Differential DIAGNOSIS FOR THE ORTHODONTIC & TMJD PATIENT
Common Signs and Symptoms:
TMJ patients will typically have one or more of these symptoms. For some patients with jaw joint problems, symptoms can be as weak as minor head tension. For others, severe migraine headaches, hearing, and vision problems can manifest.
- Headaches
- Neck pain
- Facial pain
- Ear pain
- Jaw pain
- Shoulder pain
- Eye pain
- Dizziness
- Ringing of ears
- Clicking or popping jaw joints
- Limited mouth opening
- Locking of the jaw
- Posture problems/forward head posture
- Opening deviations to the left or right
- Difficulty swallowing
- Visual disturbances
- Numbness/tingling in the extremities
TMJ patients will typically have one or more of these symptoms. For some patients with jaw joint problems, symptoms can be as weak as minor head tension. For others, severe migraine headaches, hearing and vision problems can manifest. These symptoms coupled with one or more of the predisposing factors strongly suggest dislocation.
Predisposing Factors – What To Look For
Deep Overbite
Narrow Jaw Structure
Optimal Jaw Structure
Dental Retrusion
Openbite
Receded Lower Jaw
Limited Mouth Opening
Opening Deviation
Weak Masseter Contraction
Referred Pain Patterns
The X marks represent tender or ischemic areas referring pain to areas remote from the X or trigger point. Muscular compensation over time due to displacement caused from a malocclusion can refer pain to the areas indicated. Poor muscle physiology may be due to systemic factors such as hypothyroidism, thyroid resistance or what is now considered peripheral or tissue hypothyroidism.
Diagnostic Tomograms for Screening:
Condylar head dislocation (black arrows) and associated reduced joint space (red arrows). Due to the presence of a deep overbite, a narrow maxilla, and/or dental retrusion there will be a strong predisposition to mandibular “entrapment.”
Other Questions to Ask
- Have you ever had previous orthodontic treatment?
- Do you have missing teeth?
- Do you experience cold hands and feet?
- Are you a “mouth breather” at night [dry mouth in morning]?
- Has your dentist ever told you that you have a small mouth?
- Have you ever been diagnosed with sleep apnea?
Dr. J. Michael Dierkes, DDS, MS, NMD is a nationally recognized orthodontic specialist who has been creating beautiful smiles for over 30 years. His services have improved the lives of people from Roswell and the surrounding areas, including residents of Sandy Springs, Alpharetta, Marietta, and Atlanta. Whether you are an adult, a child, or a teenager, our knowledgeable staff is committed to helping you achieve the radiant, beautiful smile you deserve. Please call us today to schedule your initial consultation!