These three terms can be confusing because they may be used to describe the same damaged condyle from different points of view.

Arthritis describes inflammation or degeneration within the joint. Idiopathic condylar resorption, or ICR, means the condyle is progressively losing bone and the cause remains unknown after other causes have been ruled out. A compressed condyle describes a proposed mechanical problem in which the condyle and surrounding tissues are being loaded or restricted in an unhealthy position.

A CBCT may show flattening, erosion or loss of condylar bone, but the picture alone may not explain why it happened. It also may not show whether the destruction is active or occurred years ago.

Patients should ask:

• What exactly do you see—flattening, remodeling, erosion or active bone loss?
• Is this only an imaging finding, or is it a confirmed diagnosis?
• Do you have an earlier scan for comparison?
• How will you determine whether the condition is still progressing?
• What evidence supports arthritis, ICR or mechanical compression in my case?
• Should I have an MRI to examine the disc, inflammation and other soft tissues?
• Have autoimmune, inflammatory, hormonal, traumatic and surgical causes been considered?
• Do I need an evaluation by a rheumatologist or oral and maxillofacial surgeon?
• Could my changing bite, open bite, jaw retrusion or facial changes indicate loss of condylar height?
• How will treatment protect the joint, and how will you monitor whether it is working?

The most important question may be: Are you naming what the damaged condyle looks like, or have you determined why it is being damaged?

A responsible diagnosis should combine the patient’s history, examination, bite and jaw function, appropriate imaging, medical evaluation when indicated, and comparison over time. One scan should not be expected to answer every question.

Put your fingertips on your temples and gently bite down and release several times. Move your fingers around until you clearly feel the muscle tighten. That is your temporalis muscle, one of the major muscles that closes your jaw.

Do this on both sides. Now gently feel around the muscle. Are there areas that are sore, tender, or feel like a little knot? A tender knot may be what is commonly called a trigger point.

Here's another interesting check. Keep a finger on the temporalis and slowly open and close your mouth while moving your finger upward toward the top of your head. At some point, you will reach a line where you no longer feel the muscle moving. That helps you find the upper border where the muscle transitions into its attachment via tendons. Inflamed tendons can also cause pain.

If pressing along the muscle or its attachment reproduces the pain or headache you commonly experience, that is useful information to tell whoever is examining your TMD. This type of exam should happen when your dentist is examining you for TMD.

It doesn't diagnose the cause of your TMD. It simply gives you another clue about what structures may be involved.

I am a retired TMD dentist from the USA and developer/moderator of this sub. I spend much of my retirement sharing what I know through my 50 years of experience in dealing with patients in pain. A little over a year ago, Jonathan Fashbaugh and I wrote a book that shares my experiences in successfully treating TMD/TMJ.

I see so many residents from the UK with so many questions but few answers about TMD. Here is a five-star review of our book on Amazon UK. See if you relate to what this reader says:

5.0 out of 5 stars Empowering book and first step for all TMJD sufferers

Reviewed in the United Kingdom on 18 December 2025

Format: Audiobook

This is an excellent book for people wanting to learn more about their TMJD, and how to go about treating the problem.

Firstly, it feels reassuring and empowering just to be understood, and to feel that you're not alone - an effect which the authors of the book strongly achieve.

Secondly, it offers practical and realistic information to help you grapple with the very NON ideal situations in which TMJD places you.

The author is honest, humble and comes across as genuinely helpful.

I appreciate the author's honesty about the situation; the good, the bad and the ugly. He doesn't pull the wool over your eyes but doesn't leave you stranded in the bright lights either.

The book is the closest I may come to some relief for some time (more in spirit than bodily as of now) although there are excellent self management and habit correction tips, too while you save up for further treatment). It is useful as an informative, empowering guide; a realistic assessment of where you stand, and a little beacon of of hope as to the future, and what you can do in the meantime while you save money and find the right specialists. It's something for everyone at various stages of their TMJD journey.

It calmed me down because I am a recent sufferer and initially I did not take my TMJD very well. It's hard when you live a pain-free life and then suddenly there's constant pain and it threatens to be with you always. I was lost, confused, desperate, hopeless and depressed. Now, I am less of those things and more empowered. I feel more an agent of control and less a victim of a chaos.

It is a rather costly web to untangle from, with so many potentially wrong twists and turns along the way, so I do also appreciate the practical tips on investigating dentists to see whether they are genuinely TMJD specialists because losing a lot of money (that's not plentiful) is hard, so losing it to the wrong doctor is even harder. The author is aware and armed with some practical tips for this conundrum and I am grateful for that.

Also the author goes into some detail about various TMJD causes as well as some useful information on sleep apnea which is another issue I am grappling with both for myself and a loved one.

One person found this helpful

Over the past year, I've noticed something interesting.

