TMJ Diagnosis: The Essential First Step Almost Always Ignored
The mere fact that you are reading this missive likely means that either you or someone you know is suffering from Tempo-Mandibular Joint problems. It is, after all, not a subject that has a wide audience of persons not directly affected by it.
Perhaps you are looking to confirm your suspicions, to verify that jaw joint noises (popping and clicking), jaw locking, pain in the jaw, pain in the side of the face, and limitation of opening, all are related to what is referred to as “TMJ”. (Technically, of course, the TMJ is the joint on either side of the jaw, and the syndrome of issues as listed is called “Tempo-Mandibular Dysfunction”, or TMD, but that is a side note. For the purposes of this article, TMJ and TMD will be used interchangeably.) It is imperative to have an objective diagnosis of the problem prior to any attempt to correct it.
Physical deterioration of the joints can certainly lead to all the above-mentioned problems, but when you are only measuring subjective symptoms, you often get erroneous diagnoses. If you have a limp. for example, the cause can be anything from a postural problem to an incompetent toe joint to a bad hip or knee; it could even be a pebble in your shoe. It only makes sense to diagnose the situation objectively as early in the treatment as possible, to minimize the risk of correcting the wrong problem.
Most dentists receive scant education in treating TMJ, and limit their exams to a list of symptoms, verified perhaps by feeling the joint as the patient opens and closes. This may pick up gross popping and clicking, but provides little reliable information, other than that there is a problem in how smoothly the jaw opens and closes. And to treat with such a diagnosis, without specific measurable goals, is to invite a very compromised result.
The jaw joints are the most complex joints in the body and require a great deal of coordination between them. Neither side can operate independent of the other. They rely 100% on muscular coordination, on each side of the midline. The position of the teeth, how they hit and when, is critical to directing the joint movements. Furthermore, there is a thin and delicate disk of cartilage that needs to maintain its position throughout the movements of the jaw. This is not a mechanism that can be “fine tuned” bit by bit, without direction and objective data.
The first step in diagnosing the health of the TMJ is to run a very easy, and completely non-invasive, test which listens to the sounds of your jaw joints as the jaw opens and closes. This objective and highly reproducible data give us an accurate picture of how each component of each joint functions, how “out of sync” they may be, and at what stages in the open/close cycle any disturbances occur. Very simply, it lets us more accurately evaluate the ideal treatment for your very specific situation.
This exam is done via a set of headphones, but instead of delivering music to your ears, it listens to the sounds generated by your joints, as you simply open and close your jaw. It is quick, comfortable, completely non-invasive, and incredibly accurate, and it provides us with essential information unavailable in any other manner.
So, why is this important? It is important because the joints are the least directly correctable part of TMJ. You can adjust the bite (how the teeth interact), and through them, how the muscles react, but you cannot do anything to correct the internal physical deteriorations of the TMJ themselves without intricate surgeries. So, it is imperative to know the conditions of the joints before attempting anything else.
Please note that very few TMJ sufferers have joints that cannot be improved by refining how the teeth interact; current statistics show that fewer than 15% of TMJ sufferers are in this category. This quick screening enables us to be more candid and upfront with you, by providing data unavailable by other means. Because, of course, no one wants to be frustrated in the results.
The Sonogram is so important in diagnosing TMJ that we use it with every patient, even with our complimentary consultations. The patient always deserves to know their true condition from the start, and there is no simpler or more accurate, or more comfortable, way to determine this than through the sounds your jaw joints make when opening and closing.
Because treating TMJ/TMD can be a journey, and if you get off on the wrong path from the beginning, you will almost certainly wind up somewhere other than where you want to be.