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Do we need to treat non-symptomatic joint clicking?

Do we have to treat every noise or click that we observe in our patients? And the answer is not necessarily. What I am going to say is we always have to go back to the complete examination.

 

It is the power of the examination that really drives everything we are going to do

The Complete Exam is so important for our process. So if we have a patient that we are thinking, "Does this patient have some type of potential joint issue? An intracapsular issue? Is there a disc that is off. And if it is off, is it partially off or completely off? Do we have degenerative bone disease going on?"

It is not one thing that is going to point you in the direction of that potential diagnosis. It is the entirety of the examination. We are looking at joints, muscles, and teeth.

If we were to do an examination and the only thing we had was an occasional click, it might not be every time, or we thought that we have a click just on the lateral pull, and the muscles are okay, the teeth are not wearing out, there is no other symptoms, do we necessarily have to treat that? And the answer is probably no.

Account for all the factors and communicate to the patient

But you have to factor in everything else from your examination, as well:

  • The age of the patient.
  • What else is going on with the patient?
  • Are there restorative needs for the patient?
But if there are no other needs and that is the only thing that we have it is maybe not somebody we need to treat at this time. But it is a patient though that you have to have a conversation with, always. You tell them that things are going on inside the joint because a normal healthy joint is not going to make any noises, but it is maybe then somebody that you can observe over a period of time. The patient owns the potential problem. And if things change we are there to evaluate further if needed.

Learn more about treating TMJ disorders at TMD Patient: Diagnosis and Treatment.

Test your knowledge on occlusomuscle disorders

Dr. Cobb was born and raised in the Washington DC area and graduated from Georgetown University School of Dentistry in 1984. He joined the practice of his father, Dr. Everett Cobb, and maintains a private practice in the District of Columbia focusing on restorative and esthetic dentistry. Dr. Cobb is involved with a number of dental organizations including the American Academy of Cosmetic Dentistry, the American Equilibration Society and is a Fellow in the International College of Dentists. In addition to maintaining his practice, Dr. Cobb volunteers extensively both nationally and internationally. He volunteers routinely with local dental clinics for the underserved in the DC area, the AACD “Give Back a Smile” program and Somos Amigos Medical Mission in the Dominican Republic. Dr. Cobb has been on numerous trips with Somos Amigos and is the dental coordinator for the mission. He has been recognized with numerous awards for his philanthropic efforts.