mouth and dental disorders
Temporomandibular Disorders (TMDs)
Diagnosis of Temporomandibular Disorders
A dentist's or doctor's evaluation Sometimes imaging tests For infectious arthritis, aspiration of fluid Sometimes polysomnography (sleep study) A dentist or doctor almost always diagnoses a temporomandibular disorder based solely on a person's medical and dental history and on a physical examination. Part of the examination involves gently pressing on the side of the face or placing the little finger in the person's ear and gently pressing forward while the person opens and closes the jaw, and listening and feeling for sounds of catching, clicking, or popping. Also the doctor gently presses on the chewing muscles to detect pain or tenderness and notes whether the jaw slides when the person bites. The person is asked to open the mouth as wide as is comfortable. An average-sized person can open the mouth at least 1½ inches (about 4 centimeters). When a doctor suspects an internal joint derangement, further tests can be done. Magnetic Resonance Imaging (MRI) (MRI) is the standard with which doctors assess whether internal joint derangement has occurred or why a person is not responding to treatment. A doctor suspects osteoarthritis when a creaking/grating sound is heard when the person opens the mouth (crepitus). X-Rays and/or a Infectious arthritis may be suspected when the area over and around the temporomandibular joint is inflamed and when movement of the joint is painful and limited. Infection in another part of the body serves as a clue as well. To confirm the diagnosis of infectious arthritis, the doctor may insert a needle into the temporomandibular joint and withdraw fluid (aspiration), which is then analyzed for bacteria. If hypermobility is the cause, the person typically can open the mouth wider than the breadth of 3 fingers. The jaw may be chronically dislocated. If ankylosis is the cause, the jaw's range of motion tends to be markedly reduced. If symptoms of muscle pain and tightness continue, doctors may arrange testing for a sleep disorder. This test is called Testing . 