#154 Why is It Important to Know About TMD

There are many reasons why it is important to know about Temporomandibular Joint Disorder, (TMD).  If you are one of the unfortunate people who suffer from one or more of the disparate symptoms associated with this disease, you first want to recognize the symptoms and know there is a simple solution. 

The two most common symptoms of TMD are headache and neck pain. Headache and neck pains are two of the most prevalent symptoms on the planet.  If one does a scientific medical literature review about the prevalence of headaches, you’ll find that at least 40% of the population suffers from headaches on a yearly basis. Depending on which study you read, the prevalence of neck pain approaches 50%.  That’s a lot of headaches and neck pain seen throughout the population on a yearly basis.  

Continuing to read you’ll learn about the different types of headaches and neck pain including a long list of possible causes.  When a patient shares symptoms of headache and neck pain with a doctor, it’s up to the doctor to further investigate those symptoms by asking further questions, and doing further studies, tests, and examinations that point to the correct diagnosis.   This is called the production of a differential diagnosis.  It is not the actual diagnosis, but rather the list of the possibilities.  It’s then up to the doctor to either do additional tests and studies to rule in or rule out each disease on the differential diagnosis list until there is only one left. This final diagnosis would then be treated according to standard protocol.   

The problem with TMD is its never found on medial doctor’s (MD’s) differential diagnosis for headaches and neck pain.  After reviewing many scientific studies about the causes for headache and neck pain, I’ve never found one that included TMD as a possibility.  Physicians, physician assistants and nurse practitioners never think about TMD as a cause for headaches and neck pain even though roughly 50% of the population presents with these symptoms.  But independent studies have shown that headache and neck pain are the two most common symptoms associated with TMD.   

This divergence in knowledge is the primary cause for patients spending months, years, and sometimes decades going from doctor to doctor looking for relief.  TMD is never considered in the differential diagnosis for headaches and neck pain by medical doctors.   So, the medical doctors treat headaches with drugs and call them migraines, cluster headaches, or tension headaches.  They additionally spend huge amounts of time and money looking for brain tumors.  They similarly treat neck pain with drugs, physical therapy, and surgery. 

It is important to place TMD on the differential diagnosis list when a patient presents with one or both symptoms.  But it is consistently overlooked by the medical establishment even though it is easy to rule in or out.  

The symptoms of TMD are created by chronic inflammation within the Temporomandibular Joint, (TMJ).  Chronic inflammation within the TMJ is the common denominator for all the disparate symptoms associated with TMD.  It is very easy to determine if there is chronic inflammation within the TMJ.  It can be done as a self-exam or by the doctor. 

First, the patient needs to open their mouth as widely as possible.  Second, either the patient themselves or the examiner places their index finger FIRMLY into the depression in front of the ear created by the forward motion of the lower jaw, (mandible) moving out of the jaw socket.  Third, close the mouth as rapidly as possible and bite the back teeth together in the normal and usual fashion.  Biting rapidly is very important in achieving an accurate test. 

If the closing motion of the jaw causes pain underneath the fingertips, and the patient has a history of headaches and/or neck pain, it is likely this person has TMD.  Of course, any additional positive disparate symptoms associated with TMD add validation to the diagnosis.