The acronym “TMJ” is a broad, umbrella term that covers a wide range of disorders. “TMJ” is not a specific, well defined condition that is the same for every patient. TMJ-related problems can vary from fairly simple, straightforward conditions to conditions that are quite complex.
Confusion about this can arise because the symptoms, in all of these variations, can be fairly similar, although the severity of the symptoms may vary. Therefore, distinctly different TMJ-related conditions are often grouped together because of the similarity of their symptoms.
However, the symptoms are not the disorder. In each variation, the symptoms are an expression of the actual disorder. Treatment, whatever it may be, should address the underlying disorder that is producing the symptoms. If only symptomatic treatment is proviced, the patient is likely to be left predisposed to have the symptoms return in the future.
There is no single, universal treatment that is appropriate for all of these variations. Treatment of a temporomandibular disorder should always be based on a biologically-specific diagnosis; i.e. a recognition of the actual anatomic and physiologic basis for the disorder. Arriving at a specific diagnosis requires completing a thorough history and a thorough exam. Only after taking the history and doing the exam can the treating individual accurately categorize the underlying condition, and therefore know what treatment is appropriate for that specific condition.
The treating clinician should be able to describe to the patient the nature of their problem and explain the treatment objectives that will hopefully resolve the actual condition, not just the symptoms.
If a biologically-specific diagnosis cannot be defined and described to the patient, it may indicate that the clinician has only a limited understanding of the nature of the specific disorder. This may also indicate that any proposed treatment is intended to do no more than address the symptoms, not the cause.
A patient should not be reluctant to ask the clinician if the proposed treatment addresses the condition that is producing the symptoms. If the patient feels uncomfortable with the response to this question, they should continue to seek help for their condition by a clinician with a more in-depth understanding of their problem.
Described below are several examples of overlapping conditions that may have no distinct demarcations of signs and symptoms.
1. Facial Pain with No History of Sounds (clicking/popping) from the Jaw Joints (TMJs)
2. Jaw Joint (TMJ) Sounds with No Pain or Limited Opening
3. Recent Onset of Jaw Joint (TMJ) Click/Pop with Associated Facial Pain
4. Prior TMJ Click/Pop That Has Now Progressed to Intermittent Catching or Locking
5. Persistent Limited Opening, Facial Pain, Prior History of TMJ, Prior Click/Pop Now Absent
6. Long-Standing Limited Opening with Facial Pain & Grating/Grinding Sounds from TMJs
7. Age-Related Onset of Grating/Grinding Sounds from TMJs
8. TMJ Sounds & Facial Pain in a Patient with Chronic Tooth Grinding (Bruxism)
9. Locking Open When Yawning or Other Wide Opening (Dental Visits)
10. Onset of TMJ Pain & Click/Pop During Orthodontic Treatment
11. In a Child Who Grinds Their Teeth, Jaw Soreness on Awakening
12. Arthritic Changes in the TMJs of a Child