Status of the TMJs – The TMJs guide and position the lower jaw allowing the teeth to come together. If the TMJs are not functioning properly, the way the teeth come together can be adversely affected. The hard and soft tissue anatomy of the TMJs must be properly evaluated and diagnosed in order to determine if injury or pathology exists. MRI is the only imaging modality that allows for proper evaluation of the hard and soft tissue anatomy of the TMJs.
Status of the Bite – The way the teeth come together is determined by the TMJs. If the TMJs are not functioning properly, the way the teeth come together can be affected, resulting in a bad bite (i.e., a mal-occlusion).
The Nature of Your Pain – Pain to the head, neck and face can have many origins. Pain patterns can overlap and be multifactorial. The key to understanding pain is that “all pain can be traced to its source.”
Examples of events that can damage the TMJs are:
- A simple fall down
- Surgical medical procedures (e.g., adenoids, tonsils, appendix or gallbladder removal) that involves administering general anesthesia by propping the mouth wide open
- Surgical dental procedures (e.g., wisdom teeth removal, tooth extraction, bone grafts, sinus lifts, implant placement that can involve over-opening the mouth)
Key: Diagnosis must precede treatment
Reasons for a TMJ evaluation
- Pain to the head, neck face and jaw that is not accounted for
- History of face/jaw trauma (e.g. fall down, chin bunk, sports related, auto accident)
- Joint pain with and without movement
- Facial, lower jaw and/or dental distortion, asymmetry in children
- Children whose lower jaws and faces are not properly growing
- Facial, lower jaw and/or dental distortions, asymmetry in adults
- Adults whose lower jaws and faces are changing in a negative manner
- Bad bites (e.g. broken, worn, excessive mobility or spreading or teeth)
- Restorative needs (e.g. crown, bridges, bonding, veneers and implants)
Proper history is critical for proper diagnosis
- Any history of trauma to the face, chin or lower jaw?
- Facial-skeletal changes – previous or new?
- Occlusal (bite) changes – previous or new?
- Pain patterns – previous or new?
KEY: Can they reproduce their pain? (e.g. talking/chewing)