Newsletter June 2025

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—a behavior 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, ear pressure, ear congestion, or ringing in the ears. Contributing factors like stress, anxiety, depression, and sleep disturbances (including obstructive sleep apnea) intensify clenching and related 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 TMD issues: myogenous 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 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,