Sleep and Breath – the indivisible relationship to understanding your body and symptoms better.
The relationship between breathing and TMD is remarkably close which is a greatly exampled by many patients who suffer from sleep interruption as well as cranio facial pain. The video illustrates clearly the differences between nasal and mouth breathing and the collateral effects of jaw positioning.
Airway and TMJ –
The normal way to breathe is through your nose. As we grow and develop, certain things such as pollen, cow milk and other variables can cause an allergic reaction – causing lymphoid tissues known as tonsils and adenoids to become swollen. As the tonsils and adenoids become swollen. They develop into an obstruction for nasal breathing and slowly mouth breathing becomes the primary intake of air into the body.
In order to breathe into the mouth the lower jaw comes down and the tongue comes off the pallet and settles on the lower teeth. Nasal breathing is the correct way for the air to enter the body. During nasal breathing the tongue rests on the pallet, and the pressure of the cheeks is bound by the tongue. During mouth breathing the pressure of the cheeks is unopposed by the tongue. The oral system becomes unbalanced and results in the deformation of the upper jaw creating a v shaped arch as opposed to a correct u shaped arch. This also results in an incorrect swallowing function.
Upon swallowing the tongue rests upon the lateral cheek entering the normal tooth eruption causing a lateral tongue thrust. A constantly open mouth causes the insides to over-erupt. The result is a deformation of the lower arch known as the by-cosmic drop off. The result of this deformation of the upper and lower arches is the presence of premature contact upon closing which shifts the lower jaw distally off the physiological trajectory. The narrowing of the upper arch pushes the lower jaw back. This forces the TMJ condo to shift distally while the TMJ disc shifts forward.
Upon opening the disc can shift onto the conduit to restore the TMJ’s correct position and then shift back to the backward forward position upon closing. This is what causes a reciprocal flick – in addition the muscle can be in a state of hypertosis or spasm which can result in tension headaches .An incorrect position of the lower jaw can result in Para functional ability of the muscles such as clenching and grinding. Over time grinding can result in down teeth. As a result the teeth become even shorter and the lower jaw moves distally even further in the vertical of the mouth – decreasing further. In time joint degeneration occurs – the joint becomes deformed and the ligament of the joint becomes damaged – as a result.
The TMJ disc can get trapped in front of the condo. While the click may go away limited mouth opening will occur. A distally shifted jaw and tongue position restricts the air way even further. In order to open up the air way the neck moves forward and the head tilts backwards. This stresses the spine and fatigues the neck muscles, which results in neck, back and shoulder pain.