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Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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TMJ Syndrome Diagnosis

• Medical history: In diagnosing your jaw problem, the doctor will ask the following questions:



• What kind of pain do you have?



• Is it an ache, a throbbing pain, or a sharp stabbing pain?



• Is the pain continuous or intermittent?



• Can you outline the area of pain on your face with your finger?



• What helps to alleviate the pain? What aggravates the pain?



• Do you grind or clench your teeth? Do you bite your nails or chew on any objects, such as pens or pencils?



• Do you hold the telephone with your shoulder against your ear for a long time?



• Do you chew gum often? For how long?



• Do you have any oral habits that you have not mentioned?



• Physical examination: During the physical examination, the doctor will examine your head, neck, face, and temporomandibular joints, noting any of the following:



• tenderness (pain) and its location;



• sounds, such as clicking, popping, grating;



• the mandible (lower jaw) range of motion and whether it is easy to open and close and can move from side to side and forward-backward without any pain;



• your assessment of pain on a scale from 0 (no pain) to 10;



• wear and tear on the buccal cusps of the mandibular teeth, especially the canine teeth;



• the rigidity and or tenderness of the chewing muscles;



• how your teeth fit together: normal, open bite, crossbite, overbite, dental restorations, or skeletal deformity.



• Imaging: X-rays may be taken of the mouth and jaw. CT or MRI scans may also be used. The MRI was designed for imaging of soft tissue and, therefore, will show the location of the TMJ disc in relationship to the jaw and skull bones. That will give the doctor a better idea as to the proper treatment approach.