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Diagnosis of Temporomandibular Disorders (TMD)

TMD is usually diagnosed when your doctor listens to your description of symptoms and performs a thorough physical exam.

A careful physical exam may be completely normal despite symptoms, or may reveal:

  • Jaw or muscle tenderness
  • Muscle spasm in the area of the temporomandibular joint (TMJ)
  • Clicking, popping, or grating sounds and sensations when you open or close your jaw
  • Misalignment of the jaw or teeth or easy displacement of the jaw
  • Difficulty fully opening the mouth

The number and severity of symptoms and findinds can allow TMD to be staged.

There are no specific tests available that can definitively diagnose TMD. If your symptoms are extreme, your healthcare provider may try the following:

  • Jaw x-ray
    • Unfortunately, these aren’t usually helpful in diagnosing TMD
    • May sometimes reveal problems, such as fractures or dislocations, or systemic disease.
    • Commonly used to exclude other conditions that might mimic TMD.
  • Ultrasound—This test can provide a good view of the joint and is useful when the dentist or doctor thinks that pain is coming from within the joint. (Pain in TMD most commonly originates outside the joint, primarily in muscles.) Ultrasound can also provide a view of the muscles adjacent to the joint.
  • CT scan —This test is commonly used, especially when TMD ultrasound is not available.
  • Arthrography—It’s rarely ordered for diagnosing TMD, although it can be helpful in situations where you are having extreme pain that doesn’t improve despite treatment.
  • Magnetic resonance imaging (MRI)—Like arthrography, this test is reserved for patients who have severe pain that persists despite treatment.

Revision Information

  • Puri P, Kambylafkas P, et al. Comparison of Doppler sonography to magnetic resonance imaging and clinical examination for disc displacement. Angle Orthod . 2006;76(5):824-829.

  • Siccoli MM. Facial pain: a clinical differential diagnosis. Lancet Neurology . 2006;5:257-267.

  • Temporomandibular joint (TMJ) dysfunction. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated November 27, 2012. Accessed April 5, 2013.

  • TMJ. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/tmj.cfm . Updated December 2010. Accessed April 5, 2013.

  • TMJ. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/t/tmj.aspx . Accessed April 5, 2013.

  • TMJ (temporomandibular joint and muscle disorders). National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/TMJ . Updated March 21, 2013. Accessed April 5, 2013.

  • Tognini F, Manfredini D, et al. Comparison of ultrasonography and magnetic resonance imaging in the evaluation of temporomandibular joint disc displacement. J Oral Rehabil . 2005;32(4):248-253.