Read the Latest News

TMJ RoundTable Update - June 2017

From the time of the June 16, 2016 meeting, until last month, progress has been slow. However, over the past couple of months we have the following accomplishments to share with you.

Pain Drawings: An Important Tool for Health Care Practitioners

Last year we shared with you a study in which investigators found patients with more severe and chronic TMD are likely to experience other persistent pain conditions in other parts of the body, seemingly unrelated to problems in the jaw or face. Yet patients often do not mention these "overlapping" or "comorbid" pain conditions when they see a dentist or health care provider.

Primary Temporomandibular Disorders and Comorbid Conditions

The aim of this study is to evaluate the distribution of the most common comorbid conditions associated with chronic temporomandibular disorders, and the pharmacological agents which play an integral role in the overall management of temporomandibular joint disorders. Abstract: INTROD

Overdiagnosis and Unnecessary Therapy

Many dental practitioners continue to use radiographic or magnetic resonance imaging (MRI) findings in the temporomandibular joint (TMJ) as the sole means of establishing that there is a pathology present that requires treatment.

TMD Self-Management Programs

Self-management (SM) programs in temporomandibular disease (TMD) are a core component of pain management of TMD throughout its course and are often given to patients as a first essential step after diagnosis.

DIAGNOSING YOUR TMD

  • Oct 26, 2016

To aid health care providers, the The American Association for Dental Research recommends that a diagnosis of TMD or related orofacial pain conditions should be based primarily on information obtained from the patient’s history and a clinical examination of the head and neck. They may note, for example, whether patients experience pain when mild pressure is applied to the joint itself or to the chewing muscles. The patient’s medical history should not be restricted to the dentition (the teeth and their arrangement) or to the head and neck, but instead should be a complete medical record, which may reveal that the patient is also experiencing one or more of the comorbid conditions found to occur frequently in TMD patients. Blood tests are sometimes recommended to rule out possible medical conditions as a cause of the problem. Before undergoing any costly diagnostic test, it is always wise to get an independent opinion from another health care provider of your choice (one who is not associated with your current provider).

In addition to a detailed history and careful clinical examination, imaging studies of the teeth and jaws may sometimes be helpful as a diagnostic tool. These include:

  • Routine Dental X-rays and Panoramic Radiographs. These show the teeth and provide a screening view of the bony structures of the TM joint.
  • Computed Tomography (CT or CAT scan). This provides greater detail of the bone but a somewhat limited view of the disc and soft tissues. It is indicated when a screening radiograph of the TM joint shows some bony changes. More info on CT scans by FDA.
  • Magnetic Resonance Imaging (MRI). This provides images of the disc as well as the muscles and other soft tissues surrounding the joint.
  • Scintigraphy (Bone scan). This involves the injection of a radioactive substance that is absorbed by the bone cells and shows whether a pathologic process is in an active or inactive state.

As a patient, you should discuss your concerns with your primary care physician or internist to help rule out any other conditions which could be causing  symptoms as well as to help get your pain under control.

Articles of Interest

Conditions Which May Produce Similar Signs and Symptoms as TMJ Disorders

Conditions that may produce similar signs and symptoms as TMJ disorders (pain and/or jaw dysfunction) and can lead to misdiagnosis include:

  • Atypical (vascular) neuralgia.

  • Hypo- and hyperkinesia (abnormal jaw movements).

  • Lyme disease.

  • Myositis (muscle inflammation).

  • Myositis ossificans (calcification in a muscle).

  • Otitis (earache).

  • Parotitis (salivary gland inflammation).

  • Scleroderma (chronic hardening of the skin).

  • Sinusitis.

  • Temporal arteritis (inflammation of the temporal artery).

  • Toothache.

  • Trigeminal neuralgia.

  • Trotter's syndrome (nasopharyngeal carcinoma).


In Treating TMJ

To view or order a free booklet about TMJ Disorders, visit the National Institutes of Health website.

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
National Institutes of Health
National Institute of Dental and Craniofacial Research
Office of Research on Women's Health