A Thorough Diagnostic Examination to Understand Your TMJ Symptoms
Many patients who come to see us have been managing their symptoms for a long time and may have seen multiple practitioners without finding a clear explanation. Our goal at your first visit is to listen carefully, examine thoroughly, and provide you with a clear picture of what the assessment has found.
Before Your Appointment
When you book your appointment, you will receive a comprehensive questionnaire to complete before your visit. Please take the time to fill it in thoroughly. The more detail you can provide about your symptoms, their history, and any previous treatments, the more informative your first visit will be. If you have not received the questionnaire, please contact our office and we will send it to you.
The Diagnostic Process
Appropriate treatment depends on accurate diagnosis. Our first visit follows a structured, comprehensive process.
1. Medical and Dental History
We begin with a thorough review of your health history, including all past medical and dental problems and treatments, any history of trauma (particularly to the head and neck), and detailed questions about your current symptoms—their nature, location, duration, and any factors that affect them.
2. Cranial and Structural Examination
A cranial examination evaluates the alignment of the skull, jaw joints, and dental plane of occlusion in relation to the rest of the body, assessing whether structural asymmetries or alignment issues are contributing to your symptoms.
3. Postural Assessment
Poor posture is both a common contributing factor to and a potential consequence of TMD. Our postural examination looks for musculoskeletal imbalances including scoliosis, lower back involvement, and leg length discrepancy that may be perpetuating jaw symptoms or resulting from them. Please wear tight-fitting clothing for posture photos so we can accurately assess alignment and movement.
4. Functional Examinations
We assess key oral functions including swallowing pattern, breathing mechanics, and chewing—all of which can contribute to or be affected by TMD.
5. Sleep Disorders Screening
Because sleep-disordered breathing and TMD are closely related, every patient is screened for signs of sleep apnea and snoring. If further evaluation is indicated, we will discuss next steps and facilitate a referral to a sleep physician as appropriate.
6. Dental Examination
We evaluate the shape and symmetry of the dental arches, assess tooth wear or fracture patterns, review existing restorations, and look for dental findings that may inform the diagnosis.
7. Neurological Screening
A focused neurological screen is included to evaluate whether nerve involvement may be contributing to symptoms, particularly relevant in cases of facial pain, numbness, or atypical sensations.
8. TMJ Examination
- Range of motion assessment—how far and how freely the jaw opens, closes, and moves laterally
- Quality of movement—smoothness, deviation, speed
- Assessment for internal derangement, joint inflammation, and tenderness
- Evaluation of joint sounds—clicking, popping, crepitation
9. Joint Vibration Analysis (JVA)
JVA is a non-invasive technology that records the vibrations produced by the jaw joint tissues during movement. Sensors placed gently over the joints capture the pattern of each joint in motion, which is compared against established norms for healthy joint function. This provides objective diagnostic information that complements the clinical examination.