364 A P P E N D I C E S

As your symptoms improve or if you have a fl are - up, you will need to increase or decrease this opening and time. Be very careful not to cause yourself any aggravation with this exercise, because this may hurt your progress.

Patients report this exercise does not provide immediate symptom improvement, but takes about 1 – 2 weeks before benefi ts are noticed. Similarly, stopping does not cause immediate loss of these benefi ts, but also tends to take 1 – 2 weeks to be noticed. With the normal symptom fl uctuation most TMD patients experience, it is often diffi cult for them to relate their symptom improvement or aggravation to the starting or stopping of this exercise.