The temporomandibular joint is the joint is among the most complex joints within the human body. Given the complexity surrounding movement of this joint, it can pose a tremendous and unique challenge to both health care providers and patients when issues arise. The temporomandibular joint connects the mandible to the temporal bone. The temporal bone is the bone at the side of the head, and the mandible is the lower jaw. This joint is vital for speech, chewing, and yawning. The movement of this joint is controlled by muscles attached to and surrounding the jaw.
Symptoms of TMJ include ear pain, neck pain, headaches, and tenderness of the jaw. One indication of TMJ may be jaw pain and soreness caused by teeth grinding at night that is more prevalent in the morning rather than later in the day. Patients suffering from TMJ may have difficulty chewing or be unable to fully open and close their mouths. Those suffering from TMJ often experience a clicking or popping noise when opening and closing their jaws.
There are a variety of known causes for TMJ. However, there is no standard test available to correctly diagnose all TMJ conditions. Dr. Federman recommends that patients refrain from self-diagnosis because each case is unique. In some cases, a simple physical examination of the face and jaw by a dentist may be sufficient for diagnosis. In more complex cases, a physician or dentist should refer the patient to a specialist in the treatment of TMJ disorders for a more comprehensive evaluation and diagnosis.
In order to successfully diagnose the cause of TMJ pain, the doctor should make a detailed note of the patient’s medical and dental history, including any current medications and past surgeries. Before making a diagnosis of TMJ, the doctor should eliminate other known causes of facial pain. Besides TMJ, facial pain may be caused by sinus problems, ear infections, headaches, and facial neuralgias (nerve-related facial pain). The doctor should proceed to conduct an exam of the jaw, neck, head, and face. Upon evaluation of the patient, a panoramic x-ray (Pano), cone beam computed tomography (CBCT) scan, or magnetic resonance imaging (MRI) may be recommended to detect possible abnormalities in the joints. After a comprehensive examination and evaluation of medical imaging, a trained specialist should be able to correctly diagnose the cause of TMJ in the patient and recommend a treatment plan going forward.