Temporomandibular Joint (TMJ) Syndrome (cont.)
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, whether it is easy to open and close, if it 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 while the jaw is being manipulated;
- wear and tear on the buccal cusps of the mandibular teeth, especially the canine teeth;
- rigidity and/or tenderness of the chewing muscles; and
- how your teeth align together: are the teeth normal, is there an open bite, crossbite, or overbite; have you had dental restorations; and is there a facial bone deformity.
Depending on the what doctor suspects as the cause, he/she may order blood tests that include a white cell count and other tests to rule out lupus, rheumatoid arthritis, or gout as a cause of the TMJ syndrome.
- Imaging: X-rays may be taken of the mouth and jaw.
- Ultrasound may also be ordered to assess the function of the TMJ. It is a useful tool to assess the inside of the TMJ.
If the diagnosis of TMJ syndrome is not clear or some other disorder is suspected, CT or MRI scans may also be obtained The MRI scan can help assess the soft tissues and the inside of the joint. A CT scan can help assess the bony structures and muscles. Experts believe that in doubtful cases, MRI is the study of choice as it is useful in evaluating TMJ disease.
In rare cases, if all the above tests fail to make a diagnosis of TMJ syndrome and pain still persists, the surgeon may use a needle to clean and irrigate the joint (arthrocentesis).
Medically Reviewed by a Doctor on 11/9/2015
Steven S. Bhimji, MD, MSc, PhD
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