Avoidance Protocol

CLICKING AVOIDANCE

Once a disc is out of place it can not be put back. Therefore, first and most important is avoidance of the clicking by limiting the opening of the jaw. Avoidance will allow the disc to adapt to its new position and reduce the chances of getting arthritis in the joint in the future. Fortunately, the jaw joint can hinge open two fingers width (25 mm) without sliding forward. It is critical that you must not slide forward or side-to-side.

CLENCHING AVOIDANCE

Many patients are not aware that they put their teeth together during the day. This is not good, since it allows you to generate additional contraction in the jaw muscles. When you do this you compromise or reduce blood flow in the jaw muscles. You should consciously avoid all tooth contact (unless eating) during the day.

No tooth contact except when eating:
Use a timer to remind you every 30 minutes to keep you teeth apart.
Place stickers in different locations that you pass during the day (walls, desk, phone, car, refrigerator, etc). Every time you see the stickers remember that your teeth should be apart.

REDUCED JAW FUNCTION

As mentioned in click avoidance, you need to avoid all hard foods (e.g. tough breads, hard meat) and any chewy food (e.g. gum, salad). Hard foods delay the healing process. A soft diet will allow your chewing muscles to rest. Chewy foods produce a repetitive rubbing of the joint surfaces together. If they are damaged they never have a chance to heal and repair. It is similar to typing several hours with a sore wrist; it may not hurt much while you are doing it, but it will hurt later. The injured joint has a better chance of healing with a strict program of reduced function.

Avoid hard/chewy food: Limit foods to those that do not aggravate the pain, this does not mean eat foods with low nutritional value (high in sugar and fat and low in protein).
Cut food into small pieces: One way of achieving a good soft diet program can be by simply cutting your food into small pieces.
Avoid talking, singing, laughing: Limited talking and use of the jaw during the initial treatment period (usually 3-4 weeks).

HABIT AVOIDANCE

Do NOT bite your nails.
Do NOT chew your checks or lips.
Do NOT chew ice cubes.
Do NOT bite on pens or pencils.

OPENING WIDE AVOIDANCE

Hold your chin up when yawning and tip your head forward.
Cut food into small pieces.

PROLONGED DENTAL APPOINTMENT AVOIDANCE

When you go to the dental office, make sure you tell the dentist or hygienist about your jaw problem and ask if they have a bite block they can give you to help support your jaw when it is open. (The best bite blocks are made of soft Styrofoam.) Next it is critical to ask that they only work for short periods and give you the opportunity to close your mouth regularly during the appointment.