Did you know that one of the main causes of orofacial pain is poor postural design of the head and neck in relation to the shoulders? The underlying cause of jaw clenching headaches and excruciating temporomandibular joint (TMJ) dysfunction is directly correlated to postural distortion patterns of the first posture quadrant.

According to the TMJ Association, approximately 12% of the population, or 35 million people in the United States are affected by TMJ disorder at any given time. TMJ disorders are a serious problem.

Patients suffering from TMJ dysfunction will commonly present with restricted range of motion of the jaw, with reported “popping” and “clicking” of the jaw when opening and closing their mouth. TMJ disorders can range from a slight irritation to a severely debilitating condition. Advanced TMJ disorder can impact patients’ ability to eat, breathe, talk, and sleep, and can give rise to teeth sensitivities, ear problems, headaches, facial nerve pain and muscular aches in the neck and shoulder region.

“Good posture is important, yet many people don’t realize how their posture affects their oral health,” says Ludwig Leibsohn, spokesperson of the Academy of General Dentistry.

There is a strong correlation between forward head posture and backward lower jawbone posture. TMJ disorder patients typically have both forward head posture and posterior lower jaw posture.

Munhoz et al. (2004) stated, “Patients suffering from TMJ disorder show a tendency towards increased morphologic and functional alterations of the cervical spine” after researching cervical radiographs of patients presenting with painful TMJ dysfunction. They discovered that patients with more severe TMJ symptoms exhibit cervical spine hyperlordosis.

With proper alignment of the head and the neck, the ear and the shoulder are in alignment. As the head goes forward in relation to the shoulders, such as during computer use, when sending a text message, and other sedentary activities, the muscles of the TMJ joints, as well as all of the neck and shoulder muscles are contracted and working overtime to support the weight of the head upright against the constant force of gravity.

The muscles of the jaw complex are small, and perform precise functions to open and close the mouth, they are not intended to support additional weight of the head caused by forward head posture. As the head goes forward, the jaw goes back, and the muscles become restricted. Muscular stress results in an inability to move the jaw smoothly and freely, resulting in clicking and cracking of the jaw, tension, stiffness, and often pain.

The muscles of the neck are also affected. Trigger points arise in the trapezius and SCM muscle groups and patients often report the presence of associated neck pain and headaches.

Head posture affects the pressure pain threshold of orofacial pain. Research supports the biomechanical relationship between the cranio-cervical region and the dynamics of the temporomandibular joint, as well as trigeminal nociceptive processing in different cranio-cervical postures (LaTouche et al., 2011).

Many patients, like Rosa the accountant who you met in “The Jaw Clenching Headache Survival Guide,” don’t make the connection between TMJ problems and head postural presentation. To learn more about Rosa and her case presentation that was resolved from head posture structural restoration, visit the next blog “Head Posture Restoration for Relief of Orofacial Pain.” Learn clinical guidelines for head posture structural restoration that you can utilize with your patients.

To correct TMJ dysfunction without specific posture correction exercises would be considered incomplete. Although the patient may feel temporary relief, the problem will almost certainly return.

Wright et al. (2000) concluded, “Posture training and TMD self-management instructions are significantly more effective than TMD self-management instructions alone.” To learn more about specific head posture structural restoration for patients with TMJ dysfunction and orofacial pain patterns, join us in the next blog Head Posture Restoration for Relief of Orofacial Pain.

Yes I Want More Expert Tips!

Written by:
Dr. Krista Burns DC, DrHA, CPE CPEP
Co-Founder The American Posture Institute
Doctor of Chiropractic
Doctor of Health Administration

References:
Academy of General Dentistry, spokesperson Ludwig Leibsohn.

La Touche, R. et al. (2011) The influence of cranio-cervical posture on maximal mouth opening and pressure pain threshold in patients with myofascial temporomandibular pain disorders. Clinical Journal of Pain 27(1).

Munhoz, W. et al. (2004) Radiographic Evaluation of Cervical Spine of Subjects with Temporomandibular Joint Internal Disorder. Brazilian Oral Research 18(4).

Wright, E. et al (2000) Usefulness of Posture Training for Patients With Temporomandibular Disorder. Journal of the American Dental Association 131(2).