TMJ Disorder Leading to Jaw Locking: Expert Advice from Dr. Adatrow
What to Expect for Your First TMJ Diagnosis Appointment?
If you begin to feel pain, tension, or clicking in your temporomandibular joint (TMJ), you may seek treatment to correct this condition, also known as temporomandibular joint disorder (TMD) or TMJ disorder. But first, you’ll need a diagnosis from Dr. Adatrow, who specializes in the condition. There is no single standard test for diagnosing TMJ disorder, so Dr. Adatrow may use a TMJ questionnaire, health history evaluation, physical examination, and diagnostic imaging to assess your condition.
What is a TMJ questionnaire?
Before or during your first appointment, our dental office will likely ask you to 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 sleep or while 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 that psychological factors like stress, anxiety, and depression are often elevated in TMD patients. Our dental team conducts a psychological evaluation to provide you with the best treatment. Dr. Adatrow will ask about your pain level on a scale of 1-10 and may also have you fill out a questionnaire regarding your anxiety and depression levels.
What is the different diagnostic imaging used in TMJ evaluation?
Depending on the severity of your disorder, Dr. Adatrow may order diagnostic imaging to assess the joint’s integrity, monitor the condition’s progress, and determine an individualized treatment plan for you. Common imaging techniques used to diagnose TMJ include routine and panoramic x-rays, CT scans, MRI scans, and scintigraphy (bone scans).
Why was I recommended x-rays for TMJ evaluation?
Dr. Adatrow may prescribe a radiographic (x-ray) evaluation of your temporomandibular joint (TMJ) if deemed necessary to provide 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) uses 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 the soft tissue structures of your TMJ, such as jaw muscles, disc displacements, or any other swollen structure of the joint.
Can teeth-clenching cause TMD?
Clenching or grinding of teeth, also known as bruxism, can happen intentionally or unintentionally, during the day or at night. When you grind your teeth, it places excessive stress on the muscles and structures around the jaw joint and the TMJ itself, leading to the onset or worsening of TMD symptoms. Teeth grinding also wears down your teeth, causing a loss of balance in the relationship between the upper and lower teeth (occlusion).
How will my TMJ Diagnosis be evaluated in the clinic?
Our dental team will perform a thorough clinical examination to diagnose TMJ disorder. The clinical evaluation of TMJ involves the following steps:
- Our dental team will obtain your detailed medical and dental history, including any previous trauma.
- Dr. Adatrow will evaluate your jaw opening by measuring the distance between the upper and lower front teeth.
- The doctor will examine the muscles around your jaw joint through palpation (touching) to check for pain or soreness.
- He will palpate your TMJ by asking you to open your mouth by 1-1.5 inches and assess for pain or tenderness.
- He will feel for any TMJ sounds by placing a finger over your TMJ while you open and close your mouth.
What is a health history evaluation?
Many health conditions can mimic TMJ disorder. Therefore, Dr. Adatrow will ask questions about your current and previous health status, stress levels, hormonal imbalances, and medications. Some conditions that can mimic TMJ disorder include sinus or ear infections, dental cavities, or nerve disorders like trigeminal neuralgia.
Why is clinical evaluation necessary?
History and clinical evaluation play a critical role in assessing the health of your TMJ. Providing detailed information is essential for us to offer the best treatment plan.
Should I inform my dentist about the supplements I have been consuming?
Yes, to give our dental team a complete picture of your overall health, bring a list of your medications, including supplements, 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 that is guided to various detectors. These detectors move around the patient to capture 360-degree images. The images are received as data on a computer monitor and can be reconstructed to form two-dimensional (2D) or three-dimensional (3D) images. This method is ideal for viewing all the bony structures of the skull and jaw regions.
Can ultrasound (US) be used in diagnosing TMJ dysfunction?
If an MRI is not suitable, ultrasound (US) can be used to detect internal TMJ dysfunctions. Ultrasound can identify soft tissue disorders or complications related to the temporomandibular joint and visualize all soft tissue structures in and around the TMJ, such as salivary glands, internal discs, and muscles.
What is scintigraphy?
Scintigraphy, also known as a bone scan, requires an initial dye injection into the affected area. Once your bones have absorbed the dye, a scan is performed to assess the health of your bones.