HEADACHE AND FACIAL PAIN: TEMPOROMANDIBULAR JOINT DISORDERS: TMD EVALUATION

Screening for temporomandibular joint disorders (TMD) should be part of routine dental and medical examinations. Your doctor or dentist may ask you if you experience or have experienced any of the following:

· Jaw pain

· Headache

· Neck ache

· Noises in the TMJs

· Catching or locking of the jaws

· Injuries to the jaw, head and/or neck

· Previous TMD or orofacial pain treatment

During the examination, your dentist may:

· Measure your jaw opening and evaluate side to side movements

· Examine jaw deviation on opening

· Feel (palpitate) the TMJs, jaw, head and neck muscles to localize painful areas

· Identify joint noises

· Evaluate the gums, oral soft tissue and teeth for disease, excessive tooth wear from bruxism and general symmetry of the jaw, face and head

If your dentist notices evidence of TMD, he or she will recommend a more comprehensive history and clinical examination.

Comprehensive TMD Evaluation

A comprehensive TMD evaluation may include:

· Comprehensive history of all jaw, head and neck symptoms and medical history, dental history, personal history, family story and psychological history.

· Comprehensive physical evaluation of TMJs, cervical spine, muscles of the jaw, head and neck, neurological-neurovascular structures, teeth, gum and soft tissues.

· Psychological evaluation, including a brief interview and testing when indicated.

· Additional tests including X-rays and diagnostic imaging, biopsies, blood tests, urinalysis, neurological tests and diagnostic injections.