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Temporomandibular Joint (TMJ) Syndrome (cont.)

How Long Do TMJ Symptoms and Signs Last?

Acute TMJ symptoms and signs may last anywhere from a few days to a few weeks and then disappear after the injury or cause of discomfort has resolved. For a chronic TMJ condition, the symptoms can be ongoing with episodes of sharp and/or dull pain that occur over an extended period of time (months to years).

When Should Someone Seek Medical Care for TMJ?

Occasional pain in the jaw joint or chewing muscles is common and may not be a cause for concern. See a doctor if your pain is severe or if it does not go away. You should also see your health-care professional if is hurts to open and close the jaw or if you have difficulty swallowing food. Treatment for TMJ syndrome ideally should begin when it is in early stages. If the condition is identified early, the doctor can explain functioning of the joints and how to avoid any action or habit (such as chewing gum) that might aggravate the joint or facial pain.

If your jaw is locked open or closed, go to a hospital's emergency department.

  • The open locked jaw is treated by sedating you to a comfortable level. Then the mandible (upper jaw) is held with the thumbs while the lower jaw is pushed downward, forward, and backward. This maneuver is usually done by the Emergency Department physician or an ear, nose, and throat (ENT) specialist.
  • The closed locked jaw is also treated by sedating you until you are completely relaxed. Then the mandible is gently manipulated until the mouth opens.

How Do Health Care Professionals Diagnose TMJ Syndrome?

  • 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 10/18/2017

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