Temporomandibular Joint (TMJ) disorders, often referred to as TMD, affect the hinge connecting the jawbone to the skull. When this joint malfunctions, it can be painful, leading many to wonder how to cure TMJ permanently.
This complex joint allows movements for speaking, chewing, and facial expressions. When the TMJ isn’t functioning correctly, it can lead to pain, discomfort, and a host of other symptoms.
One often overlooked cause of TMJ dysfunction is the presence of tethered oral tissues (TOTs), such as tongue-tie (ankyloglossia), lip-tie, and cheek-tie.
These conditions can restrict the movement of oral structures, leading to compensatory behaviors that strain the TMJ over time.
The Connection Between Tethered Oral Tissues and TMJ Disorders -How To Cure TMJ Permanently
Tethered oral tissues occur when the frenula—small bands of tissue that secure the muscles of the tongue, lips, or cheeks—are unusually short, thick, or tight.
This restriction can impede the natural range of motion, leading to functional limitations.
Tongue-Tie (Ankyloglossia) and Its Impact
Tongue-tie, or ankyloglossia, is a condition where the lingual frenulum (the tissue connecting the bottom of the tongue to the floor of the mouth) is too tight or short, limiting tongue mobility.
There are two main types of tongue ties: anterior and posterior. The latter identifies where the restriction occurs under the tongue: either close to the tip, anterior, or mid-back of the tongue, posterior.
Whether in the anterior or posterior position, this restriction can have several consequences:
- Speech Difficulties: Limited tongue movement can hinder articulation, making it challenging to pronounce certain sounds. As an adult, you may feel sluggish in your speech when speaking for a lengthy period or strained in your vocal cords.
- Feeding Issues: Tongue-tie can cause a poor range of motion for manipulating foods into a bolus and reduce strength for propelling the food into the throat.
- Oral Hygiene Challenges: Restricted tongue movement can make it difficult to clear food debris, increasing the risk of dental problems.
The compensatory mechanisms adopted to assimilate proper speech and swallowing can place undue strain on the TMJ.
For instance, individuals might thrust their lower jaw forward or engage neck muscles excessively to achieve an adequate swallow, leading to TMJ stress and potential dysfunction.
Lip-Tie and Cheek-Tie: Additional Considerations
Similar to tongue-tie, lip-tie, and cheek-tie involve restrictive frenula that limit the movement of the lips and cheeks, respectively. These conditions can contribute to:
- Open mouth Posture: Weakness in the lips or cheeks can lead to open mouth posture. This position places the jaw in a tense open placement rather than closed and relaxed.
- Dental Issues: Restricted lip or cheek movement can affect tooth alignment and oral hygiene. Tooth extractions can lead to bone loss in the jawbone surrounding the extraction site, potentially causing changes in facial structure and alignment of surrounding teeth
The compensatory behaviors resulting from lip and cheek restrictions can also impact the TMJ, as the muscles and joints adapt to accommodate limited mobility.
How Tethered Oral Tissues Lead to TMJ Dysfunction -How to Cure TMJ Permanently
The human body is adept at compensating for limitations. When oral tissues are tethered, individuals often develop alternative movement patterns to perform necessary functions like speaking and eating. These compensations can include:
- Altered Jaw Mechanics: To accommodate restricted tongue or lip movement, individuals might adjust their jaw position, leading to misalignment and increased TMJ stress.
- Muscle Overuse: Muscles not typically involved in certain oral functions may become overactive, leading to fatigue and pain.
- Postural Changes: Chronic compensatory behaviors can affect head and neck posture, further exacerbating TMJ strain.
Over time, these adaptations can cause the TMJ to move out of sync and alignment, leading to joint breakdown if the underlying tethered tissues are not addressed.
If you’d like to complete a self-assessment to judge if you have a tongue tie, check out our guide HERE and this guide for Lip tie. They will be delivered directly to your inbox!
Visual of Oral Muscle Pathways -How to Cure TMJ Permanently
Looking at these two diagrams, we see a general flow of the muscles back toward the TMJ.
