Understanding TMJ-Focused Facial Massage

As an esthetician, I often hear clients mention that they suffer from TMJ, but TMJ isn’t a disorder. The temporomandibular joint (TMJ)  is actually the hinge that connects the mandible to the skull at the temporal bone. What they likely mean is that they grind their teeth and thus have temporomandibular disorder (TMD). Roughly 5%-10% of the population suffers from some variation of TMD, with the discomfort affecting women twice as much as men. Bruxism, the unconscious habit of clenching and grinding, can be a result of stress, worry, anger, anxiety, and habitual jaw holding. It may happen consciously or unconsciously at night, and can bring on sore masseter muscles, migraines, and worn-down teeth and night-guards.

The muscles that are mainly affected by bruxism and would benefit from massage, both external facial massage and the intraoral (buccal) version, are the muscles of mastication – the masseter, the temporalis, and the medial and lateral pterygoids. The sternocleidomastoid (SCM), the prominent muscle running from behind the ear down to the sternum and clavicle, would benefit from the massage, as well. Even though it’s not directly involved in chewing, the SCM is sometimes prone to increased tension radiating down from a clenched TMJ.

A facial massage that focuses on bruxism and TMJ release may temporarily improve comfort and help relax overactive tense muscles surrounding the jaw. Start the massage with gentle neck and shoulder relaxation, once you get to the jaw, to help locate the masseter, you may ask the client to clench and release. The best movements for this type of massage are slow compression, circular, and controlled strokes over the masseter. Work around the joint, rather than directly pressing into it. More pressure isn’t necessarily better, as clenching irritates the jaw muscles already.

Gua sha facial massage, especially a pinpointed movement called Bo Jin is beneficial for breaking up muscular tension on the face. While Gua Sha uses flat, smooth stones with light-to-medium pressure in long, sweeping, unidirectional motions across the skin surface to boost lymphatic drainage and circulation, Bo Jin uses precise pressure. It employs bi-directional, pressing, circular, and short strumming strokes to release deep muscle, tendon, and fascial tension, especially in the muscles of mastication.

Low-level electrical stimulation with a microcurrent device may also help with neuromuscular re-education and temporarily reduce the feeling of muscular tension. With a client who chronically clenches, the goal would be relaxation of excessive muscle tension, not aggressively stimulating or “working out” an already overactive masseter. Rather than intensely stimulating an already overactive masseter, the objective is to encourage muscular relaxation and support more balanced neuromuscular function.

Another approach may be intraoral/buccal massage, since buccal massage techniques provide direct access to structures from inside the mouth. It’s best to check your state’s scope of practice before offering it, since it isn’t within scope in most states and is a gray area in some.

As with any condition mentioned to us by clients, if TMD is bothering your client and he or she persistently complains of jaw pain, locking, significant clicking accompanied by pain, inability to open normally, swelling, or trauma, it is always best to refer him or her to a dental professional for imaging and evaluation.