It hasn't come just from Reddit. I've heard it from readers of my book, listeners of our podcast, emails from around the world, and conversations with TMD patients.

Most people are not asking me for a miracle treatment.

They're asking questions like:

• Why am I hurting?
• Why have I been told different things by different providers?
• Why do some dentists say my bite has nothing to do with it, while others say it might?
• Why does one doctor recommend physical therapy, another Botox, another an oral appliance, and another surgery?
• Who should I trust?
• Where do I even begin?

To me, that says the biggest problem isn't just the pain. It's the confusion.

TMD isn't one disease with one treatment. Many different problems can produce similar symptoms, which is why a careful diagnosis matters so much.

Whether your treatment ultimately involves an oral appliance, physical therapy, sleep evaluation, stress management, medication, orthodontics, surgery, or a combination of approaches, the first goal should be understanding why you're having symptoms.

An informed patient is in a much better position to ask good questions and make good decisions.

I'd be interested to hear your experience.

What has been the most confusing part of your TMD journey?

Below is the address of a study published in Cranio, a dental publication. Yes, it's difficult to read, but it outlines rules for proper TMD diagnosis that somewhat dismiss the importance of how the teeth fit together.

Since, you, the members of r/TMDnotTMJ are the ones who are suffering, it would be interesting and important to get your feedback as to how TMD treatment is explained in the article. It's what the dental profession is arguing about.

Please do your best to read and then comment your personal experiences and thoughts,

https://www.tandfonline.com/doi/epdf/10.1080/08869634.2024.2405298?needAccess=true&fbclid=IwY2xjawTW2LRleHRuA2FlbQIxMABicmlkETE4c0ZscmRYcE5JMkVsTVh5c3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHl_53V5sDR-IdPK3L6FNBeAaHzE4wo1_MlnIveO6OcF2X1-PXupp5JqS1Yei_aem_hz7_Qal_9OeSJhk6SDeK7g

Learning to diagnose and treat TMD is, in many ways, a heuristic journey. A heuristic is a practical method of learning through observation, experience, careful testing, and problem-solving when all the answers are not yet known. If clinicians waited for perfect scientific proof before helping every TMD patient, many patients would continue to suffer while the research slowly caught up. Progress in medicine and dentistry has always depended on thoughtful clinicians who observed, questioned, tested their ideas responsibly, learned from their results, and shared what they discovered. Good science and good clinical experience should work together—not compete with each other. Clinical experience generates questions, scientific research tests those questions, and together they move patient care forward.

Learning to diagnose and treat TMD is, in many ways, a heuristic journey. A heuristic is a practical method of learning through observation, experience, careful testing, and problem-solving when all the answers are not yet known. If clinicians waited for perfect scientific proof before helping every TMD patient, many patients would continue to suffer while the research slowly caught up. Progress in medicine and dentistry has always depended on thoughtful clinicians who observed, questioned, tested their ideas responsibly, learned from their results, and shared what they discovered. Good science and good clinical experience should work together—not compete with each other. Clinical experience generates questions, scientific research tests those questions, and together they move patient care forward.

Not ear pain, not ringing, just an ear canal that constantly itched, even though your doctor said your ears looked perfectly normal.

I've had patients mention this over the years, along with fullness, pressure, or a "something is in my ear" feeling.

I'm curious...

Did anyone else experience itchy ears before or during their TMD journey?

If so, did treating your TMD make any difference?

My TMJ pain is getting worse. I wear a mouth guard at night but since I have had a cpap, my teeth grinding is almost non existent. I have extremely loud popping and crunching sounds that others can hear sitting close to me when I open my mouth. I saw my pcp and she sent me for a jaw mri which I am waiting for the results of. The entire right side of my face and jaw area, temple , ear and sometime my throat hurt. I get a headache if I eat chewy foods or talk too much. The scariest thing yet is a couple of weeks ago my husband face barely brushed against my face and it set off excruciating pain in my right ear. It lasted about 30 seconds and scared us both to death. The pain was a 9 or 10. I had something similar happen a month ago when I was mowing the yard and I started having pain shooting through my ear and temple on the right side. When I took the goggles off the pain subsided. That pain was about a 7. My pcp mentioned the trigeminal nerve possibly being irritated. I have PsA/psoriatic arthritis which I know can affect the jaw. Has anyone with TMJ developed TN symptoms?

For those who have been diagnosed with ICR, here is a point of discussion. Idiopathic means the cause is unknown, but what if the cause is simply not recognized due to lack of training?

>

For those who have been diagnosed with ICR, here is a point of discussion. Idiopathic means the cause is unknown, but what if the cause is simply not recognized due to lack of training?

>

Yes. This can be a complicated issue to wrap your head around, so think of your upper and lower jaws like a door and its door frame.

