As the signs and symptoms of TMD match various other disorders, patient evaluation starts with thorough oral and physical examination. The dentist also takes a complete health history of the patient.
A dentist does the following oral examination in case of any suspicion of TMD:
Check jaw for pain or tenderness by palpating extra auricular area.
Listen for clicks, pops, or grating sounds while patient moves the jaw.
Evaluate the proper working of the jaw by placing small finger intra-auricularly.
Observe the range of motion of the jaw.
Extra-oral examination for facial symmetry, postural imbalances, nasal deviation, etc.
Intra-oral for malocclusions, missing teeth, faulty dentures, tongue position, etc.
After thorough oral examination, the following diagnostic tests may be done for confirmed diagnosis of TMD:
Radiographs of jaws, temporomandibular joints and teeth:-
1. Lateral Cephalogram to for airway patency and jaw placement.
2. OPG to look for the status of teeth.
3. TMJ View (left and right, open and close).
MRI to find if the TMJ disc is in the proper position during jaw movement as it provides images of the disc as well as the muscles and other soft tissues surrounding the joint.
The patient may be referred to a Physiotherapist or ENT surgeon to get rid of any other ascending or descending causes of TMD.
Diagnosis of OSA involves thorough physical examination and complete history taking of the patient. Physical examination includes:
Physical examination includes examination of the back of throat, mouth and nose for extra tissue or abnormalities, measurement of the neck and waist circumference, weight imbalance.
Radiographic examination includes Lateral Cephalogram to look for airway patency.
Airway CBCT Volumetry
Extra-oral and Intra-oral examination
Sleep study (HST- Home Sleep Test or PSG- Polysomnography)
The most important reading from this sleep report would be the AHI (Apnoea-Hypopnea Index) and the number of desaturations. It involves overnight monitoring of the breathing and other body functions of the patient including:
Blood oxygen levels
Electrical activity of the brain