TMJ Surgeries

This guide was specifically designed to help you recover from your procedure in a timely manner, as well as sustain good jaw health. Jaw stretching, strengthening activities and proper diet and nutrition are necessary daily activities that are required for your successful recovery. The easy and effective activities in this guide will help you relieve discomfort and swelling as  well as increase your range of motion.

Warning: This is a general guide, with broad information that could be dangerous to you. Please consult your doctor and therapist before performing any therapy described here or otherwise.

You may want to continue the stretching activities long after you have healed to maintain full range of motion. As always, employing correct posture and position throughout your life will help you ensure a fully functional jaw.

Be careful to avoid sharp pain and muscle guarding. If you feel sharp pain discontinue what you are doing and take a short break. Try pain relievers, heat or cold. If the pain does not stop, contact you doctor. Muscles guarding is the feeling that your muscles are stressed and won't relax. This works against your rehabilitation. Moist heat can help relax muscles. Or try doing your exercises 30minutes after taking pain medication.

Five subsections below go into more detail on recovery: Diet and Nutrition, Posture, Do's and Dont's, Pain, and Rehabilitation.

Diet and Nutrition

• Avoid: biting and pulling with your front teeth; chewy or hard foods like french bread, steak, gum, and candy; and caffeine.
• Chew with back teeth, utilizing both sides of your mouth evenly
  
• Cut food into small pieces to avoid extreme mouth opening

Correct Posture and Jaw Position

• Tongue up, teeth apart, jaw relaxed. Place your tongue lightly on the palate behind your upper front teeth, allowing the teeth to remain apart, and relaxing the jaw muscles
  
• Monitor your position, keep it neutral and comfortable
  
• Do not chew on pens and do not open items with your teeth
  
• Avoid holding the phone between your ear and shoulder
  
• Avoid resting your jaw in your hands
  
• Avoid loud singing and excessive yawning
  
• Do not thrust your lower jaw forward (common when smoking)
  
• Do not sleep on your stomach
  

Post-Procedure Care: Do's and Dont's

• Don’t use mouthwash with alcohol
• Don’t use straws or create a suction for 7 days
  
• Don’t smoke for 7-10 Days
  
• Do take special care to maintain good posture
  
• Do keep any incisions clean and dry. Be careful when showering, bathing, washing your face or shaving.
  
• Do sleep slightly inclined to help reduce throbbing
  
• Do use caution when cleaning ears. Don’t use Q-Tips.

Pain Prevention and Relief

The application of heat prior to stretching may relax muscles in preparation for your rehabilitation. After rehabilitation exercises and stretching, an ice treatment may reduce swelling and soreness. The goal of your rehabilitation is to recover function as soon as possible. While each patient will vary, a good goal for your mouth opening is 35-40 mm.

1. Heat and Ice

• 1st 24-72 hours post-procedure, apply a cold-compression system (or use cold packs or ice at least three times daily for 15-20 min). Avoid over-cooling the skin.
• After 72 hours, utilize heat and cold at least three times a day for 15-20 min each. Begin with 15min heat, followed by 15min ice.
  

2. Self Massage - Do each for 1 minute, 2-4 times per day:

• Placing thumb inside opposite cheek, massage cheek between thumb and fingers back towards jaw bone in circular motion
  
• Massage the floor of your mouth, under the tongue
  
• Place fingertips on either side of head above the ears and massage in a circular motion
  
• Massage the area between your thumb and index finger

Rehabilitation for Joint Surgeries

After your procedure you may be referred to a physical therapist to increase oral range of motion and function and for exercise instruction. You may also be sent home with a rehabilitation device such as the TheraPacer™ continuous passive motion unit, or the OraStretch Press Jaw Exerciser. Special devices like these may speed your recovery, reduce pain and swelling and increase your range of motion and we encourage you to work with your physical therapist while using these devices.

Self-Exercises

Tongue and Lip Stretching
For each item below, conduct 15 Repetitions, 3 times per day

• Smile and then pucker your lips
  
• Place the top of your tongue on the roof of your mouth and open as wide as possible.
  
• Place your hands behind your neck and gently stretch your head backwards over your hands and hold for 5 sec

TMJ Stretching
For each item below, conduct 6 Repetitions, 3 times per day

• Open jaw slowly as wide as comfortable and close
  
• Glide jaw sideways as far as comfortable, doing this in front of a mirror may be helpful
  
• Open jaw and hold for 10 sec, close for 10 sec
  
• Stretch jaw open by utilizing the TheraBite device or Pacer CPM.
  
• Stretch jaw laterally using one finger, gently press jaw sideways and hold for 5 sec, do both sides
  
• Place thumb under your chin- open your jaw slowly and gently resist mouth opening with your fist
  
• Rotate your jaw in a large circle, doing this in front of a mirror may be helpful
  
• Stretch your jaw as far forward as comfortable and rest

Neck Stretching
For each item below, conduct 8 Repetitions, 3 times per day

• Attempt to touch your ear to your shoulder without raising your shoulder. Hold each stretch for 5 sec and stretch both sides
  
• Turn chin to shoulder, hold for 5 sec then drop your chin to your collar bone (look at your armpit) and hold for 5 sec
  
• While seated, touch your chin to your chest using the weight of your head to provide the stretch, hold for 5 sec, if your chin easily touches your chest you can use hand pressure on the back of your head to provide additional gentle stretching ? Rotate your shoulders clockwise and then repeat rotating counter-clockwise