Treatment of the temporomandibular joint: a detailed description of the methods. Pain syndrome due to dysfunction of the temporomandibular joint - symptoms and treatment of TMJ

Temporoinferior dysfunction jaw joint in dentistry it is called differently - Costen's syndrome, muscular-articular dysfunction, TMJ myoarthropathy, etc. Essentially, this anomaly is a malfunction, impaired coordination of a given joint and accompanying symptoms. Data medical statistics disappointing - according to research results, at least 80% of the world's population are faced with one or another manifestation of muscle-articular TMJ dysfunction.

This is due to the fact that the temporomandibular joint is one of the most actively involved joints in the entire body. The TMJ takes part in the act of swallowing, is involved in diction, and is “turned on” when yawning and chewing food. Moreover, this joint has a specific anatomy (the head does not match the size of the fossa), because of this the TMJ is especially susceptible to traumatic injuries with any careless movements of the head (jaw).

Why is there a problem?

TMJ dysfunction in modern dentistry explained by 3 groups of factors:

occlusal-articulatory (increased abrasion of tooth enamel, dentition defects, mechanical injuries, damage, malocclusion, medical errors during prosthetics, low position of the alveolar ridge, congenital anatomical anomalies of the jaw or teeth);
myogenic (hypertonicity, incorrect work muscles of the face and neck, bruxism, increased speech load, the habit of chewing food only on the left or right side);
psychogenic (malfunctions in the central nervous system, which lead to overstrain of individual muscles and organs).

The course of the disease is accompanied by a mass various manifestations– from pain in the affected joint (or both) to jamming of the jaw, deterioration of vision and hearing

The syndrome of painful dysfunction of the TMJ is accompanied by a complex of problems - a violation of occlusion, muscle tone of the jaw and an incorrect relationship between the elements of the joint in space.

Signs

Symptoms of TMJ dysfunction vary from person to person and depend on the cause of the disorder. Classic manifestations of pathology are:

pain in the joint (or both) of an aching, pulsating nature, which radiates to the back of the head, extends to the ear, neck, lower jaw;
crunching, clicking in the TMJ when chewing, while talking, yawning or other jaw activity (sometimes these sounds are heard not only by the “victim” of dysfunction, but also noticeable to others);
dizziness, migraine;
TMJ pain dysfunction syndrome is characterized by stiffness, limited range of motion of the joint(s), the patient, as a rule, is not able to fully open his mouth;
rapid fatigue of the facial muscles;
lump in the throat;
toothache unclear localization;
discomfort in the neck and shoulder area;
noise, ringing in the ears, hearing loss;
spasms of the facial muscles (suddenly the jaw tightens);
swelling, facial asymmetry;
“jamming” of the joint - in order to open the mouth, a person is forced to look for a suitable position of the head.

The following signs may indirectly indicate temporomandibular joint dysfunction syndrome: snoring, insomnia, depressive states, photophobia, blurred vision, problems with coordination.

Causes pathological phenomenon can be covered in dental diseases, and lie in the neurological, psychological plane

Important! Pain in the temples and jaw with TMJ dysfunction is not always present. As a rule, it indicates the development of local inflammatory process(arthritis) or indicates muscle spasms.

Diagnostics

The vagueness of signs of TMJ dysfunction complicates the diagnosis. Many patients with joint dysfunction are sent for consultation to the wrong specialist (for example, a neurologist, because clinical picture malfunction of the TMJ is similar to neuralgia trigeminal nerve). In order to get a complete picture of the causes, course, form, stage of the disease, the diagnosis should be carried out by a dentist who:

examines and assesses the condition lower jaw and units of the dentition;
palpates the affected area, determines whether there are clicks or crunches during joint movements;
compiles anamnesis;
if there are indications, he performs arthroscopy (examines the condition of the elements of the TMJ using a special device - an arthroscope).

Add to list modern methods Diagnosis of temporomandibular dysfunction also includes ultrasound, X-ray, MRI, Dopplerography, phonoarthrography (necessary for detecting extraneous sounds in the joint).

Solution

Due to the fact that most patients seek medical care for late stages pain dysfunction, treating this pathology can be quite problematic. Before going to the dentist for symptoms of TMJ problems, there are some therapeutic measures you can take at home:

apply a warming or, conversely, cooling compress for 15 minutes;
on the advice of a doctor, take a painkiller tablet (Ibuprofen, No-shpy);
reduce functional load on sore joints (refuse to eat hard, difficult-to-chew foods, maintain a gentle speech regime);
master the technique of relieving muscle spasms, meditation to eliminate psychogenic causes problems of the temporomandibular joints.

