What to Expect for Your First TMJ Diagnosis​ Appointment?

Suppose you begin to feel pain, tension, or clicking in your temporomandibular joint (TMJ). In that case, you may seek treatment to correct this disorder, also known as temporomandibular joint disorder (TMD or TMJ disorder). But first, you'll need to be diagnosed by Dr.Adatrow who specializes in the condition. There is no one standard test to diagnose TMJ disorder, so that he may use a TMJ questionnaire, health history evaluation, physical examination, and diagnostic imaging.

What is a TMJ questionnaire?

Before or during your first appointment, our dental office will likely have you answer specific questions about your TMJ pain and discomfort.
Questions may include:
• Do you experience any clicking, popping, or grinding sounds when you open and close your jaw?
• Do you have any pain, ringing, pressure, or fluid buildup in one or both ears?
• Do you clench your jaw or grind your teeth during your sleep or while you're awake?
• Do you find it difficult to open your mouth fully?
You may also be asked when the symptoms began, how severely they impact your daily life, and if there is any activity or time of day during which the pain is worse.

How are psychological factors assessed in TMD?

Studies have found psychological factors like stress, anxiety, and depression to be elevated in TMD patients. So, our dental team does a psychological evaluation on you to provide you with the best treatment. Dr. Adatrow will question you on the level of your pain on a scale of 1-10. You will be asked or fill out a questionnaire about the anxiety and depression levels you are experiencing.

What is the different diagnostic imaging used in TMJ evaluation?

Depending on the severity of your disorder, Dr. Adatrow may order diagnostic imaging. This will allow him to assess the joint's integrity, monitor the condition's progress, and determine an individualized treatment plan for you. Typical imaging required to make a TMJ diagnosis includes routine and panoramic x-rays, CT scans, MRI scans, and scintigraphy (bone scans)

Why was I recommended x-rays for TMJ evaluation?

Dr.Adatrow will prescribe a radiographic (x-ray) evaluation of your temporomandibular if he deems it necessary to provide you the most appropriate treatment.

What is panoramic radiography (OPG)?

Panoramic radiography provides images of your mandibular condyles, maxillary sinus, upper and lower teeth, and any alteration in the shape of your lower jaw. These structures are not visible clinically. OPG shows all the bony (hard) structures of the TMJ region in a two-dimensional (2D) view.

Why is magnetic resonance imaging (MRI) prescribed for TMD?

Magnetic resonance imaging (MRI) utilizes magnetic field pulses and radiofrequency signals rather than ionizing radiation to produce multiple digital image slices. Dr. Adatrow might recommend this when he needs to evaluate your TMJ's soft tissue structures like jaw muscles, disc displacements, or any other swollen structure of the joint.

Can teeth-clenching cause TMD?

Clenching or grinding of teeth is called bruxism and can happen intentionally or unintentionally. It can occur during daytime or nighttime. When you grind your teeth, there will be excessive stress on your muscles and structures around the jaw joint and the TMJ itself. This leads to onset or increase in the TMD symptoms. Grinding of the teeth causes the wearing of your teeth and results in loss of balance in the relation of the upper and lower teeth (occlusion).

How will my TMJ Diagnosis​ be evaluated in the clinic?

Our dental team will perform an extensive clinical examination to diagnose TMJ disorder. Following are steps in the clinical evaluation of TMJ
• Our dental team will obtain your detailed medical and dental history and history of any previous trauma.
Dr.Adatrow will evaluate the opening of the patient's jaw by measuring the distance between the upper and lower front teeth
• The doctor will examine the muscles around the patient's jaw joint by touching them (palpation), checking whether there is any pain or soreness in the muscles when palpating.
• He will palpate your TMJ by asking you to open your mouth by 1-1.5 inches and assess whether there is any pain or tenderness while doing the same.
• He will feel for any TMJ sounds by placing a finger over your TMJ when you open and close your mouth.

What is a health history evaluation?

Many other health conditions can mimic TMJ disorder. So, Dr. Adatrow will also ask questions about your current and previous state of health, your current stress levels, any hormonal imbalances, and your medications. Some of these conditions include sinus or ear infections, dental cavities, or nerve disorders like trigeminal neuralgia. • Brush and floss your teeth daily. Remember to clean your tongue, too, to remove bacteria from your surface.
• Get regular dental check-ups and ensure that dentures or braces are correctly fitted and cleaned (and clean dentures thoroughly every night).
• Stop smoking or chewing tobacco.
• Chewing sugarless gum and sugar-free sweets will also prevent the mouth from drying out.
• Keep your mouth moist by drinking water and chewing sugarless gum or sugar-free hard candy to promote the production of saliva. Eat a diet of foods that need to be chewed thoroughly to keep saliva flowing. Foods that need a lot of chewings, such as apples or carrots, are good choices.
• Over-the-counter mouthwash may help kill bad breath causing bacteria and may temporarily mask bad breathing odors but may not treat the underlying cause.
•Drinking water will hydrate you and moisten your mouth too.

Why is clinical evaluation necessary?

History and clinical evaluation play a critical role in assessing the health of your TMJ. So, you should provide detailed information to ensure that we offer you the best treatment plan.

Should I inform my dentist about the supplements I have been consuming?

Yes, to give our dental team a better picture of your overall health, bring a list of your medications (including supplements) with you to your appointment.

What is cone-beam computerized tomography (CBCT) scans?

Computed tomography (CT) is a more advanced technique in which the patient is exposed to a fan-shaped x-ray beam guided to various detectors. The detectors move around the patient to get 360 degrees images. These images are received as data on a computer monitor. They can be reconstructed to form two-dimensional (2D) or three-dimensional ((3D) images. This is ideal for viewing all the bony structures of the skull and jaw regions.

Can ultrasound (US) be used in diagnosing TMJ dysfunction?

To detect internal TMJ dysfunctions, and MRI is not a suitable technique to be utilized, ultrasound is used. It can be used to identify or understand soft tissue disorders or complications concerning the temporomandibular joint. It can visualize all soft tissue structures in and around TMJ like salivary glands, internal discs, muscles, and others.

What is scintigraphy?

Scintigraphy is also known as a bone scan. This scan will first require a dye injection into the affected area. Once your bones have absorbed the dye, you will be scanned to determine your bones' health.

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