Provocation Testing To Assist Craniomandibular Pain Diagnosis

Abstract

Patients with TMD often present with complex pain symptoms, which can make it difficult to reach a diagnosis. Usually palpation of the masticatory muscles and TM joints, range of motion testing and imaging are used in the diagnostic process. Sometimes it is necessary to evaluate the jaw moving muscles from a functional prospective because they cannot be palpated due to inaccessibility or because they have other structures that are more superficial to them. In these instances, provocation testing can be a helpful adjunct in providing some insight into what is occurring in the area being tested and localizing a suspected source of pain. Anesthesia blocking can be used to confirm any positive findings. This article explores several provocation tests that can be used to evaluate conditions of the masticatory musculature, the TM joints and the stylomandibular ligament.

Additional information

Notes on contributors

John S. DuPont

Dr. John S. DuPont Jr. has authored a number of published articles and manuals on the diagnosis and treatment of temporomandibular joint disease. He has diplomate status in the American Board of Forensic Dentistry (ABFD) and the American Academy of Pain Management (AAPM) and holds fellowships in the International College of Cranio-Mandibular Orthopedics (ICCMO) and the Academy of General Dentistry (AGD).

Christopher E. Brown

Dr. Christopher E. Brown practices in New Orleans, Louisana. He is a fellow-eligible member of the American Academy of Craniofacial Pain (AACP) and a diplomate of the American Academy of Pain Management (AAPM). He also serves as an adjunct clinical professor to the senior class patient clinic at the Louisana State University School of Dentistry.