Treatment of temporomandibular joint dysfunction in dental office involves: osteopathy, massage, gymnastics and physiotherapeutic procedures to relieve spasms of the facial muscles. IN mandatory patients are prescribed symptomatic drug therapy (painkillers, anti-inflammatory drugs of systemic and local action).

Arthrosis, arthritis, dislocation, subluxation - far from full list problems arising in the TMJ due to its increased trauma

Other medicines:

antidepressants;
sedatives;
intra-articular injections of glucocorticosteroids (hormones);
botulinum therapy.

If the “culprit” for problems with the jaw joints is a malocclusion, the main method of treatment in this case is wearing braces or other orthodontic structures (especially in adolescence). Another effective way to combat jaw jamming - physiotherapeutic procedures. The most popular of them are: inductothermy, ultrasound, laser exposure and electrophoresis.

Treatment of TMJ dysfunction involves the fight against caries or extraction of affected dental units, acupuncture, severe cases – surgical intervention(condylotomy of the articular head, arthroplasty, myotomy of the lateral pterygoid muscle). In the majority clinical cases Even long-term wearing of a fixation splint allows you to get rid of discomfort in the joint and jaw area, relieve pain and eliminate other symptoms of TMJ dysfunction.

Important! This therapy also helps eliminate bruxism (teeth grinding) and prevent its dental consequences.

The first medical measure for patients with TMJ dysfunction is pain relief. Treatment includes not only taking medications, but also wearing special jaw plates and applying a neck brace. Do not forget about psychocorrection - this will lead to leveling out most of the symptoms of the pathological phenomenon and will allow you to relieve muscle clamps, increase the mobility of the “affected” joint.

Untimely treatment of the pathology (or lack thereof) is fraught with constant headaches, problems with vision and hearing, and complete immobilization of the lower jaw

Prevention and prognosis

With absence timely treatment Problems with the functioning of the TMJ can lead to serious consequences:

complete immobilization of the lower jaw;
hearing loss, vision impairment;
constant migraines, muscle pain.

To prevent pathology, it is recommended to place adequate loads on the masticatory apparatus, place fillings and dentures in a timely manner, and, if indicated, wear orthodontic structures to correct the bite. If medical assistance was provided on time, the treatment of TMJ dysfunction, although long and difficult, was still successful.

Important! Correction of posture and elimination of stress factors play an important role in the fight against pathology.

So, malfunctions in the temporomandibular joint can be caused by both dental and neurological, psychogenic factors. TMJ dysfunction is difficult to diagnose, as it is often “masked” as other diseases. If provided in a timely manner medical care (dental treatment, symptomatic drug therapy, physiotherapy and surgery) the prognosis for patients with this problem is favorable.

Diagnosis of TMJ lesions is complicated by the fact that this pathology has a lot of symptoms. But some of them can be called classic - those that affect the TMJ joints themselves, ears, head, face and teeth. Because in the joints nerve endings no, when their function in this area is impaired, the person does not experience pain. It occurs in the ears, in the neck, head, or in trigger points, which are compactions in the muscles (masticatory, temporal, sublingual, temporal, cervical) - pain is felt when pressing on them. At the same time, there is a noise in the ears, a crunch in the joints when opening the mouth.

The most common symptom is a clicking sound in the lower jaw joint, which is not always accompanied by pain. The sound made by the jaw can be heard by others. If the jaw clicks, it means that the disc is displaced and the muscles that support the lower jaw while chewing food are unnaturally tense. The consequence of this tension is pain in the muscles, face, head and neck.

Blocking or locking of the TMJ is a condition in which the joint moves unevenly due to disorders that have occurred in it. The person notices that the lower jaw opens unevenly, as if it is catching something. And in order to open your mouth wide, you first need to move your lower jaw in one direction or the other, sometimes you have to do this until a click is heard at the point of its “unlocking”.

Due to the proximity of the TMJ to ears, its defeat often causes ear pain, congestion, and even hearing loss. Ringing in the ears can be caused by both joint disorders and pain management with medications (aspirin, ibuprofen).

Prevention

Prevention is timely and high-quality treatment and dental prosthetics, bite correction, timely appeal See a doctor for help after an injury.

This is a pathology of the facial muscles, lower jaw and the joint connecting it to the skull.

