Dental rehabilitation is an important field of physiotherapy that deals with the prevention and treatment of disorders of the musculoskeletal system, which includes the temporomandibular joints. Physiotherapy focuses on normalizing tension in soft tissues, as well as restoring physiological mobility in the craniomandibular system.
The musculoskeletal apparatus of the masticatory organ, belongs to the system that is responsible for breathing, chewing, articulation, swallowing and taste sensation.
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A few words about anatomy…
The temporomandibular joint is a symmetrically paired joint, which is the connection between the mandible and the skull, always moving simultaneously on both sides. An important role is played by the articular disc, which separates the articular surfaces.
The temporomandibular joint is stabilized by three ligaments:
- external lateral ligament,
- sphenomandibular ligament,
- stylomandibular ligament.
Anatomically and structurally, the craniomandibular area includes:
- lateral and medial pterygoid muscles
- temporalis muscle,
- masseter muscle,
Functionally, we attach the sternocleidomastoid muscle and the subhyoid and suprahyoid muscles.
Etiology
Factors that increase the risk of temporomandibular joint pathology are:
- micro-injuries that can occur during eating, laughing, yawning, muscular imbalances – as a result, they can lead to arthrosis of the temporomandibular joints and degeneration of the articular disc,
- bruxism – chronic biting and grinding of teeth caused by excessive stress,
- malocclusion, among other things,
- malocclusion resulting from the removal of teeth and gnashing of teeth,
- injuries resulting from hard blows to the side of the jaw or chin and injuries to the cervical spine,
- postural defects,
- inflammatory conditions,
- stress – the resulting tension and clenching of teeth.
Symptoms
- limited mobility of the mandible, as well as visible deviation during movement,
- toothaches in healthy teeth,
- crackling and popping when opening or closing the mouth,
- head and neck muscle pain,
- tinnitus,
- hearing disorders,
- dizziness,
- wax buildup in the ears,
- frequent headaches localized in the frontal, temporal and occipital regions,
- exposure of dental necks, cracking of enamel, and pathological abrasion of teeth,
- changes in the buccal mucosa resulting from biting,
Physiotherapy
The management scheme for examining a patient with masticatory disorders is based on several basic steps. The first is a thorough history, followed by a clinical examination in the form of palpation of muscles and joints, and very often imaging studies in the form of radiographs of both joints and the entire dentition are also recommended.
It is worth noting that only a comprehensive approach to treatment can guarantee the desired results. The selection of methods and techniques of rehabilitation is individual for each patient.
The goal of masticatory motor system therapy is primarily:
- reduction of muscle tension,
- reduction of soft tissue pain/tenderness and the joint itself,
- improvement of neuromuscular coordination,
- regulation of the mandibular motion path.
When to see a physiotherapist?
- If you are struggling with masticatory pain and headaches,
- You are bothered by tinnitus,
- you are preparing for orthodontic, prosthetic or surgical treatment,
- you are undergoing treatment or following treatment in the head and cervical region,
- you are struggling with bruxism or trismus,
- you habitually clench your teeth in response to stress, or you grind your teeth.
Who is this therapy aimed at?
To the people:
- those struggling with dysfunctions in the jaw area,
- headaches,
- tension conditions,
- those working with the voice.