Lesson 45

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Patient: Good morning, Doctor.
Doctor: Good morning. What seems to be a problem?
Patient: My dentist recommended me to come to you. He said that you are a specialist in temporo-mandibular joint and I was said that the symptoms I’ve been experiencing recently may be connected with the joint.
Doctor: I see. Please tell me what’s the matter.
Patient: Actually, I do not have a terrible pain, but I feel the tension and muscle fatigue. It is particularly bothering in the morning, after waking up. What’s more, I have a headache, or more precisely – pain in my neck. My dentist said that it may be associated with the joint.
Doctor: Has anything happened or changed in your life recently? I mean particularly some stressful situations.
Patient: Hmm. Rather not, but actually yes, it did. I’ve changed my job, and therefore, I have to learn some new things , but I’m managing. However, this is at the expense of my free time.
Doctor: Have you recently been treated at the dentist’s, I mean have you had any tooth filled?
Patient: A few months ago I had a porcelain bridge done, but I’m happy with it. At the beginning it was a little too high , but now it is fine.
Doctor: Well, yes. Sometimes some things overlap. Let me ask one more thing:  do you grind or clench your teeth? Or maybe someone from your closest relatives told you about this?
Patient: I haven’t noticed , but my wife told me that I grind my teeth at night.
Doctor: All right. Now, let me examine you. First, let’s check  outside. Does it hurt when I touch?
Patient: Rather not.
Doctor: And now?
Patient: Yes, it hurts a little.
Doctor: Now clench your teeth firmly. Thank you. Now open and close the mouth slowly, please. Alright. Now, let me check by articulating paper. Bite on the strip and pull your lower jaw forward slowly. A few things are clear. But to have some more clarity, I would like to examine you with a special device and take some photography. However, we would have  to make an appointment for another day as it requires a little more time. When could you come to see me?
Patient: Even tomorrow.
Doctor: Good. Can you come at 5:00 p.m.
Patient: Yes, I can. It will be right after work, but I would like you to take care of this problem as soon as possible.

Doctor: I’ll finish the examination tomorrow, but the treatment will take longer. I will ask you also to fill out a special survey. There are questions regarding your general state of health and diseases and illnesses that you have gone through so far. As for treatment , I will give you more details tomorrow , after the examination.

Patient: I am glad that I came to you.
Doctor: It was nice to meet you. See you tomorrow.
Patient: Goodbye.


Complete the sentences with words formed from words in brackets

1. The temporomandibular joint (TMJ) is a triangle like structure __________ (LOCATION) in front of the ear on either side of the head. 

2. When one suffers from TMJD he/she may experience some popping ____________ (SENSE) in the joint.

3. Another symptom of this disorder is _________ (COMFORT) while chewing.

4. TMJ disorder may occur from ___________ (LOOSE) teeth that have led to damage of the jawbone.

5. In some cases, TMJD may be triggered by _____________ (WEAK) in different muscle groups.

6. Slumping can lead to __________ (BALANCE) that puts stress on the muscles of back, shoulders, neck, face, and jaw and in consequence TMJD may develop.

7. _______________ (MANAGE) of TMJD can be achieved through a surgical or non surgical approach, depending of course on the results of the diagnostic images and tests.

8. Over-the-counter pain relievers can ___________ (MINIMUM) the experience of pain and reduce inflammation.

9. An ice pack or cold compress applied to the ____________ (EFFECT) area for 10 to 15 minutes will reduce swelling and inflammation.

10. Moist heat applied to the area between 10 to 15 minutes can also improve ____________ (CIRCLE) to the area and reduce pain.

Read the text about TMJD treatment. Complete it with the words:


Treatment of TMJD varies, depending on what is causing the symptoms. Treatment may include:

  • Arthocentisis, a procedure that flushes debris and the 1)____________ of inflammation out of the joint.
  • Correcting poor habits such as grinding the teeth or chewing gum. Sometimes a device (a night guard) 2)____________ in the mouth can help control grinding of the teeth.
  • Corrective dental treatment.
  • Drugs to relieve pain and reduce 3)___________ and inflammation.
  • Splints that reposition the jaw, ligaments and muscles into better 4)____________
  • Surgery to 5)_________ abnormalities of the jaw
  • Stress management such as meditation, deep breathing and progressive muscle relaxation may be used to help 6)___________ the jaw muscles and prevent teeth clenching or grinding.
  • Stretching or 7)__________ the jaw muscles.
  • Applying heat or cold to the muscles to 8)____________ the inflammation and pain.

Rearrange the letters to form words describing different symptoms of TMJD

O N G I P P- _________-

A. G C R K C L I N- ______________

I C C L I K N G- ___________

L E N N C C H I G- _______________

N D I G R I N G- ________________

F S T I F N E S S- _______________

S S T E E N R D N E- __________________

G T R I A N G- ______________

W E S L L I N G- _______________

 F A T G I E U D   J W A- _________________ (two words)

TMJD is sometimes treated with surgery. Read the descriptions of 3 different surgical procedures and then match them with a proper term.

A. Open-joint surgery         B. Arthroscopy      C. Arthrocentesis

_______. This procedure is the least invasive of any procedure. It involves injecting steroids into the joint to reduce inflammation.  

_______. This procedure is guided by a very small camera inserted through a small incision in front of the ear. The camera allows the doctor to examine the temporomandibular joint and establish a cause of the TMJ condition, such as tissue inflammation or a misaligned disc or joint. Then the doctor can correct the problem by removing inflamed tissue or adjusting alignment of the joint.

________.  If arthroscopic surgery is not available for any number of reasons, the TMJ region may need to be opened to allow a surgeon full view and access to the temporomandibular joint for diagnosis and correction.

Lesson 45 answers Lesson 45 answers