The danger of this disease is that patients do not immediately come to see to the right doctors, mistakenly believing that their problems relate to other areas of medicine.

The first definition of the disease was given by James Kosten, an otolaryngologist from the USA, who in the thirties of the twentieth century was the first to draw attention to the connection between middle ear pain and jaw pathologies in his patients.

In honor of him, the disease is called “Costen syndrome”.

Other names based on the main symptom are TMJ myoarthropathy.

The TMJ is one of the most complex joints in the human body. It consists of two mirror halves that work as one, providing the jaw with several degrees of freedom: the ability to open and close the mouth, longitudinal movement, and rotation of the jaw.

This is one of the most loaded joints of the body; it is involved in breathing, yawning, chewing, swallowing, facial expressions, and conversation.

The syndrome of painful dysfunction of the TMJ is caused by changes in the location of its various parts, muscle dysfunction, and the closure of teeth. The pathology is widespread; it is estimated that up to 75% of people visiting dentists experience it in one form or another.

The code according to ICD 10, the international classification of diseases, for TMJ disorders is K07.6.

For joint dysfunction in this classification the number K07.60 is provided.

Why does this disease occur?

Factors causing the syndrome Dysfunctions of the temporomandibular joint are divided into three groups:

Myogenic, associated with muscle dysfunction. Increased tone, spasms, straining, using only one side of the mouth when chewing. This group includes bruxism - teeth grinding during sleep, excessive conversational load, as in lecturers, announcers, actors.
Occlusal-articulatory, caused by pathologies of the dentofacial apparatus. These are bite defects and poor-quality prosthetics. The cause of problems may be the removal of a tooth or several, or a filling placed by the dentist that is too high.
Psychogenic, caused by disruption of the central nervous system. TMJ dysfunction can be triggered by mental stress that impairs muscle coordination.

Also, the reasons for the development of this disease can be congenital; this usually happens when the head of the jaw bone does not fit the socket on the temporal bone.

Such problems appear in childhood or adolescence. In case of juvenile dysfunction, to exclude possible complications- surgical intervention is recommended.

The bilateral structure of the articulation leads to the fact that when dysfunction of the joint appears on the left, soon, due to a change in the functioning of the left node, it appears on the right, or vice versa.

How is it diagnosed?

Diagnosis of temporomandibular joint pain dysfunction syndrome is difficult wide range external signs accompanying the disease.

Instead of the necessary dentist-orthodontist and neurologist, a person with TMJ dysfunction tries to be cured by an ENT specialist, a rheumatologist, a regular therapist, and others.

Primary diagnosis consists of taking anamnesis - listening to the patient’s complaints, finding out the medical history.

After that:

The jaw joint is palpated and auscultated. In addition to listening with a stethoscope, phonoarthrography is used to visualize intra-articular noise.
The doctor measures the width of the mouth opening and the limits of free movement of the joint.
Gnathodynamometry is performed to measure chewing force.
Mock-ups of the jaws are made to build a diagnostic model.
A wax occludogram is taken to find the area where the teeth are closing too early.
To examine the joint and bones, X-rays, CT and ultrasound are used.
The condition of nearby soft tissues is assessed using MRI results.
To identify problems with the blood supply, Dopplerography or rheoarthrography of the vessels supplying the joint is performed.
Electromyography is performed to assess muscle functionality.

When conducting differential diagnosis, Costen's syndrome is differentiated from, fracture bone process, arthritis, arthrosis, hemorrhage in the joint, inflammation of its contents, and other diseases.

Symptoms and signs

Signs that manifest TMJ dysfunction are divided into three groups:

Pain syndrome. Muscle pain appears not only in the masticatory and temporal muscles, it can occur in the cervical, chest, and even back. Frequent ear and toothache. Painful sensations can disguise TMD as neuralgia, osteochondrosis, inflammation of the joint or ear and other diseases.
Joint jamming. To open your mouth, you first have to look for the position of the jaw in which this will be possible, moving it back and forth and left and right. This movement causes the jaws to appear twitchy.
Extra sounds in the joint. Patients with TMJ dysfunction report clicking, squelching, and creaking sounds when moving the jaw. Sometimes they can be heard by the doctor even without a stethoscope. Sounds may be accompanied by unpleasant sensations, and occur without signs of pain.

In addition to the symptoms included in these three groups, TMD can mimic nervous breakdown with symptoms such as migraine, insomnia, depression.

