DIAGNOSIS OF TM DISORDERS
TMD diagnosis is a complex and often daunting process. This explains why physicians and dentists who are not board-certified orofacial and craniofacial pain specialists may miss a potential TMJ disorder in a patient that is suffering from chronic head, neck and/or facial pain.
How is the diagnosis made?
The usual evaluation of the TMJ involves a physical examination of the muscles of the head, face, neck and shoulder with manual palpation. The doctor feels for muscle spasm and rules out "trigger points" which can refer pain to other areas. Ranges of Motion Studies–measurements of jaw movement when moving side to side and on full opening of the mouth, are assessed. General skeletal alignment is also assessed. Additionally, radiographs allow us to see actual pictures of the joint components and their relative state of health. In many cases, additional tests may be recommended. At our office we also utilize the latest in computer diagnostics to measure and record jaw joint activity and jaw movement.
We use the latest in computerized diagnostic modalities including EMG (electromyography), ENG (Electrognathology-Jaw Tracking) and JVA (Joint Vibration Analysis). The use of EMG, ENG and JVA along with radiographs allows for a more accurate determination of the nature or type of TMD experienced.
JVA (Joint Vibration-Noises Analysis
Joint Vibrationa Analysis is a device that measures how well the joint functions while in motion. This is accomplished by placing headphones over the joints and recording the vibrations(noises) of either soft tissue (quiet, when disc is working properly) or bone on bone grinding (crepitus, gravel sounding).
ENG / JT (Jaw Tracking)
Jaw Tracking (Electrognathography) is used to track the jaw movements three dimensionally and to record the point of dysfunction so it can be corrected. A headset is placed on the patient and with a magnet inside their lower front teeth, a recording of the lower jaw movement is made. With this diagnostic tool we can measure and analyze jaw movement during clenching,chewing and swallowing. Jaw tracking is a completely non-invasive technique.
EMG is a non-invasive device used to evaluate muscle activity through surface/skin electrodes.
TMJ x-rays are important to determine the position of the condyles (top of the lower jaw bone).