#102 Screening for TMD/TMJ

Included with your annual or semiannual visit with your primary care physician you routinely do some lab tests.  Sometimes your physician wants you to give some blood, urine, or maybe some x-rays taken.  These tests are usually done as a method to screen for diseases that may or may not have already displayed symptoms.  They are done to catch a disease before it does irreversible damage to the body.  Examples of medical screening include urine and blood tests for diabetes, liver disease, prostate cancer, heart disease, and lung disfunction. A review of symptoms is also a very effective screening technique.  I’m sure you are asked a list of yes or no questions every time you visit a new doctor pertaining to symptoms that may have been occurring. 

Both of these screening techniques are very effective in identifying disease early and in some cases prevent disease completely. 

TMD/TMJ is just as devastating to some patients as diabetes or prostate cancer.  TMD/TMJ when left untreated can eventually end up with patients having severe limitations on what they can eat, how the can or can’t chew their food, how well they sleep, how much work they miss, how they interact with others, and generally the well being of their physical and mental health.   

So why doesn’t your dentist screen for TMD/TMJ if it can end up with devastating consequences.  There are several reasons.  The dentist is all about prevention when it comes to tooth decay and periodontal disease.  Screening for both diseases is why you are supposed to go to the dentist every 6 months to have your teeth cleaned and “checked” for decay and gum disease.  It is actually called a “check up”.  But the dentist knows almost  nothing about TMD/TMJ.  In most cases, dentists don’t want anything to do with TMD/TMJ because they think it is a very complicated disease.  They were taught little to nothing about it in dental school.  A few have taken weekend courses about the problem but come away with the idea that you have to be a specialist to treat TMD/TMJ.  Nothing could be further from the truth.  Half of all dentists are afraid to treat TMD/TMJ and half treat it with a night guard because that is what has been considered standard of care for 70 years even though studies have shown that night guards are useless in treating TMD/TMJ. 

But yet, it is a devastating disease.  Physicians know nothing about it.  Half the female nurse practitioners and physician assistants in convenient care clinics have the problem themselves but have no idea what to do about it other than send it to the dentist.  What a conundrum. 

The truth is TMD/TMJ is a simple disease to understand and treat.  The diagnosis is easy to make and in addition it is easy to screen for.  So why doesn’t every dentist screen for TMD/TMJ?  It’s because they are afraid of what they don’t know.  That is why TMJ Services is on a mission to educate both dentists and physicians on how to screen for, diagnose, and either treat or refer these patients.   

Just like screening for diabetes or cancer, it boils down to asking a few questions and doing a simple exam.  An enlightened health professional can either rule out, or rule in, TMD/TMJ in about 3 minutes.  All it takes is asking the patients whether or not they have a history of symptoms commonly associated with TMD/TMJ and doing a 90 second exam indicating whether or not there is inflammation within the joint.  If the patient has TMD/TMJ symptoms and the joints are inflamed, the diagnosis is confirmed.  

 This screening process should be done in every dental office by either the dentist or the dental hygienist.  It’s the dental hygienist who has best access to the patient and can not only take the history and do the exam but will easily observe some of the physical abnormalities associated with TMD/TMJ like bony knots on the jaws next t the teeth or inability to open the mouth fully and without pain.  

You don’t need complicated machines or x-ray equipment to properly diagnose TMD/TMJ.  All that is needed is a little bit of knowledge and the courage to confront the problem. 

When confronted and diagnosed early, the dentist or dental team member can help the patient avoid decades of pain, suffering, and mental anguish. 

Screening for TMD/TMJ should be taught to every primary care medical and dental provider.  Preventing the consequences of a disease is always better than dealing with the consequences when they have gone on for a length of time.