Comprehensive TMD Evaluation

Screening for TMD and associated disorders such as sleep apnea and migraine headaches should be an essential part of routine dental and medical examinations. A brief screening evaluation may include:

• Brief history of jaw pain, headache, neckache, noises in the TMJs, catching/locking of the jaws, injuries to the jaw/head/neck, and prior TMD/orofacial pain treatment.
  
• A screening exam with palpation of the TMJ's/jaw/head/neck muscles to localize painful areas, identify joint noises; evaluate the gums, oral soft tissue and teeth, noting disease, excessive tooth wear from bruxism, and general symmetry of the jaw, face, and head. If significant findings for TMD are identified, a more comprehensive history and clinical examination should be conducted, including measurements of jaw opening, and side to side movements, and jaw deviation on opening.

The Comprehensive TMD Evaluation may include:

• Comprehensive history of all jaw/head/neck symptoms, medical history, dental history, personal history, family history, and psychological history.
• Comprehensive physical evaluation of the TMJ's, cervical spine, muscles of the jaw/head/neck, neurological-neurovascular structures, teeth, gum and soft tissues.
• Psychological evaluation including a brief interview or referral for assessment when indicated.
• Additional tests, including X-rays and diagnostic imaging, biopsies, blood tests, neurological tests, and diagnostic injections.