What is the best initial strategy for a patient with acute TMJ pain after facial trauma?

• A. Application of heat to the jaw
• B. Instructing the patient to maintain the tongue on the hard palate
• C. Referral for imaging studies
• D. Using a jaw-supporting brace

Answer: (B)

In the context of acute temporomandibular joint (TMJ) pain following facial trauma, maintaining the tongue on the hard palate serves multiple purposes that can benefit the patient's condition. This position helps stabilize the jaw and can provide a degree of relief by minimizing movements that might exacerbate pain or discomfort associated with the injury. Additionally, keeping the tongue in this position encourages a neutral occlusion, which may reduce strain on the TMJ and surrounding musculature.

While other strategies like applying heat or using a jaw-supporting brace may offer comfort or support, they do not specifically address the need for stabilization in the immediate aftermath of trauma. Imaging studies are generally not the first step unless there are signs of more serious injury such as fractures or dislocations, and that decision usually comes after an initial assessment. Therefore, instructing the patient to remain mindful of their tongue position is an effective and practical initial strategy that aids in managing acute TMJ pain.