The Walter White of TMD??
Yep. Meet... the Lateral Pterygoid.
The lateral pterygoid is intimately involved in your oral function. If you move your jaw forward or side-to-side your lateral pterygoid is involved in this motion. Since chewing is not a straight up and down motion like a hinge, but rather a circular type motion when viewing your mouth from the front, the lateral pterygoid contributes to this important daily activity.
Quite simply, this muscle lying beneath your cheek and attaches to the disc and the mandibular condyle laterally and the sphenoid bone medially. It acts to pull the jaw and disc forward and medially (towards the center of your face).
When your Mouth starts "Breaking Bad"
So what happens when the Lateral Pterygoid does it's best Walter White impersonation and starts "Breaking Bad"?
In the popular Fx show, whether it was lying to a guillible Jesse or even his own family, we could always count on Mr White to have a special knack for causing some sort of friction in his relationships. The lateral ptyergoid has this same annoying tendency. Under normal circumstances, much like Mr White, a high school chemistry teacher- the lateral pterygoid is harmless. But power- as it always does- corrupts the most harmless of intentions.
The unconscious mind at night can struggle to cope with a day's worth of pent of frustration. Whether it's rocky relationships or rush hour traffic our minds and bodies find ways to cope. This can easily lead to your mouth clenching or even teeth grinding or bruxing. Your mouth, and specifically the lateral pterygoid, is positioned to forcefully move the jaw back and forth which it does fervidly during bruxing causing an abundance of friction. With this repeated activity, the LP can cause pain and spasm- eventually causing all around it to feel the pain of its progressive breakdown.
Was there ever a time when the duplicitous MWhite didn't lie? He was as shifty a character as I've seen. Well, the lateral pterygoid is a shifty one too.
What to Do About You-Know-Who
When the lateral pterygoid spasms, it can shift the bottom jaw forward separating the back teeth. This is characteristic of a lateral pterygoid spasm. How then to get this muscle to relax again? It will benefit from dry needling and stretching. Stretching can be performed effectively by jaw depression and retrusion. I personally was surprised at how specific this stretch felt. Often times this can be an effective stretch after the jaw is placed in a protruded position for a period of time- like when a splint positions the jaw forward. An ARA or anterior repositioning appliance is one of the splints that aims to move the jaw forward. The lateral pterygoid can adaptively shorten over time.
Dry needling the lateral pterygoid involves needling between the mandibular condyle and coronoid process of the mandible. The muscle is not able to be palpated due to its depth. It generally is accepted to lie deep within the jaw attached to the sphenoid at roughly 40 mm deep. It's also interesting to note that the lateral pterygoid can refer to the sinuses just below the eye. Sometimes soreness below the eye from lateral pterygoid pain can be easily misinterpreted as sinusitis or sinus infections.
The next time you see a mouth that's creating friction and you suspect its behavior seems just a little too shifty-
Don't forget to consider the lateral pterygoid- the Mr White of Orofacial Pain.
Yep. Meet... the Lateral Pterygoid.
The lateral pterygoid is intimately involved in your oral function. If you move your jaw forward or side-to-side your lateral pterygoid is involved in this motion. Since chewing is not a straight up and down motion like a hinge, but rather a circular type motion when viewing your mouth from the front, the lateral pterygoid contributes to this important daily activity.
Quite simply, this muscle lying beneath your cheek and attaches to the disc and the mandibular condyle laterally and the sphenoid bone medially. It acts to pull the jaw and disc forward and medially (towards the center of your face).
When your Mouth starts "Breaking Bad"
So what happens when the Lateral Pterygoid does it's best Walter White impersonation and starts "Breaking Bad"?
In the popular Fx show, whether it was lying to a guillible Jesse or even his own family, we could always count on Mr White to have a special knack for causing some sort of friction in his relationships. The lateral ptyergoid has this same annoying tendency. Under normal circumstances, much like Mr White, a high school chemistry teacher- the lateral pterygoid is harmless. But power- as it always does- corrupts the most harmless of intentions.
The unconscious mind at night can struggle to cope with a day's worth of pent of frustration. Whether it's rocky relationships or rush hour traffic our minds and bodies find ways to cope. This can easily lead to your mouth clenching or even teeth grinding or bruxing. Your mouth, and specifically the lateral pterygoid, is positioned to forcefully move the jaw back and forth which it does fervidly during bruxing causing an abundance of friction. With this repeated activity, the LP can cause pain and spasm- eventually causing all around it to feel the pain of its progressive breakdown.
Was there ever a time when the duplicitous MWhite didn't lie? He was as shifty a character as I've seen. Well, the lateral pterygoid is a shifty one too.
What to Do About You-Know-Who
When the lateral pterygoid spasms, it can shift the bottom jaw forward separating the back teeth. This is characteristic of a lateral pterygoid spasm. How then to get this muscle to relax again? It will benefit from dry needling and stretching. Stretching can be performed effectively by jaw depression and retrusion. I personally was surprised at how specific this stretch felt. Often times this can be an effective stretch after the jaw is placed in a protruded position for a period of time- like when a splint positions the jaw forward. An ARA or anterior repositioning appliance is one of the splints that aims to move the jaw forward. The lateral pterygoid can adaptively shorten over time.
Dry needling the lateral pterygoid involves needling between the mandibular condyle and coronoid process of the mandible. The muscle is not able to be palpated due to its depth. It generally is accepted to lie deep within the jaw attached to the sphenoid at roughly 40 mm deep. It's also interesting to note that the lateral pterygoid can refer to the sinuses just below the eye. Sometimes soreness below the eye from lateral pterygoid pain can be easily misinterpreted as sinusitis or sinus infections.
The next time you see a mouth that's creating friction and you suspect its behavior seems just a little too shifty-
Don't forget to consider the lateral pterygoid- the Mr White of Orofacial Pain.
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