Temporomandibular Joint Disorders

TMJ Diagnosis

A diagnosis of TMJ often involves a primary care physician as well as a dentist. In some cases, an ear, nose, and throat specialist (ENT), an oral and maxillofacial surgeon, and/or a physical therapist also may be consulted. Temporomandibular joint disorder diagnosis often involves taking a medical history (including a history of symptoms) and performing a physical examination and diagnostic tests.

Patients should be prepared to describe TMJ symptoms in as much detail as possible. Important information includes the following:

• Where exactly is the pain located? Is the pain sharp or is it a dull ache?
• Is jaw pain constant or intermittent (come and go)?
• When is the pain most severe? When is it mildest?
• Do you chew gum frequently or chew on objects such as pens or pencils?
• Do you grind your teeth at night?
• Do you bite your nails or cuticles?
• Does your work require long periods of sitting (e.g., at a computer)?
• Do you regularly participate in activities (e.g., work) that require repetitive motions? If so, which motions?
• Do you talk on the phone for long periods of time (e.g., at work or at home)?
• Do you practice proper body mechanics (e.g., while lifting heavy objects) and generally have good posture?
• How long have you experienced these TMJ symptoms?
• Have you ever experienced a jaw injury? When did the injury occur?
• Have you had a recent dental procedure or surgery?
• How would you describe your stress and anxiety levels?
• Do you use any strategies to help reduce stress? If so, how do you cope with stressful situations?

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During the physical exam, the doctor or dentist observes the jaw closely as the patient opens and closes his or her mouth, checks the alignment of the jaw, and examines the patient’s bite and each individual tooth.

If TMJ is caused by injury or inflammation to the soft tissue around or within the joint, x-rays may not be useful in the diagnosis. However, an x-ray may be ordered to help rule out other conditions. Other imaging tests (e.g., CT scan, MRI scan) may be performed to diagnose temporomandibular joint disorders. CT (computerized tomography) scans and MRI (magnetic resonance imaging) scans provide more detailed images of the tissue surrounding the jaw than standard x-rays.

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