Warning Signs in Your Medical History
We will take a complete medical history to determine whether you have other medical conditions that may put you at increased risk for TMJ, such as rheumatoid arthritis, lupus, or irritable bowel syndrome (IBS).
We will also talk to you about your pain. You have the most experience with your jaw pain, which makes you the expert on it. And because TMJ is a highly individual condition, we will listen carefully to your description of your pain. We’re especially interested in when it started, whether it’s a continuous pain, intermittent, related to jaw motion, or if you’ve just experienced it once. We want to know whether your pain limits your activities or not.
We’ll also ask about related symptoms, such as jaw sounds, headaches, ear pain, or ringing in the ears. In addition to physical symptoms, we’ll ask about psychological symptoms, such as might be related to depression or anxiety. We’ll ask about symptoms that may or may not be related to your TMJ to make sure that you don’t have other conditions that could be confused with TMJ or might be related, such as sleep apnea.
Your TMJ Diagnosis Exam
After taking your medical history, we’ll perform an examination of your entire jaw system. We will observe you opening and closing your jaw. We may want to feel your jaw as you open and close it to get a good sense of what’s happening—it’s often easier to feel subtle sounds than hear them. We may take detailed measurements of your jaw as you open and close it.
Next, we will feel all your jaw muscles. We will press on them gently to determine if they’re loose or tensed. You may also experience pain when we do this. If you do, it’s important to report it — it will help us track down the exact nature of your TMJ. You should also tell us if the pain you’re feeling is new or familiar.
We’ll feel your temporomandibular joints when they’re relaxed, but also when you open or close your jaw. We will also have to feel muscles inside your mouth.
Imaging and Measuring Your TMJ
The questionnaire and physical exam will give us a lot of information, but sometimes the only way to get usable data about your TMJ is to get detailed imaging of the joints themselves. Sometimes a panoramic dental x-ray will be sufficient, but often we will use a CT scan for imaging the bones of the joint or an MRI for imaging soft tissue like the cushioning disk or ligaments in the joint. Sometimes ultrasound can be used for imaging the joint, too.
In addition, we may use what is known as a K-7 to get data about the state of your joint. It has the ability to precisely measure the exact sound of your jaw joint, can determine how tensed your individual jaw muscles are, and use computerized tracking in 3D to pinpoint irregularities in your jaw motion.
We may use a TENS (transcutaneous electrical nerve stimulation) machine to help with measurements. TENS is a kind of electric massage that helps your muscles relax so we can see how much of your jaw position and motion is related to muscle tension.
These are the most common techniques we will use to assess your TMJ, though special techniques may be necessary in your case. Please call (248) 480-0085 or email us for an appointment at the Michigan Center for TMJ & Sleep Wellness.