Stephen H. Gamerman, D.D.S. P.A.	Temporomandibular Joint Dysfunction
Baltimore Office: 107 W. Saratoga St. Baltimore, MD 21201 (410)539-1155	Billing & Correspondence: P.O. 65028 Baltimore, MD 21209
Laurel Office: 9811 Mallard Dr., Suite 112. Laurel, MD 20708 (301)523-1470

Screening Exam For TMJ Disorders

If patient has headaches, a negative C.A.T. Scan and a normal neurological evaluation, you may well have a Temporomandibular Disorder

I. History of Trauma
	A.	Automobile accident with direct trauma to head face, or neck.
	B.	Automobile accident with air bag deployment.
	C.	Rear end automobile accident with whiplash injury to neck, back, or jaw.
	D.	Work related injury with direct trauma to head, face, or neck.
	E.	Repetitive work related injury.
	F.	Airplane baggage compartment related injury to head face or neck.
	G.	Assault.

II. TMJ Disorder Assessment Questionnaire
	A.	Does patient experience Headaches ? (Especially in the morning when he or she wakes up or when he or she goes to bed)
	B.	Does patient have pain around the eyes. in the forehead, or at their temples?
	C.	Does patient have pain around the face, neck, or shoulders?
	D.	Does patient have pain, ringing, or buzzing in their ears?
	E.	Does patient experience clogging, fullness, or pressure in their ears that comes and goes?
	F.	Does patient experience a clicking popping or snapping in their jaw joints when you open wide close your mouth, or bite down?
	G.	Does patient have pain when opening wide, closing their mouth, or biting down?
	H.	Does patient have difficulty with chewing talking, or yawning?

III. TMJ Screening Examination

A.	Observe opening movement of the mouth:
Abnormal TMJ Opening
	1. Lower jaw pulls to left or right on opening mouth.
	2. Lower jaw pulls to one side, then to the other side on opening the mouth.
	3. Pain or limited opening of mouth (less than 50 millimeters)  Normal TMJ Opening Lower jaw opens straight to 50 millimeters.

B.	Have patient point to where it hurts when they have their headaches:
C.	Press firmly the following, assessing for pain on the left, right, or both  sides:

1. Press at their left and right temples.

2. Press above their left and right ears.

3. Press in front of their left and right ears while opening and closing their mouth.

4. Have patient open their mouth wide, put your small finger in their ear, then have patient bite closed to determine if there is any popping, clicking, or pain on this palpation. Palpate The Jaw

A HISTORY OF TRAUMA, "YES" TO SEVERAL OF THE TMJ QUESTIONS AND PAIN ON DOCTOR'S EXAMINATION MAY WELL INDICATE THE NEED FOR FURTHER EVALUATION BY A TEMPOROMANDIBULAR DISORDER (TMJ) SPECIALIST.

ANXIETY AND FATlGUE CAN INFLUENCE THE PROGRESS OF THIS CONDITION.

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