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TMJ Patient RoundTable Project: Status Update

The TMJ Association is acting as the catalyst to develop the TMJ Patient RoundTable, a broad initiative to advance the interests of patients with temporomandibular disorders (TMD). It encompasses collaborations with all stakeholders and

Educational Brochures on Chronic Overlapping Pain Conditions

This brochure addresses what are Chronic Overlapping Pain Conditions (COPCs), how COPCs are diagnosed, the complexity of the chronic pain experience, and how to work with your health care provider to develop a treatment plan. It is available by postal ma

Study Highlights TMD Evidence and Current Practice Gaps

The TMJ Association has long championed the need for strong evidence-based demonstrations of the safety and efficacy of TMD diagnostics and treatments. Sad to say, as the following journal article indicates, even among a network of research-oriented practices, dental providers are still resorting to such TMD treatments as occlusal adjustments in which teeth are irreversibly moved, ground down, or in other ways altered, a treatment for which there is no scientific evidence of efficacy.

Beware of Ticks and Lyme Disease

We are currently in the peak season for Lyme disease. Each year at this time we highlight this topic because we have heard from a number of patients over the years who were misdiagnosed and underwent unnecessary TMD treatments when they actually had Lyme

#*!"@!**! ... May Help Your Pain... and Improve Strength!

Our headline is adopting the comic strip convention of using symbols to denote swear words because we are intrigued by a report that swearing may have some health benefits.

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).