Diagnosis of temporomandibular joint (TMJ) disorder begins with a medical history and a physical examination of the patient. The physician or dentist will look for pain or tenderness in the jaw joints and chewing muscles, examine the jaw during movement for clicking or popping sounds, and observe for locking of the jaw or limited motion while opening.

During the physical examination, the patient may have a noticeable deviation of the lower jaw (mandible) when opening or closing the mouth. In some cases, the patient’s ability to open or close the mouth is severely limited. There are other possible causes of orofacial pain that must be ruled out before a diagnosis of TMJ disorder can be made, including:

• Congenital abnormalities
• Tumors
• History of trauma to the face

Depending on the findings of the medical history and physical examination, some physicians may order panoramic x-rays or other specialized x-ray tests, such as arthrography, a joint imaging test using a special dye. MRI (magnetic resonance imaging) is used in rare cases where the physician suspects an underlying cause of arthritis or internal joint derangement. Radionuclide imaging can help detect a variety of bone diseases, such as tumors or osteomyelitis (bone infection).

It is not uncommon for many conditions to be ruled out before a diagnosis of TMJ disorder is made. Many patients will see several healthcare providers, including primary care physicians, dentists, sleep specialists, neurologists, endocrinologists, rheumatologists, pain specialists, chiropractors, ear, nose and throat (ENT) specialists or oral and maxillofacial surgeons in their search for a definitive diagnosis of the cause of their symptoms.

In order to make a proper diagnosis, it is recommended that the patient be prepared to describe symptoms and answer questions regarding the pain, such as those on a pain assessment, including:

• What kind of pain is it (e.g., stabbing, aching, throbbing or sharp)?
  
• Does the pain come and go, or is it constant?
  
• Is there anything that alleviates the pain?
  
• Is there anything that aggravates the pain?
  
• On a scale of 1 to 10, what is the intensity of pain?
  
• Is there any evidence of teething grinding at night?
  
• Does the patient bite the nails, chew on pencils or chew a lot of gum?