| Pain |
Pain remission/reduction;Reduction of related emotional aspects (anxiety) |
Self-management directions Mindfulness practices |
Thermotherapy for 20 to 30 minutes followed by self-massage, awareness about habits and behaviors that contribute to pain, directions about sleep hygiene and regular physical exercises.13 we practices focusing breathing and orofacial structures, with the therapist's assistance. |
| Masticatory muscles |
Coordinate/strengthen jaw movements |
Mandibular exercises |
Lower and raise the jaw gently with the support of the apex of the tongue on the hard palate, aiming at a rectilinear motion (3 sequences of 10 movements each); gently press a rubber band (latex) of 5 mm in diameter, placed between the posterior teeth, varying at each bite between premolar and molar teeth (3 sequences of 10 bites each), 1 to 3 times a day. |
| TMJ |
Lubricate |
Mandibular exercises associated with the use of the occlusal splint |
Mandibular excursive movements for mouth opening, as already described, right and left laterality, protrusion. (Exercises with occlusal splint) |
| Tongue |
Coordinate |
Stimulate the sensitivity, mobility, increase tension, favor habitual position |
Concomitant mechanical stimulation on the sides of the tongue using toothbrushes, lightly passing the bristles in posteroanterior direction for approximately 15 seconds, repeating 5 times in sequence, with 3 to 5-second intervals; Lingual movements to the sides, up and down, slowly, with instruction to touch the apex of the tongue in the labial commissures, in the center of the upper lip and in the center of the lower lip, respectively;Use of the pró-fono lingual appliance in accordance with the protocol suggested in the instruction manualPass the apex of the tongue gently and continuously in back and forth movements for approximately 5 minutes and then, remain resting keeping this contact of the tongue against the hard palate consciously for an indeterminate time, without the interposition of the tongue between the dental arches (several times per day). |
| Speech |
Eliminate ceceos and mandibular deviations |
Mandibular exercises, and speech and articulation exercises |
Lower and raise the jaw gently with the support of the apex of the tongue on the hard palate, aiming at a rectilinear motion (3 sequences of 10 movements each); symmetrically right and left laterality exercise, protrusion exercise trying not to create deviations. (Exercises with occlusal splint); tongue exercises described above; repetition of syllables, words, texts, phonetically balanced with phonemes where the ceceo and mandibular deviations occurred. |
| Chewing |
Balance |
Create awareness about the mode used, expanding the attention and perceptions during this function with different food, establish chewing without pain and without aggravating the problem (Mindfulness) |
Common chewing exercises of different food, consciously, broadening the perceptions about the sensations caused, such as pain, easiness, difficulty, the difference between the sides, physical food characteristics and taste perception; simultaneous bilateral chewing exercise, that is, chewing a portion in each side of the mouth simultaneously. |
| Swallowing |
Eliminate compensations |
Tongue and swallowing exercises |
Tongue exercises described above and swallowing exercises of water and food, with the instruction to position the apex of the tongue opposed to the anterior region of the hard palate, performing a waving movement of the body of the tongue in the anteroposterior direction propelling the food bolus into the pharynx. |
| Resting |
Keep the functional space free/prevent teeth clenching |
Awareness and relaxation, positioning the tongue properly, strengthen the levator muscles of the jaw |
Enhance the attention (Mindfulness) in the day-to-day for perception and awareness of the teeth clenching events, using reinforcement strategies as reminders such as self-adhesive notes in different places in the house and at work; gently and countinuously pass the apex of the tongue in back and forth movements for approximately 5 minutes (RLPM) and then, to rest and counsciously keep this contact of the tongue against the hard palato for an undeterminate time, without the interposition of the tongue between the dental arches (several times per day; gently press a rubber band (latex) of 5mm of diameter, placed between the posterior teeth, varying, at each bite, between the pre-molar and molar teeth (3 sequences of 10 bites each), 1 to 3 times per day. |
