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An approach to eliminating para-functional habits involves the taking of a detailed history and careful physical examination. The medical history should be designed to reveal duration of illness and symptoms, previous treatment and effects, contributing medical findings, history of facial trauma and a search for habits that may have produced or enhanced symptoms. Particular attention should be directed in identifying perverse jaw habits such as clenching or teeth grinding, lip or cheek biting, or positioning of the lower jaw in an edge to edge bite. All of the above puts strain of the bilateral external pterygoid muscles and resultant jaw pain. Palpation of these muscles will cause a painful response. There are many external factors that place undue strain on the TMJ. These include but are not limited to the following: l. Over-opening the jaws beyond their range for the individual or unusually aggressive or repetitive sliding of the jaws sideways (laterally) or forward (protrusive). These movements may also be due to perverse habits or a malalignment of the jaws or dentition. This may be due to : A. Speech habits resulting in jaw thrusting. B. Excessive gum chewing or nail biting. C. Excessive jaw movements associated with exercise. D. Size of foods eaten. E. Sexual activity. |
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