How is temporomandibular disorder (TMD) diagnosed?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner

Diagnosis typically involves a review of your medical history and a physical examination by a doctor or dentist. Tests used for diagnosis depend on the temporomandibular disorder the person is suspected of having. A physical exam involves the doctor pressing on the face looking for soreness. It may also involve the person opening and closing the mouth so the doctor may observe jaw movement or listen for clicking or popping noises coming from the joints. If an anatomical problem is suspected, such as arthritis of the joint or dislocation of the jaw, the doctor may perform an X-ray, MRI, ultrasound, or CT scan to get a better look at the temporomandibular joints.

A dentist can help identify the source of the pain with a thorough exam and appropriate x-rays to determine if it is TMJ. Often, the pain may be from a sinus problem, a toothache or an early stage of periodontal disease. But for some types of pain, the cause is not easily diagnosed. The pain may be related to the facial muscles, the jaw or the TM joint.

Diagnosis is an important step before treatment. Part of the dental examination includes checking the joints and muscles for tenderness, clicking, popping or difficulty moving. Your complete medical history may be reviewed, so it’s important to keep your dental office records up-to-date. Your dentist may take x-rays and may make a "cast" of your teeth to see how the upper and lower teeth fit together. Your dentist may also request specialized x-rays for the TM joints. Depending on the diagnosis, the dentist may refer you to a physician or another dentist.

To diagnose temporomandibular disorder (TMD), a painful condition in the joints and muscles that open and close your mouth, your doctor or dentist will first ask you to describe the pain. For example, your symptoms may include pain in the jaw directly in front of the ear, or on the side of the face and head and then extend to the neck. Your pain may be constant or worsen with chewing, or you may have a cracking in the jaw when opening your mouth. Pain may limit your ability to open the jaw, or the jaw may move to one side when opened. 

Your dentist will take X-rays of the mouth to check for dental problems and bite abnormalities. Your dentist may notice an imbalance in the way your teeth come together with higher pressure in one or both jaws and temporomandibular (TM) joints. Or if you are missing teeth on one side, causing an abnormal chewing motion, it may create increased pressure on the other side of the mouth and result in TMD pain.

Stress is a major and common cause of jaw pain and TMD. Stress can result in clenching the teeth during the day or grinding the teeth at night (bruxism), and can cause increased tension in the muscles in your face, neck, and jaw. Your doctor or dentist will check your joints and muscles for clicking or popping sounds. Your dentist may make an impression of your teeth to see how your bite fits together. Your dentist may also need to take more X-rays of the TM joints to look for inflammation or abnormalities. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.