TMJ Diagnosis and Treatment in a General Dental Office

The nagging click that you hear, the headache that just will not quit, and a jaw that is constantly sore are signs of temporomandibular joint (TMJ) disorder. This condition is caused by the cartilage that protects the jaw joint deteriorating, making all movements of the jaw much more challenging. The first step in managing temporomandibular joint disorders (TMDs) is visiting a dentist; this way, your TMJ can be evaluated to determine what is impeding its proper function.

Your dentist: The TMJ detective

No one is better trained to diagnose and provide personalized treatments for TMDs than a dentist. Here is what patients can expect during the appointment.

The deep dive chat

TMJ consultations often begin with the dentist interviewing the patient to determine when the pain started, the primary sources of discomfort, and the factors that exacerbate it. Any history of teeth grinding is also evaluated because bruxism is closely associated with TMJDs.

The hands-on exam

After the interview, the dentist performs a physical examination, palpating the patient’s TMJ and the surrounding muscles. They might be asked to open and close their mouth while the dentist listens closely for clicks, pops, or grating sounds. The dentist will also evaluate how wide they can comfortably open their mouth.

The bite check

How the teeth come together (one's bite, or occlusion) plays a massive role in TMJ stress. The dentist will carefully examine the patient's teeth for unusual wear patterns, chips, or looseness, as these are all telltale signs of grinding or clenching.

The imaging test

Dentists sometimes use imaging tests to evaluate what is going on underneath a patient’s gums. In certain cases, magnetic resonance imaging may be used to evaluate the soft tissues within the TMJ.

The goal of these steps is to pinpoint the source of the patient’s TMJ trouble, as it can be muscular, joint related, bite related, or a combination of all three. The National Institute of Dental and Craniofacial Research suggests that over 12 million Americans are affected by TMDs. A proper diagnosis is key to effective treatment.

A personalized TMJ treatment plan: Conservative and effective

Dentists typically focus first on non-invasive treatment options that are proven to reduce pain and restore proper function of the TMJ. These include:

• Lifestyle tweaks and self-care: These are often part of the first line of defense against TMD. A dentist might advise the patient to avoid chewy foods to rest their jaw, apply warm compression to their face, and practice gentle stretches. Stress management practices, such as deep breathing exercises, may also be recommended, as stress is a contributing factor.
• Occlusal splints/night guards: These are customized appliances that are primarily worn at night. They act as shock absorbers, minimizing the damage done by teeth grinding.
• Bite adjustment: TMDs can be caused by a patient’s jaw not closing correctly. It can sometimes be fixed by reshaping the biting surfaces of teeth or improving their alignment.
• Medication management: Over-the-counter anti-inflammatory medication may be recommended if there is considerable inflammation around the TMJ.
• Physical therapy: Tools like ultrasound stimulation, massage, and targeted exercises can help alleviate symptoms of TMDs.