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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