Dr. Singer understands that there is an intimate connection between your overall health and the function of your jaws and teeth. He is educated, experienced, and has the proper instrumentation to diagnose and treat TMD. He believes in a multi-disciplinary approach and often refers patients to ENT doctors, physiatrists (sports medicine rehab), integrative medicine specialists, chiropractors, and nutritionists. Read more about Our Philosophy.
Those who clench or grind their teeth during sleep will typically wake up with a sore jaw, but jaw pain alone does not necessarily mean that there are problems with the temporomandibular joint. If the pain is severe or lasts for more than a few weeks, you should come into our office for an evaluation. Generally, people complain that the pain in the jaw associated with TMD is an ache due to the muscular stress of improper joint function. Over time, this pain usually begins to radiate into the neck, shoulders, ears, and beyond.
These symptoms are often associated with sleep disordered breathing or sleep apnea, and it is critical to screen for sleep apnea.
In order to provide a diagnosis, Dr. Singer evaluates you in a number of ways:
- A comprehensive history with a number of specific questions about your symptoms. These questions include sleeping habits and symptoms throughout the body. Ninety-five percent of patients with TMD also have sleep issues.
- Examination of the dental arch, noting characteristics that are frequently associated with TMD, such as extra bony growths called lingual tori, palatal tori, or bony exostosis.
- Determination if your upper and lower teeth meet properly (occlusion/bite).
- Evaluation of your jaws range of motion, including palpations to see if the tendons, ligaments, muscles, and other structures associated with the TMJ are tender.
- Evaluation of your posture. People with TMD often carry their head too far forward or have one shoulder higher than the other, among other postural abnormalities.
- A cone beam (C-arm) CT scan to look at the joint structures in 3D. This scan shows if there are any blockages to the airway from the nose down to the epiglottis. It also provides high-definition digital images in a single, quick scan that exposes patients to less radiation than traditional x-rays, while also providing the doctor with much more data.
- Ultrasound to examine the condition of the soft tissues of the jaw.
- Neurologic strength tests called postural sympathetic dystrophy or motor reflex testing to evaluate the brains perceived condition of the structural integrity of the body and what structures the brain considers injured. This helps Dr. Singer determine if the TMJ is the primary injury, secondary to another injury, or a dual primary condition along with a lower back injury.