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1. TMJ problems are not uncommon. The first step here, once you rule out obvious causes, is to see a general dentist and not an oral surgeon. If the general dentist indicate that this is not a dental issue, then I will proceed with further evaluation.

2. MRI I believe is the best imaging modality to look at TMJ. X-rays may show arthritis or dental issues but MRI will give you the best detail.

3. TMJ problems often can be solved once the cause is identified and treated. Treatment include self care activities such as eating soft food, avoiding chewing gum, exercise, relaxation, use of splint, and medications. I have not found physical therapy to be helpful with treatment of TMJ.

4. Surgery should be avoided if possible. Always ask for MRI first especially if surgery is being considered. No one I believe should be operated on without having an MRI first. Also, find another independent oral surgeon yourself in another town or preferably at a university setting to get a second opinion if surgery is being considered.

5. If still not sure, see a rheumatologist who can do the work-up for you and make a proper referral if needed.