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DIAGNOSING TMD: Musculoskeletal Dysfunction (MSD) of the Head and Neck Resulting in Temporomandibular (Jaw) Joint Dysfunction (“TMJ”)
Patients suffering facial pain, headaches, neck aches, shoulder, and/ or back pain often have to learn to live with the pain.
Some patients have subjective hearing loss, ringing of the ears, dizziness, pain in the ear, a feeling of fullness or pressure in the ears, clicking/ popping of the jaw joints and eye pain. The mouth, teeth and throat may also be affected. When competent clinicians cannot find an organic basis for these symptoms, they often suggest it might be psychogenic.
There is a classification of disease known as Musculoskeletal Dysfunction of the head and neck (MSD). MSD seems totally unrelated to symptoms such as back pain or ear disorders. Yet, correction of this condition may alleviate many medical symptoms; acute or chronic diseases of the ear, nose, throat, head, neck, shoulder and back. The syndrome is medically as well as dentally related.
TMJ/ MSD is a dysfunction of a group of associated muscles, ligaments, nerves and supportive structures that are associated with the temporomandibular joint. Unfortunately, TMJ/ TMD is one of the most misdiagnosed of the medical/ dental conditions. There are two aspects that contributes to this sad phenomenon of misdiagnosis.
- First, few doctors including physicians, ENT specialists, dentists, chiropractors, osteopaths, etc. have a comprehensive understanding and perspective in the diagnosis and treatment of TMJ/ MSD.
- Secondly, these disorders have many overlapping symptoms which mimic many other conditions such as neurological disorders, ringing and fullness in the ear, headaches, etc.
Misdiagnosis is the rule rather than the exception with MSD.
Patients wander from specialist to specialist, depending on the type of pain and problems they experience.
- Symptoms focusing on ear, sinuses, or swallowing problems are referred to the Otolaryngologist.
- Limitations of jaw movement are referred to the Orthopedist and or Oral Surgeon.
- Persistent head pains are referred to the Neurologist,
- Head and neck problems are referred to the Chiropractor, Osteopath, Physical Therapists, Massage Therapist, etc.
As the wanderers are told and retold that there seems to be no organic basis for their pain, that the cause is psychogenic, their anxiety mounts. When physical findings.
Note: A key part of any comprehensive TMD diagnosis is to assess the 6 dimensional “Physiologic” jaw relationship between the maxillary arch and the mandibular arch. (Mounted diagnostic casts is best used so the dentist and patient can see visually the problems in 6 dimensions). Without a clear picture of how these two entities relate in a bio-physiologic manner the clinicians will continue to guess and make recommendations without a clear direction as to how to resolve the problem.
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