Association of TMJ Disorders with Other Problems

The diagnosis of TMJ Disorders is usually based on the occurrence of the distinguishing clinical signs and symptoms that the patient presents upon examination. In other words, for the most part, the patient expresses that he or she is suffering from a group of subjective symptoms, such as recurring headaches, neck aches, ultra-sensitive teeth etc. Using what the patient tells the dentist, he will then begin to look for more objective signs of the TMJ disorder such as clicking of the joints, divergence upon opening and closing the mouth, and periodontal involvement.

There is, however, one objective sign that is visible upon dental x-rays which may lead the dentist to believe that the patient is obsessed with parafuntional habits such as bruxing, ice and/or excessive gum chewing and severe clenching the teeth.

The dentist will be able to discern a widening of the periodontal ligament toward the crown of the teeth. Rather than a normal, relatively thin line between the bone and the tooth, it will begin to widen as it progresses up the root toward the crown. This widening is called “funneling” of the periodontal ligament, and is a prime indication that the patient tends to place immense pressure on the teeth. The presence of funneling on dental x-rays nearly always means that the patient is bruxing, but it does not always indicate that the patient actually requires treatment for TMD. When a dentist notices this objective sign on an x-ray, he will ask the patient if he or she is suffering from any of the fundamental symptoms of TMJ disorder. If the patient answers in the negative, then no treatment is indicated, however, if the answer is in the positive, then the patient is told the treatment options. If the patient determines their symptoms are severe enough to require treatment, then the dentist will proceed from there.

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