Dr. Robert Axelrad Dental Office

Making Brampton Smile Since 1997

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TMD Exam

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This is the last entry in the TMD series. I felt that it was important to end the series with this entry, because the information provided may help those of you who have TMD symptoms to figure out what they in fact are all about.


Clinical Exam

1) Noises upon opening and closing:
Are there noises at the ‘joint’ upon opening and closing? Clicking sounds are generally ok…they are common and if you hear them, it doesn’t mean you need treatment. Grinding and grating noises are NOT ok. This means the bones at the joint are rubbing against one another…not good!

We often use a stethoscope to hear noises at the joint.

2) Range of opening:

a) The normal amount of jaw opening is at least 2 of your knuckles or 40 mm. At this point everyone is putting their 2 knuckles in their mouth.

b) Side to side or lateral movement is approximately 7-10 mm.

c) Forwards or protrusive movement is approximately 6-9 mm.

3) Discomfort: Of the muscles of the face, jaws, neck…pain and/or stiffness.

4) Occlusion: We check and evaluate how your teeth come together. As mentioned in the previous blog, ‘treatment options for tmd,’ if your teeth are in the correct alignment and occlude (or come together when you close) properly, then the actual ‘ball part of the joints’ will most likely also be in their correct positions. The correct positioning of these ball joints is important for both TMJs to function properly and for the muscles of the face to be relaxed.

5) Tooth wear: Excessive wear of teeth is associated with grinding and bruxing. This can lead to overactive facial muscles and pain (see ‘What Causes Tmd’).

6) Sensitive Teeth: The roots of the teeth are embedded in the bone. The bone is what anchors them in. But they are not cemented in to the bone. There are tiny fibers that connect the roots to the bone. These are called ‘ periodontal ligament fibers ‘ or PDL fibers. These fibers have sensory receptors in them. So if the teeth are clenched together , this means that the roots are being pushed or compressed in to the bone. This in turn means that the fibers, which have sensory fibers in them, are being ‘squished’. This is why you end up with sensitive teeth when you clench.

7) Headaches: Especially at the area of the temples on the sides of the head.

X Rays: If TMD does not improve using conservative treatment (see TMD Treatment Options), then we may need specialized x rays to help in the diagnosis. Lateral CT scans are often used to photograph the joint area , particularly for disc abnormalities.

I hope that the tmd series has helped those who suffer from this problem to better understand what it is all about!

Until the next time…

If you have jaw pain or ongoing headaches, it could be that you’re suffering from TMD. Relief from TMD is as close as Dr. Robert Axelrad & Associates Brampton dental office. Let us help. Simply dial (905) 791-3867 today to book a consultation. We’re located at 40 Finchgate Blvd., Suite 121, in the heart of Brampton, Ontario.

Our office is now open. We are taking the following precautions to combat COVID-19;

  • A plexiglass barrier stands on the front desk in the waiting room.
  • All patients have their temperature taken with a non-touch digital infra-red thermometer.
  • All staff wear mask, gloves, gown, bonnet, goggles and face shield.
  • Hand sanitizers are readily available for staff and patient use.
  • Patients will wait outside or in their car until their appointment time.
  • No visitors are permitted in the office.
  • Social distancing will remain in effect in the office.
  • Patients experiencing influenza-like-illness (fever with a cough, sore throat or muscle aches) should not come to the office.
  • Air purifiers with hepa filters have been installed in each operatory and waiting room.
  • All COVID-19 precautions put forth by both the dental and hygiene boards have been put into force in the office.

We look forward to seeing you soon. 
Dr Axelrad and Staff