As a practicing general dentist, seeing thousands of patients over the past eight years, I honestly can’t tell you how many of them make a passing remark about a doctor, dentist, or chiropractor saying they had “TMJ.” Even now, when I tell people I am doing a “TMJ PRACTICE”, they will say “Oh Yeah, I Have That.” So what does that mean exactly? “TMJ” is really just the name of the joint itself- temporomandibular joint. People that experience pain or discomfort, clenching at night, or even popping and clicking sometimes think they have “TMJ”- when what they really mean is TMJ-D. The “D” in this diagnosis stands for dysfunction or disorder, either one. It is really a technicality, but I thought I would clear it up. For “TMJ-D,” it has become so common to call it “TMJ” that people and even most doctors now just say TMJ, and everyone knows what we mean.
So what exactly is TMJ (TMJ-D)? It’s a pretty broad term that can be broken down into many different categories of dysfunction. The first thing I always try to figure out about TMJ disorders is- is there pain? Pain is the primary indicator of whether or not someone has a true problem that needs to be treated. The second thing-is function- is there limited opening for instance? Very rarely, I will see someone who has limited opening with no pain. It is not super common, so let’s just focus on pain.
If there is pain, the next thing I want to know- is the pain coming from the actual joint or is it from the muscles? There are a couple of things I will check to verify my diagnosis:
- Palpate (push) on different areas that indicate the source of the pain- the muscles vs. the joint. Is the pain in the cheek (indicates more muscle) or is it directly in front of the ear (indicates more joint)
- Is the opening restricted from the normal amount? Normal opening is 40+mm or 3 fingers stacked on top of each other. If the range of motion is less than that, then I want to know what happens if I try to push it open more? Does it move, but hurts (indicates more muscle), we call this a “soft end feel” or is it a rigid, fixed stop (indicates more joint), we call this a hard end feel.
There are a variety of other things that we can do during an exam to indicate a proper diagnosis. If you are having pain anywhere in your face or jaws, we can help! Diagnosis is key, and not every doctor or dentist wants to treat this complex set of disorders. That is why this practice exists. Did you know, our number one referral source for patients is practicing dentists?
If there is good news about TMJ pain– it is that usually the pain is muscle driven. Muscle problems are much easier and more predictable to fix. If you have any questions about your TMJ or TMJ-D we would love to help.