What is TMJ physiotherapy?
TMJ physiotherapy, also called dental physiotherapy, deals with the temporomandibular joint (TMJ), the chewing muscles and their links with the neck and head posture. Problems in this area are known as temporomandibular disorders – and they are more often caused by overloaded muscles and habits than by damage to the joint itself. We write more about the symptoms and causes on the page about jaw and TMJ pain.
We do not treat your bite or your teeth. An occlusal splint, orthodontic treatment or prosthodontic work are decisions for the dentist – we work on the muscles, jaw movement and the habits that keep the symptoms going.
Who it is for
TMJ physiotherapy is worth considering if:
- the area in front of your ear or your facial muscles hurt – when eating, talking or yawning,
- your jaw clicks, jumps or shifts to one side when you open your mouth, especially if this comes with pain,
- you cannot open your mouth wide or feel that your jaw “gets stuck”,
- you clench or grind your teeth – during the day while working or at night – and your chewing muscles feel tired in the morning,
- you have pain in the temples and headaches that get worse after clenching your teeth – often together with tension headache or neck pain,
- you are about to start, are going through or have finished orthodontic or prosthodontic treatment, and your dentist has recommended work on the chewing muscles.
When symptoms may come from the teeth, the sinuses or inflammation, we refer you to a dentist or doctor first.
What a visit looks like
- History – we ask when it hurts, what makes it worse, and about teeth clenching, sleep, stress and any dental treatment so far.
- Assessment – we look at the path and range of mouth opening, side-to-side jaw movements, clicking in the joint and tenderness of the chewing muscles, as well as neck mobility and head position.
- Treatment – manual therapy of the masseter and temporalis muscles from the outside and, where needed, from inside the mouth (wearing disposable gloves, with your consent), plus mobilisation of the temporomandibular joint and the neck. For some people, dry needling of tender spots in the muscles is a useful addition.
- Exercise and education – exercises to control the path of mouth opening and jaw mobility, the correct resting position (“lips together, teeth apart, tongue on the roof of the mouth”), ways of catching yourself clenching during the day, and simple relaxation techniques, including calm breathing.
How many visits and what to expect
Most temporomandibular disorders settle with conservative treatment – exercise, manual therapy and changing habits. Research points to a moderate effect of physiotherapy, mainly on pain and on how wide you can open your mouth. This usually means a few visits over 6–10 weeks, increasingly spaced out. Treatment on the couch eases the symptoms, but whether the effect lasts depends on what you do between visits.
Clicking without pain and without restricted movement is common and usually needs no treatment – we do not have to “get rid of” it.
Working with your dentist
The best results come from cooperation: the dentist assesses your teeth and bite and decides about a splint, while we take care of the muscle treatment and exercise. If you are under the care of a dentist or doctor, we are happy to take their recommendations into account. You can book a visit via the Contact page.