The upper jaw is the fixed door frame, or jamb. The lower jaw is the door that must fit into that frame. Now add the hinges—the jaw joints.

The hinges on a normal door are fixed in place. But the TMJ is different. Its "hinges" are movable. The lower jaw can change position within the joint sockets, especially when there is disc displacement, inflammation, swelling, adhesions, or changes to the joint structures.

Now imagine what happens if you move the hinges on a door. The door may no longer fit the frame correctly. It may hit in one place and leave a gap in another.

The same thing can happen with your bite. If the position of the lower jaw changes because of changes within one or both jaw joints, the teeth may no longer fit together as they once did.

This is why a patient who says, "My bite has changed," should never simply be dismissed. The bite may be giving us an important clue about what is happening within the joints.

And this is why caution is needed before permanently moving teeth with orthodontics when the bite has recently changed. The first question should be: Why did the bite change, and are the jaw joints now stable?

Think of it this way: Before permanently altering the door to fit the frame, first make sure the hinges are stable and in the right position.

Yes. This can be a complicated issue to wrap your head around, so think of your upper and lower jaws like a door and its door frame.

The upper jaw is the fixed door frame, or jamb. The lower jaw is the door that must fit into that frame. Now add the hinges—the jaw joints.

The hinges on a normal door are fixed in place. But the TMJ is different. Its "hinges" are movable. The lower jaw can change position within the joint sockets, especially when there is disc displacement, inflammation, swelling, adhesions, or changes to the joint structures.

Now imagine what happens if you move the hinges on a door. The door may no longer fit the frame correctly. It may hit in one place and leave a gap in another.

The same thing can happen with your bite. If the position of the lower jaw changes because of changes within one or both jaw joints, the teeth may no longer fit together as they once did.

This is why a patient who says, "My bite has changed," should never simply be dismissed. The bite may be giving us an important clue about what is happening within the joints.

And this is why caution is needed before permanently moving teeth with orthodontics when the bite has recently changed. The first question should be: Why did the bite change, and are the jaw joints now stable?

Think of it this way: Before permanently altering the door to fit the frame, first make sure the hinges are stable and in the right position.

Yes. This can be a complicated issue to wrap your head around, so think of your upper and lower jaws like a door and its door frame.

The upper jaw is the fixed door frame, or jamb. The lower jaw is the door that must fit into that frame. Now add the hinges—the jaw joints.

The hinges on a normal door are fixed in place. But the TMJ is different. Its "hinges" are movable. The lower jaw can change position within the joint sockets, especially when there is disc displacement, inflammation, swelling, adhesions, or changes to the joint structures.

Now imagine what happens if you move the hinges on a door. The door may no longer fit the frame correctly. It may hit in one place and leave a gap in another.

The same thing can happen with your bite. If the position of the lower jaw changes because of changes within one or both jaw joints, the teeth may no longer fit together as they once did.

This is why a patient who says, "My bite has changed," should never simply be dismissed. The bite may be giving us an important clue about what is happening within the joints.

And this is why caution is needed before permanently moving teeth with orthodontics when the bite has recently changed. The first question should be: Why did the bite change, and are the jaw joints now stable?

Think of it this way: Before permanently altering the door to fit the frame, first make sure the hinges are stable and in the right position.

https://reddit.com/link/1uq61l4/video/5guv711f3vbh1/player

This is a simple demonstration of how an orthotic can help those who have a compressed TMJ. Pause the video each time it changes. The first image is a normal joint and normal disc. Second is a compressed joint, which displaces the disc. Third is orthotic in place, which decompresses the joint.

Yes. The jaw, head, and neck function as a connected system. When the jaw is strained, the neck muscles often work harder to stabilize the head and maintain posture.

Many patients with TMD report chronic neck tightness, stiffness, or pain. While neck pain can have many causes, jaw dysfunction is frequently overlooked as a contributing factor.

Related Topics:
Posture
Muscle Dysfunction
Head and Neck Connection

Book Reference:
Chapter 7 TMJ Trifecta

Yes. Overworked jaw muscles can refer pain into the temples, forehead, behind the eyes, and the sides of the head. Many patients with chronic headaches are surprised to learn that their jaw system may be contributing to their symptoms.

Not every headache is caused by TMD, but the jaw should always be considered as part of a thorough evaluation.

Related Topics:
Muscle Pain
Migraine Confusion
Referred Pain

Book Reference:
Chapter 6

A night guard is designed primarily to protect teeth from wear. Most are not designed to diagnose or correct the underlying cause of TMD symptoms.

If the jaw joints, muscles, and bite remain unbalanced, simply placing plastic between the teeth may not relieve symptoms. Success depends on proper diagnosis and selecting the right appliance for the right patient.

Related Topics:
Orthotics
Night Guards
Diagnosis

Book Reference:
Chapter 8 TMJ Trifecta