The temporomandibular joint, or TMJ, is a complex joint in both structure and biomechanics. This joint is made up of the temporal bone and the mandibular condyle, which is cushioned by a small cartilaginous disc. It is unique in structure and relies heavily on ligamentous stability and motor control to ensure the jaw can open and close smoothly, as well as perform functions such as talking and eating. During opening the TMJ will initially hinge, which is usually not an issue, followed by forwards translation of the condyle which is where things get a little more complicated.
Common symptoms associated with jaw dysfunction:
Jaw pain or tenderness
Clicking or locking of the jaw
In Brisbane, working at The Headache, Neck and Jaw Clinic, James found a passion for treating complex cervicogenic, migraine and temporomandibular joint cases. During this time James completed Levels 1 and 2 in the Watson Headache® Approach which has provided invaluable insight into the role of cervical afferents in headache and migraine complaints. After working under highly experienced practitioners in a niche area of physiotherapy, James returns to our clinic with a skillset unique to Western Australia.
Measurements & indicators
Physical examination includes assessment of the following:
Jaw opening and lateral range
Tongue/jaw motor control in isolation
Quality and directionality during opening and closing
Resting jaw posture
Cervical spine posture
TMJ ligament assessment
Hyoid position and surrounding musculature
What to expect
There are many causes of jaw pain or dysfunction which requires a thorough examination of both the neck and jaw to better understand what is going on. We can get problems with the jaw when the joint becomes stiff, the disc gets stuck forwards and blocks the normal translation of the condyle, or conversely when there is too much movement, and we lose the ability to control what the jaw is doing. Jaw pain can occur spontaneously from trauma or sudden locking of the jaw, or worsen very gradually over time
Initial consultations require 60-minutes to assess and diagnose the issue and accurately. Once determined that care might be appropriate and safe, ongoing appointments of 30-minutes will be required to track and treat symptoms or to refer on as indicated.
Treatment of the jaw looks to correct relevant abnormalities using manual therapy. A targeted home exercise programme is often prescribed to help sustain improvements and address motor control and strength issues. In cases where the disc is displaced, we may look to relocate the cartiliginous disc or refer on to a prosthodontist or maxillofacial surgeon as indicated.Treatment modalities include:
Soft tissue release
Strength and motor control retraining
Dentist referral form
Please use the Priority Referral Form below and we will contact your patient directly and liaise with you regarding their management. For urgent appointments, call the clinic at 08 9221 8458