Diagnosis
Because the exact causes and symptoms of TMD are not clear, diagnosing
these disorders can be confusing. At present, there is no widely accepted,
standard test to correctly identify TMD. In about 90 percent of cases,
however, the patient's description of symptoms, combined with a simple
physical examination of the face and jaw, provides information useful
for diagnosing these disorders.
The examination includes feeling the jaw joints and chewing muscles for
pain or tenderness; listening for clicking, popping or grating sounds
during jaw movement; and examining for limited motion or locking of the
jaw while opening or closing the mouth. Checking the patient's dental
and medical history is very important. In most cases, this evaluation
provides enough information to locate the pain or jaw problem, to make
a diagnosis, and to start treatment to relieve pain or jaw locking.
Regular dental X-rays and TMJ x-rays (transcranial radiographs) are not
generally useful in diagnosing TMD. Other x-ray techniques, such as arthrography
(joint x-rays using dye); magnetic resonance imaging (MRI), which pictures
the soft tissues; and tomography (a special type of x-ray), are usually
needed only when the practitioner strongly suspects a condition such as
arthritis or when significant pain persists over time and symptoms do
not improve with treatment. Before undergoing any expensive diagnostic
test, it is always wise to get another independent opinion.
One of the most important areas of TMD research is developing clear guidelines
for diagnosing these disorders. Once scientists agree on what these guidelines
should be, it will be easier for practitioners to correctly identify Temporomandibular
disorders and to decide what treatment, if any, is needed.
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