Jaw therapy – First consultation

The most important element of personalised temporomandibular joint treatment is the initial assessment, which is essential for effective therapy. During the assessment, we take your medical history, using targeted questions and a physical examination to identify the underlying, maintaining, and aggravating factors of your jaw joint problem, allowing us to understand your current condition as precisely as possible. The physical examination includes palpation of the temporomandibular joint and the masticatory muscles, measurement of jaw joint movements, as well as written, photographic, and video documentation. This provides an excellent opportunity to monitor the effectiveness of the therapy.

During the consultation, your therapist will ask you, among others, the following questions:

• What symptoms do you have and when did they begin (e.g., jaw pain, jaw clicking, limited mouth opening, tinnitus, headache, toothache, facial pain, etc.)?

• What makes your symptoms worse or better?

• Do your symptoms vary throughout the day (do they appear more in the morning, during the day, or in the evening)?

• Is there any activity you cannot perform because of your symptoms (e.g., eating, speaking)?

• Do you experience pain, and if so, where is it located? Does it radiate anywhere?

• How severe is the pain? (On a scale of 0–10, where 10 is the worst.)

• Do your teeth touch during the day and/or at night? Do you notice any teeth clenching?

• Where does your tongue rest in your mouth when relaxed (on the palate, on the floor of the mouth)?

• Do you ever feel a “lump” in your throat? Do you ever feel a “tight throat” sensation?

• Do you have difficulty pronouncing certain sounds?

• Did you have any dental treatment shortly before your symptoms appeared?

• Have you ever had a traumatic injury or surgery involving the temporomandibular joint?

• Have you ever worn braces?

• Have you ever undergone splint therapy?

• What other treatments have you received to alleviate your jaw joint symptoms?

• Do you take any medication to ease your symptoms (e.g., painkillers, muscle relaxants)?

• What is your goal with temporomandibular joint therapy?

If you have already consulted a doctor regarding your symptoms, please bring the medical report and any examination results (e.g., MRI, CT, X-ray). If you use a bite splint as a complementary therapy, please bring that as well. For the examination, we recommend wearing comfortable clothing that leaves the neck area free.

The assessment begins with a detailed review of your medical history. Your therapist will ask targeted questions to understand all factors that may contribute to the development and persistence of your temporomandibular joint complaints. In addition to the detailed interview, the examination includes observing posture, head position, and facial symmetry, palpation of the jaw joint and masticatory muscles, as well as assessment of breathing and swallowing. Your therapist will also measure jaw joint movements, examine the location and nature of pain, and identify factors that increase or decrease your symptoms.

As part of differential diagnosis, palpation of the masticatory muscles is performed both inside and outside the mouth. Mild pain may occur at the site of pressure, and in some cases it may radiate, which provides valuable diagnostic information for the therapist. Intraoral examination is an essential component of temporomandibular joint assessment.

In cases of TMJ dysfunction, evaluating breathing and swallowing is of fundamental importance. Obstructed nasal breathing and an abnormal tongue position can alter physiological swallowing, which may contribute to maintaining jaw joint complaints.

For establishing the diagnosis, assessing joint movements and performing functional tests are particularly important. During the examination of jaw movements, your therapist palpates the joint and uses measuring tools to determine the extent of mouth opening. Photographic and video documentation is made of jaw movements. These objective measurements allow progress to be tracked and give both the patient and the therapist a clear picture of therapeutic effectiveness.

The results of the examination are recorded on a documentation sheet, the contents of which you may review. Your therapist will establish your TMJ diagnosis, explain its meaning, causes, and progression in detail, and draw your attention to the factors that maintain your condition. A personalised treatment plan is created in agreement with you. You will also be taught exercises during the assessment to help eliminate harmful oral habits.