For a routine health concern like recurring headaches, most of us will start by visiting our family doctor. The problem is that your family doctor may not be adequately prepared to handle a condition like TMJ that may be causing your headaches. Although training among doctors varies, we can look at this briefing document from the American Academy of Family Physicians to get a general sense of the approach family doctors and other general practitioners take to TMJ.
A Vaguely Defined Disorder
The document shows that for most family doctors, TMJ is a very vaguely defined disorder that they may not want to take the time to diagnose.
Although the briefing acknowledges that TMJ is common, it doesn’t seem to have a sense of different degrees or types of TMJ. For example, it says people with TMJ experience “one or more symptoms, which include jaw or neck pain, headache, and clicking or grating within the joint,” without understanding that the different types of joint sounds may represent different stages of the condition.
The document acknowledges “Research [on TMJ] has been hindered by the lack of clear diagnostic criteria for TMJ disorders,” but dismisses an available definition. It says the diagnostic tool developed by the International Consortium for RDC/TMD-based Research and recently accepted by the American Dental Association is too long and in-depth to be practical for family doctors. Because family doctors are trying to find quick and easy ways to come up with a diagnosis, they want a simple yes/no test for the condition.
The author recommends diagnostic nerve block as the definitive diagnostic tool. The author recommends that if numbing the joint doesn’t lead to relief, you “should be evaluated for other causes of orofacial pain.” But there are many potential origins for TMJ pain beyond just the jaw joint, and diagnosis of TMJ is more complicated than the document acknowledges.
The document also says that imaging isn’t useful for diagnosing TMJ, even though there is significant research supporting the usefulness of CBCT and MRI for diagnosing TMJ.
Diminishes the Dentist
Perhaps the biggest problem with the document is that it seems to discourage doctors from sending patients to see their dentist about TMJ problems. It implies that dental treatment for TMJ is inferior to other treatments, such as physical therapy, psychology, and alternative treatments.
This means that not only is the document telling doctors not to take the time to properly diagnose TMJ, it’s also telling them not to see a professional who will take the time to diagnose the condition.
Because of briefings like this, you shouldn’t be surprised if your doctor never mentions neuromuscular dentistry and never refers you to a neuromuscular dentist. If you are looking for relief from TMJ symptoms, you may have to take the initiative and contact one yourself.