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VNA of Care New England
by Carson-DeWitt R

Diagnosis of Temporomandibular Disorders (TMD)

TMD can usually be diagnosed based on your symptoms and a thorough physical exam.
A physical exam may be completely normal despite symptoms, or may reveal:
  • Jaw or muscle tenderness
  • Muscle spasm in the area of the temporomandibular joint (TMJ)
  • Clicking, popping, or grating sounds and sensations when you open or close your jaw
  • Misalignment of the jaw or teeth or easy displacement of the jaw
  • Difficulty fully opening the mouth
The number and severity of symptoms and findings can allow TMD to be staged.
There are no specific tests available that can definitively diagnose TMD. If your symptoms are extreme, your healthcare provider may try the following:
  • Jaw x-rays are not usually helpful in diagnosing TMD, but they may:
    • Exclude other conditions that mimic TMD
    • Reveal other problems, such as fractures or dislocations, or systemic disease
  • Ultrasound—Pain in TMD most commonly originates outside the joint, primarily in muscles. Ultrasound can provide a view of the muscles adjacent to the joint.
  • CT scan
  • MRI scan
  • Arthrography—rare, and may be used to evaluate the affected area if treatment methods are not working

References

Puri P, Kambylafkas P, Kyrkanides S, Katzberg R, Tallents RH.Comparison of Doppler sonography to magnetic resonance imaging and clinical examination for disc displacement. Angle Orthod. 2006;76(5):824-829.
Siccoli MM, Bassetti CL, Sándor PS. Facial pain: a clinical differential diagnosis. Lancet Neurology. 2006;5(3):257-267.
TMJ. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/tmj. Updated December 2010. Accessed April 5, 2013.
TMJ. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/t/tmj. Accessed April 5, 2013.
TMJ (temporomandibular joint and muscle disorders). National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/TMJ. Updated March 21, 2013. Accessed April 5, 2013.
Temporomandibular joint (TMJ) dysfunction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 27, 2012. Accessed April 5, 2013.
Tognini F, Manfredini D, Melchiorre D, Bosco M. Comparison of ultrasonography and magnetic resonance imaging in the evaluation of temporomandibular joint disc displacement. J Oral Rehabil. 2005;32(4):248-253.

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