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When to See a Dentist for TMJs Or Temporomandibular Joint Disorders

Posted Jul 01 2009 6:40pm

Basic Symptoms of TMJ Disorder

The characteristic symptoms of TMJ are pain and tenderness of the jaw muscles, clicking and grinding noises during movement of the jaw, and limited or irregular jaw movement.
Some other symptoms may include: spasm and sensitivity of various facial and neck muscles, preauricular (in front of the auricle of the ear) tenderness, facial asymmetry, malocclusion and persistent postural head tilting.

The classic problem, provoked by oral conditions, is very often an emotional one. The development of symptoms seems to be caused by a combination of factors: a physiologic predisposition, psychological and physical stress, and the sufferer’s inability to manage the stress. Stress management, used in unison with supportive treatment with heat and muscle relaxants, can often have a profound effect.

TMJ disorders cause tenderness and pain in the TMJ, the joint on each side of your head in front of your ears, where your lower jawbone meets your skull. This joint allows you to talk, chew and yawn.

It is estimated that approximately 10 percent of people in the United States experience pain associated with TMJ disorders, according to the National Institute of Dental and Craniofacial Research, part of the National Institute of Health. Women are more likely than men to develop TMJ disorders.

In most cases, pain and discomfort associated with TMJ disorders can be alleviated with self-managed care or non-surgical treatments, but more severe cases often require treatment with dental and/or surgical interventions.

It is vital to keep in mind that everyone is unique. Please see a qualified dentist to receive a thorough examination and diagnosis before jumping to any conclusions about your health.

When to See a Dentist

If you have unrelenting pain or tenderness in your TMJ, if you have facial pain and experience clicking or grating when you chew or move your jaw, or if you can’t open or close your jaw completely, seek medical attention. Your dentist can discuss possible causes and treatments of TMJ disorders with you.

See your health care provider immediately if you are having trouble eating or opening your mouth. Keep in mind that a wide variety of possible conditions can cause TMJ symptoms, from arthritis to whiplash injuries. Experts who are specially trained in facial pain can help diagnose and treat TMJ. Dentists who specialize in evaluating and treating TMJ disorders will typically perform x-ray exams and may use a kinesiograph or EMG (electromyography). They may give you a mouth guard.

A Thorough Exam is Critical

All too often patients are determined to be “chronic pain patients” and their complaints written off as stress or psychological disorders. These patients may be relegated to treatment focusing only on medication and counseling, with no treatment of the actual physical cause of their illness. A thorough analysis of each patient is essential to establish the source of their pain. Early and suitable treatment of a TMJ / TMD may avoid the progression to a chronic pain state.

Preparing for Your Appointment

You will in all probability visit your regular dentist first regarding your TMJ symptoms, before seeking a referral to a more qualified specialist.

What You Can Do

Make good use of your time with your dentist. Have a list of questions prepared ahead of time, ordering them from most important to least important in case your time runs out. For TMJ disorders, some basic questions to ask your dentist include:

What is the most likely cause of my symptoms?
Are there any other possible causes?
What types of tests will I need, if any?
What treatments are available?
What approach do you normally recommend?
Should I see a specialist? Whom do you recommend?


Questions To Ask the Specialist about Temperomandibular Joint (TMJ) Disorder

What tests need to be done to diagnose TMJ?
What is the cause of the problem?
What type of treatment will you be recommending?
Will you be prescribing any medications?
What, if any, are the side effects?
How long does it typically take the treatment to start relieving symptoms?
Will surgical correction be required?
How effective is the surgery normally, in a case like mine?

What to Expect From Your Dentist

During your appointment, your dentist will probably:

Request you fill out a full medical history, including questions about how long you have been experiencing pain, including whether you have ever had an injury to your jaw, and whether you have had any recent dental procedures
Listen to and feel your jaw, especially when you open and close your mouth
Scrutinize the range of motion in your jaw
Examine your bite to check for abnormalities in the alignment of the jaws
Check for conditions — such as a high filling, a tipped tooth, teeth displaced due to earlier loss of other teeth or certain inherited characteristics — that can cause misalignment of your jaw
Examine your teeth for unusual wear patterns that would signify chronic grinding
Press on areas around your jaw to identify sites of pain, tenderness or discomfort
Ask questions about your level of stress or anxiety and how you’re coping during the visit

What You Can Do in the Meantime

Prior to your appointment, you may be able to reduce some of your discomfort in the following ways:

Avoid clenching or grinding your teeth.
Use warm, moist heat or ice on the painful area.
Take over-the-counter anti-inflammatories, such as ibuprofen.
Try to reduce your stress and anxiety.
Avoid eating hard foods
Do not chew gum.
Drink plenty of water every day and get adequate sleep.
Maintain good posture, especially if you spend long hours at a computer. Pause often to change position, rest your hands and arms, and alleviate stressed muscles.
Use safety measures to decrease the possibility of fractures and dislocations.

Diagnosis of TMJ Disorder

TMJ disorder has so many varied symptoms, some of which can imitate other disorders. It has been called “The Great Imposter” by many physicians, and because of this, a proper diagnosis can be difficult.

The most frequent method of diagnosing TMJ Disorder (TMJD or TMD) is by visiting a physician and having a physical exam and history performed. The physician or dentist will examine the patient’s face and jaw for pain and tenderness, listen to the joint for noises, check the patient’s bite, and measure how far the jaw can open. The physician will usually take x-rays of the joints, which will permit him to see the bones and surrounding teeth and make sure that no other problems affecting these structures are causing the symptoms. Sometimes, other tests are ordered, such as CT scans, which are used to inspect the bony detail of the joint, or MRIs to observe the soft tissues of the joint, including the disc.

The types of imaging used in TMJ Disorder diagnosis are:

Computed Tomography (CT or CAT Scan) - This provides detail of the bones in the joint and surrounding areas, but does not provide great detail of soft tissues such as muscles or the discs. CT Scanners are situated in imaging centers or in hospitals.
Magnetic Resonance Imaging (MRI) - This provides detail of the soft tissues of the joint, including the discs and muscles. These are located in imaging centers or in hospitals.
Tomography – This is a type of x-ray that shows cross-sections of the jaw area. Many dentists have one of these machines in their office.
Other Dental X-Rays: Routine dental x-rays done in the dentist’s office can provide views of the joint and adjacent bones and teeth.

If the doctor diagnoses TMJ disorder, he or she might make referrals to specialists.

Check out this website for referrals of highly qualified dentists who specialize in TMJ disorders: http://www.top3dentists.com/pages/tmj

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