Dizziness and tinnitus can also be a consequence of joint dysfunction. Grinding of teeth during sleep, apnea and snoring are noted.

Sometimes the secretion of saliva is disrupted, causing a lack of saliva and an inflamed tongue.

Treatment method

Due to the unclear presentation of the disease, when it masquerades as other disorders, TMD is more often diagnosed at later stages of development. This makes treatment very difficult.

Only a specialist can carry out the therapy necessary to treat temporomandibular joint pain dysfunction syndrome, but remove unpleasant symptoms possible at home.

For this:

Use warm or cold compresses. The temperature should remain within reason and not cause injury. skin. Maximum time applying a compress takes fifteen minutes, but it can be repeated after a few hours.
At severe pain take over-the-counter analgesics, non-steroidal anti-inflammatory drugs, herbal teas. Before using them, you should refer to the instructions and take into account contraindications.
To put less strain on the affected joint, you should switch to a softer diet, eliminating foods that require effort to bite or chew.
Self-massage of the jaw is performed. Meditation and other relaxation techniques also help relieve muscle tone.

But folk painkillers and anti-inflammatory decoctions will only relieve pain and swelling, and not restore correct work joints, treatment of TMJ dysfunction occurs when you consult a doctor.

The procedures that make up the therapy are carried out by a dentist, chiropractor, physiotherapist, maxillofacial surgeon and other doctors.

After inspection and diagnostic study, depending on the form and degree of the disease, are prescribed individually or as part of complex therapy:

Exercises for facial muscles, manual therapy, massotherapy.
Painkillers, anti-inflammatory drugs, muscle relaxants. Medicines are prescribed both in tablets for oral administration and in the form of ointments or balms.
If TMD is caused nervous symptoms a short course of tranquilizers may be prescribed.
If the disorder is of a nervous nature, consultation with a psychologist and the use of psychotherapy and biofeedback therapy are advisable. This will teach you ways to cope with the causes of muscle spasms and relieve them without outside help.
In addition to medications to relieve pain They use bandages and bandages that take on the excess load on the neck, jaw and joint.
An orthopedic splint, dental guard or jaw plate reduces the load on the TMJ and protects the teeth from abrasion during sleep.
Bite correction is used with braces, aligners, and orthodontic aligners.
It may be necessary to remove a wisdom tooth or other tooth that interferes with the normal closure of the jaws.
The opposite situation also occurs, in which prosthetics are indicated. In some cases they get around machining tooth or an incorrectly installed filling. In any case, without proper distribution of the load across the masticatory apparatus, recovery is impossible.
Electrophoresis or ultraphonophoresis is used to deliver drugs to a diseased joint; inductothermy or microwave therapy is used to relieve inflammation and reduce the severity of pain.
Also applicable laser therapy, acupuncture, as well as other methods of physiotherapy.

When conservative methods is not enough, surgical intervention is used. Myotomy is used to correct the function of the masticatory muscles.

Endoscopic arthroscopy and arthrocentesis are used to reshape the joint or head of the jawbone. Through an incision in the ear area, or a direct puncture, a miniature video camera with tools for correcting the shape and location of joint elements is inserted into the joint capsule. If necessary, excess liquid is removed from the cavity.

In case of tumors or injuries of the joint capsule, operations are performed on an open joint.

Recovery after endoscopic surgery several times faster than after the classic one.

Preventive measures and prognosis

Any disease is easier to prevent than to treat; the basis for preventing muscle-joint dysfunction is regular exercise. preventive examinations at the dentist and neurologist.

You should also:

Avoid stress and unnecessary nervous tension.
Treat caries, pulpitis, periodontal inflammation, etc. in a timely manner infectious diseases oral cavity, nasopharynx, throat.
Replace lost teeth with dentures, remove problematic figure eights, correct bite.

If the disease does manifest itself, therapy is necessary.

Ignoring symptoms and refusing medical care lead to loss of mobility of the lower jaw, up to complete ankylosis, dysphagia - difficulty swallowing, deafness, constant headaches, wear of the dental apparatus and other unpleasant diseases.

TMJ dysfunction syndrome is usually detected in advanced stages and because of this, treatment is quite long, but usually ends in complete success, the return and preservation of all functions of the joint.

Pain and crunching in the jaw when chewing may indicate temporomandibular joint dysfunction (TMJ). This is a functional pathology that affects 30 to 75% of dental patients, and it is more common in young women.

