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Patients are checked for how wide they can open, slide left and right, move jaw forward, and whether or not there is a deviation or deflection of the jaw upon opening. Problems achieving a normal range of motion usually indicate a structural problem with the joint.
Muscle palpation
Excessive muscle contractions and tender trigger points may indicate a problem with the chewing muscles. Such symptoms usually mean that the lower jaw is not in the correct position.
TMD X-rays
TMD X-rays are important to see if the condyles (top of the lower jaw bone) are too far back where they would be impinging on the nerves and blood vessels at the back of the socket where the jaw bone fits into the skull. In cases where the lower jaw is too far back, dentists find a significant reduction in the signs and symptoms of TMD when the jaw is repositioned forward with a splint or a functional orthopedic appliance.
Computerized joint-vibration analysis
Joint-vibration analysis is a three-minute, non-invasive test in which headphones are placed on both jaw joints and the patient is instructed to open and close his or her mouth six times. An abnormal or dislocated joint has distinctive vibrations that can be analyzed to help the diagnosis.
Treatment
First, muscle spasms and pain are relieved. Then, a normal range of motion for the lower jaw is established. To correct the way your teeth fit together, an orthotic or splint may be prescribed to wear over your teeth until the bite is stabilized.
Permanent correction may involve selective reshaping of the teeth, building crowns, orthodontics, or a permanent appliance to cover the teeth. Although infrequent, surgery is sometimes required to correct a damaged joint.
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