In the first, looking at the tongue structure, we can see what could be described as a second tongue in the floor of the mouth. Though we cannot visualize it by looking into our mouth, it is a massive muscle system housed in the mandible jaws.
Notice how the Styloglossus originates in this massive muscle system under the tongue and then reaches back and up, anchoring near the TMJ. Should there be a posterior tongue tie or a restriction in the tongue, this would pull the styloglossus into tension.
As seen here, this muscle connects to both the upper and lower jaw areas. Compensation due to a tie can easily place undue force into the TMJ, creating TMD.
The second diagram shows the lip and cheek muscles. Again, this visual allows us to see the sweeping connections back to the TMJ region.
Any hiccup from a tie along these pathways will put strain and tension on the mandibular joint, forcing it to operate non-harmoniously.
Many doctors have said a cheek tie’s only impact is receding gum lines. However, when one considers how these muscles are interconnected, it is easier to understand that a cheek tie can cause strain on the TMJ.
Recognizing the Symptoms of TMJ Disorders -How to Cure TMJ Permanently
TMJ disorders manifest through a variety of symptoms, which can vary in intensity:
- Jaw Pain or Tenderness: Discomfort in the jaw joint area, which may radiate to the face, neck, or ears. Making speaking and chewing tasks unpleasant.
- Clicking or Popping Sounds: Noises during jaw movement, such as opening or closing the mouth. The joint is moving out and in of its socket and creating a noticeable click or pop each time.
- Limited Jaw Movement: Difficulty or discomfort when trying to open the mouth wide or move the jaw smoothly. One begins to limit, even feeling fearful, to open the jaw due to clicking/popping and pain.
- Headaches: Tension headaches, often starting from the jaw or temple area, are frequently reported by the TMJ/TMD patient.
- Ear Pain: Discomfort or a feeling of fullness in the ears unrelated to ear infections. Pain from the jaw joint can radiate into the ear and be mistaken for an ear problem.
- Facial Fatigue: Muscle fatigue or soreness in the face, especially after speaking or chewing.
If you persistently experience any of these symptoms, it’s essential to consult with a healthcare professional for a comprehensive evaluation.
Traditional Approaches to TMJ Treatment -How to Cure TMJ Permanently
Conventional treatments for TMJ disorders often focus on symptom management:
- Medications: Over-the-counter pain relievers, anti-inflammatories, or muscle relaxants to alleviate discomfort.
- Physical Therapy: Exercises and stretches designed to strengthen jaw muscles and improve joint mobility.
- Oral Appliances: Mouth guards or splints to prevent teeth grinding and reduce joint strain.
- Lifestyle Modifications: Stress reduction techniques, dietary changes to include softer foods, and avoiding excessive jaw movements.
- Orthodontic and Oral Surgery -TMD can stem from misaligned jaws or teeth. Jaw surgery aims to reposition the jaws to a more functional and balanced position. Surgery is typically considered when conservative treatments (like physical therapy, medications, mouth guards, and splints) have not provided adequate relief or when the underlying skeletal issues are severe.
While these methods can provide relief, they may not address the root cause of TMJ dysfunction when tethered oral tissues are involved.
If you’ve experienced relapses or never fully resolved your TMJ/TMD issues, it may be time to consider the root cause of tethered oral tissues when thinking about how to cure TMJ permanently.
Addressing the Root Cause: Treating Tethered Oral Tissues for How to Cure TMJ Permanently
To achieve a permanent cure for TMJ disorders that relapse, consider that it’s linked to tethered oral tissues. In this case, it’s crucial to address the underlying restrictions.
Comprehensive Evaluation
A thorough assessment by a preferred provider with a specialty in tongue ties and other tethered oral tissues is essential. Several disciplines, such as speech therapists, dentists, ENT, Oral Maxillary surgeons, and Dental Hygienists (RDH), may specialize in oral ties.
To help in your search, try this website: Tongue Tie Life, where you can search by state and profession for a provider near you.
A full assessment will involve several factors.
