Maxillofacial Rehabilitation

Jaw problems, luxation, chattering, bruxism (teeth clenching at night), pain … Your maxillofacial physiotherapy specialist can help you find lasting solutions.

The jaw joint is called the temporomandibular joint or TMJ. It’s one of the most mobile joints in the human body, one of the most used, and also one of the least stable. Like all joints, TMJs have articular surfaces, synovial fluid, a capsule, ligaments, muscles, tendons and even a joint disc. These structures can lead to osteoarthritis, inflammation, capsular retraction, ligament laxity, muscle tension or joint locking as a result of disc displacement.

Depending on the study, TMJ pain affects between 30% and 50% of the adult population at some point in their lives. The ethiopathogenesis is multi-factorial, but mainly results from incoordinated or exaggerated muscular tension, responsible for ligament and capsular, disc and muscle damage. Pain is often accompanied by joint noises and creaking. TMJ problems can be caused by: traumatic injury such as a car accident or concussion, poor posture or dental work. Some headaches and neck problems can also be linked to TMJ problems. Physiotherapy rehabilitation of the temporomandibular joint reduces pain, increases mobility and reduces noise during occlusion and mouth opening. The physiotherapist uses manual therapy techniques, exercises and electrotherapy.

Does your jaw crack?

The TMJ has a disc between its 2 articular surfaces. Sometimes, as a result of mechanical problems, the disc will move forward. The noise we hear is the sound of the disc returning to its place. So no, a creak is not normal. Note that there’s nothing to worry about if the cracking is occasional and painless. If, however, there is an audible cracking sound with every chew, your TMJ will be more prone to blockage or wear out more quickly! Even if there’s little or no pain, it’s much easier for your physiotherapist to eliminate a simple crack than to wait several years for the problem to worsen, leaving your therapist with a lot of compensation to deal with.

What are the indications for maxillofacial or jaw physiotherapy?

  • Headache / neck or facial pain
  • Numbness or tingling around the jaw
  • Pain when chewing, clenching teeth or yawning
  • Cracking or locking of the jaw
  • A clicking sound/rubbing sensation when opening the mouth or chewing
  • Decreased jaw movement
  • A change in the way upper and lower teeth fit together
  • After arthroscopy
  • Various contusions, dislocation of the temporomandibular joint
  • Following temporomandibular joint surgery
  • Following facial and mandibular fractures
  • Post-traumatic facial paralysis
  • Following a rehabilitative osteotomy of the face
  • Following hemi-resection of the mandible

The aims of maxillofacial physiotherapy are :

  • Recovery of mouth opening
  • Reduce pain, contractures and swelling
  • Recover normal muscle strength

Course of a maxillofacial physiotherapy session :

During the session, a number of techniques can be used, such as :

  • Manual therapy approaches to restore normal movement
  • Muscle-relaxation techniques for the temporal, sub-occipital and intra-oral muscles (masseter, medial and lateral pterygoids)
  • Exercise programs to maintain gains made in physiotherapy
  • Postural training (axial extension to reduce craniocervical compression)
  • Electrotherapy (Ultrasound, Tens, etc.)
  • Preventive advice will be taught throughout the treatment.