
- Parafunctional behaviour identification, monitoring and avoidance[iii]
Controlling diet is a form of self-care for TMD patients. Certain foods can aggravate the jaw by forcing the mouth to open as wide as possible. When wanting foods that traditionally do this – apples and burgers, for instance – TMD patients should cut these down into smaller pieces. For those reporting high levels of pain, reducing hard foods may be an essential step to limit mastication and jaw use.[iv]
TMD pain can manifest in two ways: a dull, steady ache, or an occasional sharp, stabbing pain. In cases of the former, patients are advised to apply heat, such as a hot water bottle or a warm towel, to the afflicted area. This increases blood circulation and allows the jaw muscles to relax. For the sharper pain symptoms, cold packs wrapped in thin towels are ideal; they reduce inflammation and numb the pain.iv
Executing exercises
Whilst alleviating pain is vital for an improved quality of life, it does not treat the problem. Therapeutic exercises are an effective treatment for TMD, especially for patients with limited mouth opening.[v] These can lead to long-term success, encouraging mobility in the temporomandibular joint (TMJ) and lowering the risk of dysfunction. Able to be done from home, therapeutic exercises offer many benefits to increase patient compliance.
Whilst some health conditions may demand a physiotherapist for rehabilitation, seen at either the patient’s house or the practitioner’s clinic, self-care eliminates this aspect as many TMD treatments do not need a professional to complete the exercises; patients only need to coordinate review appointments. Self-care therefore saves time and prevents the risk of miscommunication.
Empowering the patient
Self-care empowers patients to take control of their health, letting them choose the time that best suits them to complete their recommended exercises. Empowerment can be a pivotal value for some TMD patients, particularly those with depression or anxiety, and those who are often stressed. These conditions can increase the risk of clenching or bruxism, aggravating the TMJ.[vi] At-home solutions are appropriate for these patients, allowing them to rehabilitate from the comfort and security of home, without having to plan their day around an appointment. Doing this may increase compliance, whilst certain TMD devices can also be portable enough for patients to pack when travelling.[vii]
It should always be highlighted that self-care is an extension of the appointment – it is not them being left alone to solve a problem. Patients should be advised on the minimum and maximum exercises needed for the best outcomes, reducing the risk of over-exercising and damaging the TMJ. Practitioners can also curb this outcome by completely informing the patient about their condition – this can reduce fear, depression and anxiety too.[viii]
The road to recovery
Patients affected by TMD may find an ideal self-care solution with the OraStretchâ Press Rehab System from Total TMJ. Perfect for home use, the handheld device opens the mouth, mobilising the jaw and stretching the orofacial tissues. The simple design gives way to numerous therapy exercises depending on the severity of the condition, helping all TMD patients restore function to the jaw in a non-invasive way, ensuring compliance.
Promoting self-care gives TMD patients the best chance of managing their condition, helping to overcome chronic pain and keeping the jaw active. Following the recommended programme of therapeutic exercises can improve a patient’s quality of life – they just need the right device.
For more details about Total TMJ and the products available, please email info@totaltmj.co.uk
[i] World Health Organization (2024). Self-care health interventions. [online] World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/self-care-health-interventions.
[ii] Grzegorz Zieliński, Pająk-Zielińska, B. and Michał Ginszt (2024). A Meta-Analysis of the Global Prevalence of Temporomandibular Disorders. Journal of clinical medicine, 13(5), pp.1365–1365. doi:https://doi.org/10.3390/jcm13051365.
[iii] Durham, J., Al-Baghdadi, M., Baad-Hansen, L., Breckons, M., Goulet, J.P., Lobbezoo, F., List, T., Michelotti, A., Nixdorf, D.R., Peck, C.C., Raphael, K., Schiffman, E., Steele, J.G., Story, W. and Ohrbach, R. (2016). Self-management programmes in temporomandibular disorders: results from an international Delphi process. Journal of Oral Rehabilitation, 43(12), pp.929–936. doi:https://doi.org/10.1111/joor.12448.
[iv] The TMJ Association. (n.d.). Self Care. [online] Available at: https://tmj.org/living-with-tmj/self-care/.
[v] Herrera-Valencia, A., Ruiz-Muñoz, M., Martin-Martin, J., Cuesta-Vargas, A. and González-Sánchez, M. (2020). Efficacy of Manual Therapy in Temporomandibular Joint Disorders and Its Medium-and Long-Term Effects on Pain and Maximum Mouth Opening: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine, 9(11), p.3404. doi:https://doi.org/10.3390/jcm9113404.
[vi] The Relationship between Depression and Anxiety with Temporomandibular Disorder Symptoms in Dental Students. (2021). Maedica – A Journal of Clinical Medicine, 16(4). doi:https://doi.org/10.26574/maedica.2021.16.4.590.
[vii] Healthline. (2023). At-Home Physical Therapy: Tips, Benefits, Target Demographic. [online] Available at: https://www.healthline.com/health/at-home-physical-therapy#summary.
[viii] Pimentel, Giovanna & Bonotto, Daniel & Hilgenberg-Sydney, Priscila. (2018). Self-care, education, and awareness of the patient with temporomandibular disorder: a systematic review. Brazilian Journal Of Pain. 1. 10.5935/2595-0118.20180050. Accessed via: https://www.researchgate.net/publication/326911472_Self-care_education_and_awareness_of_the_patient_with_temporomandibular_disorder_a_systematic_review