The temporomandibular joint takes on increased loads every day. It “works” almost continuously - when talking, eating, swallowing.

The jaw joint connects the temporal bone and the lower jaw, making it mobile. During normal operation of the TMJ, the lower jaw moves synchronously on the right and left sides.

However, various disorders of the skull, jaw muscles or elements of the joint itself lead to dysfunction of the entire masticatory apparatus and deterioration of its coordinated movements.

Causes of pain in the jaw joint

Head or neck injuries, e.g. severe bruises which lead to displacement of the intra-articular cartilaginous disc;
bruxism – spontaneous night rattle teeth;
malocclusion or missing teeth;
low-quality dentures or fillings that are too high;
one-sided type of chewing food;
a state of stress in which a person tenses his facial muscles and clenches his teeth;
rheumatoid arthritis, osteoarthritis and other diseases.

Dentist answers questions about TMJ

With TMJ disease, you may feel your jaw clicking or crunching when chewing. There is also acute or It's a dull pain in the joint, which subsides over time or lasts for several years.

Other symptoms:

pain in the facial area, near the neck or ear, which intensifies when chewing;
discomfort and difficulty opening the mouth;
sudden blocking or clamping of the jaw in one position;
overstrain of facial muscles;
a feeling of “uncomfortable” bite when the teeth on the upper and lower rows do not fit together correctly;
swelling of one side of the face.

At later stages it appears headache and dizziness, tinnitus, discomfort in the shoulder area. It is also possible associated symptoms, such as snoring, sleep disturbance, depression, difficulty swallowing.

Diagnosis of TMJ dysfunctions

On initial examination The dentist finds out the patient’s complaints and palpates the joint area. It is also important to assess the amplitude (degree) of mouth opening. Instruments are used to measure the nature of the work of the head muscles under different conditions.

Typically, diagnosis involves taking impressions to make plaster models of the jaw. This makes it possible to identify disturbances in the functioning of the jaw system, including improper occlusion (closing of teeth).

In some cases, computed tomography, MRI, and ultrasound of the jaw are prescribed.

It often happens that disorders of the jaw joint are associated with unsuccessful prosthetics or difficult removal teeth. Then pain dysfunction appears only 10-12 days after the procedure.

Consequences (complications) of TMJ dysfunction

Temporomandibular joint dysfunction syndrome – most dangerous disease, which can ultimately lead to ankylosis. This is stiffness or complete immobility of the lower jaw, which is accompanied by impaired breathing, speech, and facial asymmetry.

In addition, it is possible dystrophic changes in joint tissues, the development of arthrosis and other chronic ailments.

Therefore, do not delay your visit to the dentist; treatment of temporomandibular joint dysfunction is mandatory. A list of relevant specialists is presented below.

What is TMJ dysfunction, what are its symptoms, is treatment for this disease effective without medications?

The TMJ is the temporomandibular joint, which is responsible for opening and closing the mouth, and therefore for biting, chopping and chewing food, communicating, yawning and performing other movements of the lower jaw. The joint is a pair, that is, the jaw has two heads that are attached to temporal bones at both sides.

Painful dysfunction of the TMJ - causes, symptoms, diagnosis

As a result of various congenital and acquired factors (bite disorders, jaw injuries, tooth extraction, improper installation of fillings and dentures, overstrain of masticatory muscles, stress factors) normal operation the joint on one side or another is often disrupted. TMJ dysfunction occurs, accompanied by pain and crunching in the joint when moving, limited mouth opening, headaches and neck pain, decreased mood, irritability and other symptoms. A person with painful dysfunction of the temporomandibular joint cannot eat, speak, smile, laugh, sing, yawn, etc. normally.

What to do in such a situation? Contact a dentist for an examination and thorough examination to determine the cause of the disease and promptly begin treatment for TMJ dysfunction. Usually, to clarify the diagnosis, the doctor recommends taking an x-ray (sometimes an MRI) of the problem joint, a panoramic image of the teeth of the upper and lower jaw.

Treatment usually includes anti-inflammatory medications, physical therapy, and wearing a special splint (mouth guard).

In some cases it will be effective to use acupressure, special gymnastics And autogenic training.

Reflexology for TMJ dysfunction

Properly performed, it can relieve pain due to dysfunction of the temporomandibular joint, reduce spasm of the masticatory muscles, and make it easier to open the mouth and chew food. Distant and local points are used on the channels of the large intestine (GI), stomach (E), triple heater (TR), small intestine(IG), gallbladder (VB). A specific set of points for the session is selected taking into account the characteristics of TMJ dysfunction and the presence of concomitant diseases.

