December 2011 | A Better You | Down in the Mouth

Jaw problems can be a pain in the neck—and elsewhere

By Suzanne Martin, PT, DPT

Take a test. Look at your face in the mirror. Open your mouth, make a fist with the knuckles held vertically, and see how many knuckles you can fit in between your teeth. This is called the “freeway space.” Are you able to fit the normal amount of three knuckles? The major muscles used for eating are among the strongest in the body, and so they generate an enormous amount of force. When life gets tense, we also tend to tense up our jaws. The jaw muscles work in coordination with muscles around the ears and at the base of the head. A domino effect is often created, resulting in ear, head, face, and neck pain. Check yourself.

Now feel for tenderness. There are two little muscle groups in the back of the mouth where the molars meet. You can feel their action if you stick the tips of your index fingers into your ears and gently press the pads to point forward. Is this area inside your ears a bit sore? Then open and close your jaws to feel the action of the jaw joint. Is it smooth or crackly?

Then there is a big vertical muscle on the lower jaw that pulls up into the cheekbone. Run your fingers along the bottom of your cheekbone and notice whether it’s tender. The last muscle of this group is located just up and back past your temples. Rub your scalp in this region and notice if either side is tender in this area. The muscle tenderness and jaw-opening quality and distance tell a lot about how you’re doing in more ways than one. Problems in these areas may be a major culprit in face pain, jaw pain, and headaches.

Your students’ body language also may reveal problems with jaw tension. Aspiring dancers may not realize they are clenching their jaws when attempting particularly difficult moves and often need coaching to let that habit go.

But what does it say about the teacher or studio owner who displays a stern jaw and just can’t relax? Make a note of where your tongue lies when not in use. The rest position for the tongue is with the tip on the roof of the mouth, just behind the teeth, not on the bottom. An out-of-position tongue may indicate wearing of the temporomandibular joints, where your jawbone meets your skull on either side of your head. And such wearing can cause headaches and neck pain.

The jaw is the top of the line of the biomechanical chain that starts from the feet and works its way up. Tensions, misalignments, and imbalances from below will affect the positioning of the head on the neck. Then, when you add the emotional content of facial expression, you have a recipe for ear, face, and head pain, as well as such symptoms as ringing in the ears, dizziness, and eye pain.

To compound the problem, symptoms may go untreated because oral health care is often one of the first things to go when people are forced to cut back on medical expenses during a prolonged recession. The well-being of this area of the body doesn’t loom large on most dancers’ radar anyway. We rely on our legs and feet mostly, so it only seems reasonable to neglect mouth and jaw pain until it becomes unbearable. Besides, dancers are good at managing pain. We’re proud of it.

So what can a cost-conscious dance teacher do about head, neck, and face pain? Here are some tips to help you to mind your mouth, in a good way.

First, recognize that there is a direct relationship between stress and head and mouth pain. When times are this tough, even your own success can cause stress (and when businesses are struggling to survive, just putting on a recital within budget and without a hitch may count as a major success). And if you’re doing well, you may feel awkward, guilty, or sad when so many of your neighbors are hard pressed.

Stress is best met head-on. Once you’ve set your priorities and assessed your stressors, organize your time but listen to your body. Just like our students, we show the mark of stress in our faces. Keep breathing, get enough sleep, and try these exercises.

Let the backs of your hands rest on your thighs in these exercises.

1. The Lion Exercise: Sit tall. Smile and lift your eyebrows along with your top lip. Press your tongue against the bottom teeth and push the tongue outward in a rolling action, as if

you were trying to push open a drawer from the inside. Stay and breathe 3 times and relax.

2. For the next exercise, gently move your lower jaw from side to side. Now, while keeping your head still, shift your eyes to look from side to side. Then put it all together by moving your jaw in one direction while you shift the eyes to the opposite direction. Slowly reverse the directions of the jaw and eye motion, and repeat the whole combination 4 or 5 times.

Next, tilt your chin toward your Adam’s apple and imagine you’re pressing the back of your head into sand at the beach. Feel the back of your neck lengthen and gently let your bottom jaw go slack. Stay for 3 breaths and release.

End the sequence by placing the tip of your tongue on the roof of your mouth and open your teeth to about an inch apart. Take a deep breath in for 6 counts. Exhale with an audible “ahhh.”

As an added precaution, assess your posture habits. “Forward head” is a term applied when a person carries her head forward of the center of the shoulder, causing the upper body to drift backward to compensate. This can be seen in the widespread swayback posture. Even if a dancer has a forward head, she often can make it look good. Yet adopting this posture daily can exacerbate head and neck symptoms.

Remember that the weight of the head is like a bowling ball on the long stem of the neck. Slumping at one’s computer can cause increased strain in the upper neck and jaw. Stress-relieving activities, such as knitting or watch a movie, can cause strain if you’re sitting in a deep couch and craning your neck forward, with the upper neck getting crunched as the eyes zero in on their target. Be sure your low back is supported in its natural slightly arched curve and that your head is over the pelvis as much as possible. Hold the lower neck steady and try to tilt only the head (moving only the upper neck) for vision precision. Every so often, sit forward, roll the shoulders backward a few times, and squeeze between the shoulder blades. Yawn, and open and stretch the mouth and tongue.

Next, examine your oral habits. What you do with your mouth can reveal a great deal about your anxiety level. Do you find yourself clenching your teeth at times, night or day? Grinding one’s teeth while sleeping is often an anxiety habit that cannot be broken, but we can check ourselves and consciously allow freeway space of an inch between the teeth and be mindful to allow the tongue to float to its rest position at the roof of the mouth.

Also, chewing gum occasionally is fine, but continuous gum-chewing can tighten the jaw muscles. (And nervous chewing on pens, pencils, straws—or one’s fingernails—is not a great stress-reduction method.)

Another key to head health is paying attention to your gums. A good offense is the best defense when it comes to a healthy mouth, even if you’re worried about the expense. Dental schools are easily accessed for exams and cleaning if you’ve had to give up your dental care provider.

Look at your habits. Keep flossing. Breathe. Let your body get a whole new outlook by taking control of your mouth.

I have faith in you.