logo 2002 copy John R. Droter, DDS

Facial Pain Diagnosis

TMJ is the name of a joint. Being told you have TMJ is the same as being told you have knee or you have elbow. TMJ is the abbreviation for the temporomandibular joint, it is not a diagnosis. There are over 100 causes of facial pain, only some of which are caused by a damaged joint.
Heathy TMJ

The TMJ is a synovial joint of the human body and will undergo the same diseases as any other joint. I use an orthopedic approach to diagnosing and treating damaged TMJs.
                John R Droter DDS

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What is a Temporomandibular Disorder (TMD)?

The American Dental Association’s President’s Conference on Temporomandibular Disorders defined TMD as a group of orofacial disorders characterized by: Pain in the preauricular area, TMJ, or muscles of mastication Limitations/deviations in mandibular range of motion TMJ sounds during jaw function.

TMD is Not One Disease

TMD refers to symptoms. Many different diseases will cause pain and dysfunction in and around the temporomandibular joint. See the partial list of diseases that will cause TMD symptoms below:

TMD Myalgia as primary source of pain (Muscle Pain)
Occlusal Muscle Dysfunction (OMD)

Parafunction- Grinding of Teeth
Parafunction- Clenching Teeth
Muscle Splinting, Stabilizing, Tonic Contracture
Mechanically UnstableTMJ: Deep Temporalis, Deep Masseter
Pain Avoidance: Painful TMJ, Muscle or Teeth: Temporalis, Digastric
Tongue: Stabilize Neck, Stabilize TMJ, Occlusal Cushion
Mastication Dysfunction (Chewing)
Muscle Weakness
Muscle Hypertrophy
Overuse Myalgia
Triggerpoints/Myofascial Pain
Muscle Spasm

TMD Arthralgia as primary source of pain (Joint Pain)
Physical Damage to Disc & Ligaments

Avascular Necrosis
Osteochondritis Dissecans
Hypoxic Progressive Condylar Resorption
Inflammatory Tissue Bone Resorption
Rheumatoid Arthritis
Lyme Disease
Joint Infection- Staph, Strep, Syphilis
Fracture/Crush condylar head and fossa
Psoriatic Arthritis
Crystalline Deposition Diseases
Cancer TM Joint/ TM Bones
Synovial Cyst (Ganglion)

TMD other
Cervical Damage- Atlas Misalignment

Referred pain from neck muscles
Migraine Headaches- cervical/trigeminal mediated
Trigeminal Neuralgia
Neuroma, Phantom Tooth Pain
Bell’s Palsy

 85% of people with TMJ damage do not need any treatment what so ever!!!

Damaged TMJMany people have damaged their TMJs (35% of the population), the disc is dislocated
anteriorly, and the joint makes a clicking sound on movement. Most damaged joints adapt favorable and allow good jaw function (opening and closeing), chewing, and eating pain free. The only thing they have is a clicking sound when the jaw moves. A few do however have jaw dysfunction and pain from a damaged joint that did not adapt favorably to the damage. For them, there is treatment to help the TMJ damage readapt in a more favorable manor.

Questions that need answered on all TMD patients:
Is the Temporomandibular Joint (TMJ) damaged?
If damaged, what is damaged?
Is the damaged joint actively breaking down, adapting, or has it adapted?
Did the damaged joint adapt favorably or unfavorably?
Does the joint damage have anything to do with the pain or dysfunction?