RECOMMENDATIONS

TEMPOROMANDIBULAR DISORDERS (TMD) SELF-HELP RECOMMENDATIONS

For, at least, the first 12 weeks of your treatment in this office, we request that you attempt to comply with the following recommended changes in your nutrition habits. Many people need very restricted dietary changes to get well, while others require minor alterations. Your compliance can make a significant difference in the success of your treatment. After this 12-week period, you may make the decision as to whether you wish to continue with any of these changes or revert back to your old dietary habits. If you have found major success, you may wish to continue in a maintenance program.

Prolonged pain often indicates the body’s inability to completely heal or regenerate. Essential nutrients may be deficient or unbalanced. Therefore, during treatment for headache, neck or TMJ pain, certain dietary changes can be important. Certain foods and drinks may need to be increased, decreased or eliminated. Additionally, supplements may be added.

  • NUTRITIONAL
    • Eat a good balanced diet following guidelines to protect your TM joints.
      • Place yourself on a soft diet (not liquid, but soft), which would consist of foods such as cooked vegetables, eggs, chicken, ground meats, fruit, etc.
      • Avoid foods such as corn on the cob, large pieces of lettuce in salads, whole apples, very hard chips or snacks, tough meats, ice, etc.
      • No chewing gum!!
      • By cutting your food into smaller pieces, you can reduce the force of chewing, thereby, eliminating additional stress to your jaw joints. This also allows you to eat a greater variety of foods.
    • Attempt to avoid these seven items, which are prone to cause an increase in muscle irritability.
      • NutraSweet
      • Caffeine
      • Sugar
      • Alcohol
      • Nicotine
      • Excessive dairy products
      • Chocolate
    • Vitamins/Supplements
      • Will be thoroughly discussed and provided for your particular needs.
    • Dietary foods which can reduce stress to your muscles:
      • You may increase these foods in your diet:
        • Fresh fruits
        • Fresh vegetables
        • Salads -- avoid most commercial salad dressings -- use lemon or vinegar and oil
        • Whole grain cereals only (i.e., Shredded Wheat or Nutri-Grain Cereal by Kellogg, etc.
        • Chicken, fish and tender beef
        • Unsweetened vegetable and fruit jices and as much water as possible.
      • Attempt to avoid these foods:
        • Sugar
        • Alcohol
        • Hydrogenated fats
        • Coffee
        • White flour products (margarine, Crisco)
        • Cola
        • Processed carbohydrates
      • Reduce these foods:
        • Cheese
        • Milk/milk products
        • Salt (excessive)
      • Sweeteners and drinks:
        • Drink bottled or filtered water, herbal teas,weak iced or hot tea with lemon. If a sweetener is needed, a small amount of honey may be used or Splenda. Reduce the amount of artificial sweeteners in your diet, NO NUTRA-SWEET!!
        • Carbonated beverages - limit to the fewest per week as possible (nothing with NutraSweet). Soft drinks contain phosphoric acid that is harmful to teeth and several teaspoons of sugar are found in most of them.
      • Special Notes:
        • Frozen vegetables may be used with fresh vegetables, but not totally in place of them.
        • Try to avoid all foods in cans and box packages.
        • Corn products are often sources of food sensitivities. Try to reduce these products, as well as products containing corn syrup.
        • Drink, at least, 8 (8 oz.) glasses of bottled or filtered water daily.
        • Recognize the fact that smoking is deleterious to body tissues. Stop smoking as soon as possible.
        • Potatoes are complex carbohydrates. Baked potatoes are a good food source.
        • Butter in moderation, but not margarine.
  • LIFESTYLE
    • Avoid or reduce perfumes and scented products. These chemicals aggravate sensitive muscles.
    • Don’t sit or sleep directly under ceiling fans or vents.
    • Watch head / neck position (cradling phone between head and shoulder).
    • If you are able to tolerate aspirin products, take two tablets of Advil (or equivalent), an anti-inflammatory medication, four times daily. This is taken to reduce swelling and inflammation within the joint. If you are not sure of your tolerance to aspirin-like products or if you are taking any other medication, check with our office or your physician first.
    • Prioritize your activities. Be ruthless. Eliminate those things that are least important. This involves learning to say “no” to tasks that can be put off, so you can carefully parcel out your available energy among those things that need to be done.
    • Spare your family and friends. Pointing every detail of your illness out to close relatives can backfire. Family members and friends are not equipped to deal with the devastating nature of chronic pain over the long haul. It is okay to educate those close to you about it, but be careful to monitor the amount of personal details you burden them with. You don’t want to drive your most important network of social support away.
    • Get help. Patient support groups can be a great source of comfort for many on how to deal emotionally and functionally with the disease. Others have found counseling, massage therapy and physical therapy to be beneficial.
    • Continue living. If you can’t walk a mile, walk a block. If you can’t work full-time, work part-time. In other words, try to do the same things you use to do, even if you can only handle a fraction of the activity. It is important that you occupy yourself, both mentally and physically.
    • Maintain a positive attitude. Those who do seem to cope and recover the best.
  • EXERCISE
    • Exercise every day. Cardiovascular and therapeutic exercises are recommended. For cardiovascular, we recommend walking or water walking combined with a low impact aerobics or water aerobics. Additionally, swimming is beneficial. Running or more strenuous aerobics should be limited to those people who have the physical stamina to participate in such programs.
    • 6 x 6 x 6 – For therapeutic exercises, we have a standard set of exercises called the “6 x 6 x 6.” There are six exercises to be done six times a day and each movement is to be held for six counts, six times each.
      • There are three exercises for the shoulders. Please watch forward head posture on all of these.
        • Trapezius Squeeze - while holding arms like a runner, bring shoulder blades together.
        • Shoulder rolls - bring shoulders up for six counts back for six counts and down.
        • Pectoralis Stretch - place fingers by ears with elbows out, attempt to bring shoulder blades as close together as possible.
      • There are three exercises for the neck.
        • Neck Rotation - keeping eyes level to the floor.
        • Side Bending - face straightforward and ear toward shoulder.
        • Flexion - lower chin to chest.
  • POSTURAL
    • The goal of good posture is to maintain the natural curves of your spine in their normal, balance alignment. To keep your spine aligned, chest must be up, shoulders down, and head located over the body. Then, by learning how it feels to be in good posture, you will develop the body awareness that helps you stay in good posture throughout the day, no matter what you are doing.
    • Your sleep position is vitally important. If it does not interfere with your sleep, it is best to sleep on your back, perhaps, with a pillow under your knees if that is more comfortable. You may want to also use pillows to support your sides, which would discourage turning over while asleep.
    • A tubercle type orthopedic pillow is good, or a rolled bath towel placed under your neck may be preferred. If you sleep away from home, take your pillow (or towel) with you