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MRI vs. Ultrasound for TMJ Screenings

Sep 03, 2013


Photo source: tanebaumtmj.com

Temporomandibular disorders (TMD) can be hard to diagnose for some people and very painful for all who suffer from it.  Recent Canadian studies have shown that using ultrasound technology can help identify the severity of TMD in patients.  This technology is used more often in Europe and China, but is only slowly being adopted in the U.S. where the MRI is still king.  The real debate is whether the accuracy of the standard MRI can be duplicated by the ultrasound technology. 

The temporomandibular joint is the hinge that connects the lower jaw to the temporal bone of the skull in front of your ears. This joint allows us to talk, chew, yawn and make funny faces at your spouse. There are several causes of TMD including grinding or clenching the teeth, arthritis, stress or an injury to the jaw or the muscles of the head and neck.  TMD is commonly found in people between the ages of 20 and 40 and can cause pain and tenderness in the neck, face, joint and ear area. 

The dental community is beginning to lean towards the use of ultrasounds for several different reasons.  Ultrasound scans are quicker than an MRI and this is beneficial to patients who are in a great amount of pain or who are claustrophobic. Ultrasounds are extremely inexpensive compared to MRIs and are readily accessible.  There are also no known risks associated with these scans. 

One of the greatest benefits of using ultrasound technology to identify TMD is that the patient can speak while the scan is taking place.  This allows the dentist and the patient to have a dialogue about where the pain is located and helps the dentist quickly identify problem areas.

Regardless, there are still instances where an MRI is necessary even when an ultrasound has been performed.  Dr. Lawrence Friedman from the Department of Radiology at North York General Hospital in Toronto says, "If the ultrasound is abnormal, the patient should be referred for an MRI, and any patient scheduled for surgery also must have an MRI. The main challenge is learning to detect what is normal on ultrasound. We also acknowledge that abnormal anteromedial and medially displaced disks may be missed or misinterpreted with ultrasound."

Ultrasound technology is not used as often in the U.S. because of the perception that training requires long periods of time and causes higher overhead costs for dental offices.  Dr. Friedman taught himself how to perform the procedure in two years; however, he said that sonography technicians can learn the basics of the technique in about three months.

The quicker patients can be properly diagnosed with TMD, the quicker they can be treated!  If you suffer from TMD, ask your dental professional if ultrasound scans are available and right for you. 

Sources: WebMD, DrBicuspid.com


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