The tongue is frequently involved in Obstructive Sleep Apnoea (OSA) and TMJ and Oro-Facial Pain conditions and should not be overlooked in management. Lack of strength and tone in the tongue contributes to many jaw pain and airway problems.
Myofunctional Therapy, as used for OSA and Sleep Disordered Breathing, has been clinically proven to improve OSA by as much an 50%.
While this strategy of tongue strengthening is rarely undertaken as the only management in OSA, it is certainly a useful additional mode of treatment to use along with CPAP therapy or Oral appliance therapy, as well as various other modes of treatment.
Anybody with OSA should be instructed in terms of simple exercises they can do regularly to assist in their home-care.
Incorrect tongue posture and positioning and incorrect swallowing techniques that linger from infancy can be addressed.
- A very useful exercise for relaxing painful masticatory muscles and also to strengthen the tongue and increase the muscle-tone of the tongue, the Lateral Pterygoid and Medial Pterygoid Muscles, is to raise the tip of the tongue to the roof of the mouth and hold the tongue on the palate and scrape the tip of the tongue back to the back of the palate.
Repeat this particular exercise 20 times at least twice a day and whenever else you think of it, eg in the shower, while driving etc..
This exercise is also very useful in repositioning the head of the jaw (condyle) back into its resting position on removal of the Mandibular Advancement Device in the morning.
- Open the mouth widely and close again immediately. Repeat 20 times at least twice a day.
- For actual TMJ pain cases, an additional exercise that can be done is to place the tip of the tongue on the palate just behind the upper front teeth, hold it firmly against that spot and open the jaw as wide as you comfortably can and hold it about 5 seconds with the tongue still on the palate. Close again and simply, and repeat 2-3 times a day along with the above set of exercises.
- Tik Toks. This exercise involves sucking the tip of the tongue to the palate behind the upper front teeth and “clicking” it off the palate with the lips first in a smiling position, the TIK, and then with the lips pursed as in saying “Oooh” as the TOK position. Repeat 20 times 2-3 times daily.
- Close the lips and push the tongue firmly into the upper and lower lips and cheeks, moving the tongue from upper lip, to lower lip and both cheeks. This needs only to take 15-20 seconds each time. Repeat it 3 times each exercise session and 2-3 times daily.
- Drink sips of water through a straw with the teeth held together.
A very useful relaxation technique used in many chronic pain conditions:-
- Lie flat on the floor on your back on a gym or yoga mat, not a bed. If the neck is chronically inflexible, use a folded towel so the head is passively held neither head forward nor head backward. The eyes should face straight up.
- Tuck the chin in.
- Place the tip of the tongue on the palate just behind the upper front teeth and close the lips.
- Place one hand on the stomach and the other on the chest.
- Concentrate on regular breathing into the belly not the chest.
- Hold this position for 10 minutes, although longer is fine.
- Repeat this relaxation pose twice a day for at least 2-3 weeks although it can remain a permanent habit.