Diagnosing TMJ Disorders: A Simple Clinical Approach

Dear Colleague,

Many patients with TMJ disorder (TMD) go undiagnosed simply because the condition is misunderstood. At its core, TMD is caused by nighttime clenching—something that occurs in nearly half the population during normal sleep. Most people who clench have no symptoms, but when symptoms do occur, they often include ear pain, headaches, facial numbness, sinus pressure, ear congestion, or ringing in the ears. Contributing factors like stress, anxiety, depression, and sleep disturbances (including obstructive sleep apnea) can intensify clenching and trigger symptoms. The simplest way to diagnose TMD is through palpation of the masticatory muscles. If the jaw muscles or joint are sore, your patient likely has TMD. One of the most commonly missed diagnoses is temporalis tendonitis, which often mimics upper molar pain or sinus trouble. If that tendon is sore, you’ve found your answer—no need for ENT or neurology referrals. Keep in mind there are two broad categories of TMJ issues: classic TMD (muscle pain from clenching) and internal derangements (joint-specific problems like popping or clicking). They require different management, but both can be identified through careful palpation. Thanks for taking a moment to review this. I hope this brief overview helps you confidently identify and manage TMJ disorders in your own practice. As always, feel free to reach out if I can help with a case.

Warm regards,
Jeff Doneskey

WatchPAT One

Dr. Doneskey is happy to announce that a new home sleep test (HST) is now being offered in his office. The WatchPAT One disposable sleep test offers patients convenience and efficiency in getting their results. The WatchPAT device technology not only records true sleep time but also stages of sleep (light/deep/REM). It is also the simplest home sleep test for patients to use as it does not require an abdominal or nasal monitor. The results of the study determine if future investigation is needed (full PSG). For more information, please give our office a call at any time.

The SilentPartner Oral Appliance

is a patented, FDA-approved oral sleep appliance that was developed by Dr. Doneskey and partners to effectively manage snoring and obstructive sleep apnea. In addition to this, the SilentPartner™ can also manage many TMD-related issues, including TMJ popping, locking, and grinding. Healthy jaw-friendly function, patient comfort, single-point balance, and fast complete adjustability are at the heart of its design. The appliance is customized for each individual patient while its patented mechanism makes ongoing clinical adjustments simpler and much more convenient than other oral sleep appliances on the market today. The SilentPartner™ provides patients with a convenient and comfortable alternative to CPAP therapy with the additional important benefit of effectively preventing clenching and grinding on back teeth, both of which can be secondary sleep disorders seen in most sleep apnea patients.

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