- Visual Inspections: An evaluation has seven possible ties to rule out. These are the upper cheek left and right side, lower cheek left and right side, upper lip and lower lip, and tongue frenulum. The provider will show you in a mirror and typically have you take photos of any restrictions they identify.
- Functional Limitations: The range of motion and functional impact of the tethered tissues will be assessed following the visual inspection. The provider will instruct you to perform oral motor tasks and will likely apply the TRMR (tongue range of motion ratio) to grade a tongue tie.
- Compensatory Behaviors: Once the functional range of motion measures have been gathered, adaptations contributing to TMJ stress will be identified. Talking, chewing, and swallowing tasks will be utilized to analyze the oral-facial system and jaw movements. Again, a mirror is beneficial to show you in real-time the movement patterns being identified as you complete the action.
- Overall Oral Posture: Evaluating the relationship between tongue, jaw, and airway function. Resting posture is as essential as action movements. At rest, the tongue should be up in the palate/roof of the mouth, and the lips should be closed.
Treatment Plan for How to Cure TMJ Permanently
When tethered oral tissues are involved, the treatment plan for TMJ will consist of myofunctional and myofascial therapy modalities.
An initial starting point is to utilize passive exercises such as myofascial release in the mouth and jaw’s soft tissue areas. This type of input reduces tension in the fascia and muscles.
It can be painful at first but steadily decreases as the muscle tension is alleviated.
Where a restricted frenulum is located will be a targeted area of myofascial release.
Next, we turn to active exercises. These exercises will be built around the desired functional patterns for speech and feeding purposes, which will come directly from the evaluation results.
This treatment plan will address the entire oral fascial complex, not just the Jaw. Addressing compensation and functional patterns while implementing passive and active exercises can support and heal the TMJ.
Though a physical therapist is traditionally referred to for TMJ issues, a speech therapist trained in myofunctional techniques may be the better route.
A speech therapist better understands speech and swallowing patterns, which is advantageous when correcting error patterns learned over a lifetime. However, they must be trained in myofunctional and myofascial release, not just speech and swallowing skills.
Frenectomy or Frenuloplasty
A frenectomy is a minor surgical procedure that releases the restrictive frenulum. In more complex cases, a frenuloplasty involving tissue reconstruction may be recommended.
Both are completed in an office setting and take about 10-15minutes. There is a two-week wound healing period following the surgical release.
During this time, you will continue with the developed treatment plan for myofunctional and myofascial release exercises.
These procedures can help restore natural oral function and relieve the strain on the TMJ permanently.
For a more detailed look at this process, please check out our blog article, Tongue Tie Operation in Adults.
TMJ-Specific Rehabilitation- Team Approach for How to Cure TMJ Permanently
Because TMJ may have its origins in tethered oral tissues which may have impacted head and neck posture, a physical therapist and a chiropractor may be needed.
Chiropractors can directly treat the cervical spine regions and make appropriate adjustments, while physical therapists can treat the muscle structures of those regions. The diaphragmatic and pelvic floor areas may also need treatment to complete a whole-body healing methodology.
- Manual Therapy: Techniques like myofascial release can help relieve tension in the TMJ region.
- Neuromuscular Re-Education: Exercises designed to restore proper muscle function and joint stability.
- Postural Training: Addressing head and neck posture to alleviate TMJ strain.
The Path to How to Cure TMJ Permanently
If you suffer from TMJ pain and have not considered the role of tethered oral tissues, it may be time to investigate this often-overlooked cause.
Use our self-assessment guides to help you decide whether you have a tongue or lip tie. This can be a great starting point for resolving your TMJ/TMD health journey.
By addressing TOTs through evaluation, surgical intervention when necessary, and targeted therapy, you can restore balance to your jaw function and finally achieve lasting relief.
Are you ready to take control of your TMJ health? Consult a specialist today and explore the connection between tethered oral tissues and jaw pain. Permanent relief starts with addressing the root cause.
Check out our other articles on tethered oral tissues and oral facial myofunctional therapy at the BLOG!