I'll give you the most simple diagram influence using several main points:

1st session: (on the affected side) and E 36 (both sides) – active massage each point for 3-5 minutes 3 times a day
2nd session – TR 5 and – points are massaged on both sides for 4-5 minutes 2 times a day
3rd session – GI 4 and E 36 on both sides (3 minutes each), E 6 and E 7 on the side affected by the TMJ for 3 minutes
4th session - massage of painful (trigger) points in the area of the problem joint for 3-5 minutes (good - electropuncture with a negative current of 30-50 μA in painful points for 5-10 minutes each) and on both sides for 5 minutes
5-8th sessions - alternate use of the above combinations of points (you can influence the points with a home device for darsonvalization)

In the next 2 weeks, it is good to use (if available) the Vitafon device, placing vibraphones on the area of TMJ dysfunction and carrying out the effect for 10 minutes in the second mode, 2 times a day.

Therapeutic exercises for dysfunction of the temporomandibular joint

It is necessary to begin special exercises to restore impaired TMJ function after pain has reduced. Gymnastics should be performed carefully, gradually increasing the range of movements of the lower jaw, without leading to the appearance of pain. There is a special set of exercises - Rokabado myogymnastics.
Gymnastics in the treatment of TMJ dysfunction should be done 2-3 times a day, repeating each movement 5-10 times and remaining in extreme positions for six seconds. To perform the exercises, you need to sit near a mirror, straighten your back, and, if possible, relax the muscles of your face and neck.

Slowly open your mouth to the limit (if pain or blockage appears in the problematic TMJ, “step back” a little), stay in this position for 5-6 seconds, then slowly close your mouth. Repeat 10 times.
We perform the first exercise with opening and closing the mouth, while the tip of the tongue rests on the palate, closer to back surface mouth Repeat 5 times.
Gradual, fractional stretching of the masticatory muscles with persistent muscle spasm and pronounced limitation of mouth opening. We use wooden spatulas, which fold into a rubber fingertip and are located between chewing teeth On the one side. After a minute, the number of spatulas is increased to 10-14 and they are inserted for 1-2 minutes alternately on each side.
Movements of the lower jaw with counteraction. We rest our fist (hand) on the chin from below and provide resistance while opening the mouth and for six seconds in the position of its maximum opening. Repeat 5 times.
We perform counteraction when moving the lower jaw to the left and right, providing resistance with the hand on the opposite side. Repeat on both sides 5 times.
Restoring the symmetry of the muscles responsible for the movements of the lower jaw. Sitting in front of the mirror forefinger place the left hand in the area of the left TMJ, and thumb– below (side) in the area of the angle of the lower jaw on the left. In the same way we place the fingers of the right hand on the right. We perform slow movements of the lower jaw down and up, right and left, monitoring the simultaneous (symmetrical movement) of the jaw and gently correcting possible deviations if necessary.
The exercise is a continuation of the previous one. If you find that the jaw shifts to the left when opening the mouth, apply pressure with your left hand from left to right at this moment; if a shift is detected to the right side, then pressure must be applied right hand to the left.
If there is a displacement of the lower jaw when opening the mouth, it is recommended to chew predominantly on the side opposite to the displacement (the jaw moves to the left - we chew on the right side and vice versa).
Exercise for the muscles of the head and neck. Tilt your head up and down and left and right, holding your head in extreme positions for 3-4 seconds. Repeat 6-10 times in each direction.

Considering the significant influence of stress on the occurrence and course of TMJ dysfunction, it is important to learn how to quickly relieve emotional stress, relax the muscles of the body (including masticatory muscles). To do this, we can recommend mastering methods such as neuromuscular relaxation and autogenic training.
Here's an example, standard set self-hypnosis formulas for autogenic training (classes take place in a calm environment in a lying position or sitting in a “coachman” position). Exercises are mastered gradually and sequentially - having mastered the first exercise well, you can move on to the second, etc.

After mastering all six autogenic training exercises, the full text of the session will be something like this:

Those who are unable to master these techniques on their own can contact a psychotherapist for training or conducting sessions of therapeutic hypnosis.

Once again, I would like to note that the methods proposed above for treating TMJ dysfunction are additional, and most importantly, timely contact with a qualified dentist.