TMJ MRI (Temporomandibular Joint):what to expect

Your doctor or dentist may recommend a TMJ MRI to look closely at the jaw joints, especially if you have:

• Persistent jaw pain or tenderness around the ears.
• Clicking, popping, or grinding sounds when you open or close your mouth.
• Difficulty opening your mouth wide, or your jaw getting stuck (locked).
• Headaches or facial pain that may be coming from the jaw.
• A history of jaw injury or trauma.
• A planned dental or orthodontic procedure that needs joint assessment.
• Suspected arthritis, infection, or a tumor involving the joint.

A TMJ MRI helps doctors visualize:

• The cartilage disc inside each joint and how it moves when you open and close your mouth.
• The bones forming the joint (the lower jaw and the base of the skull).
• The muscles, ligaments, and surrounding soft tissues.

It is particularly useful for identifying:

• A displaced or torn cartilage disc — the most common cause of clicking and locking.
• Joint inflammation, fluid build-up, or infection.
• Arthritis affecting the jaw joint.
• Damage from trauma, including small fractures or soft tissue injury.
• Tumors or cysts involving the joint or nearby tissues.

Usually no. A standard TMJ MRI for jaw clicking or pain does not require contrast dye. Gadolinium may be used in specific situations, such as suspected infection, inflammation that has not responded to treatment, or a possible tumor. If you have known kidney problems or contrast allergies, mention them before the scan.

Dentures should be removed before the scan — they can move during imaging and may also contain small metal parts. Removable retainers usually need to come out for the same reason. Fixed braces are more complicated: they are generally MRI-safe but can distort the images near the teeth and jaw. The team will assess whether the distortion is acceptable for the question being asked, or whether your orthodontist needs to temporarily remove a wire. Mention any dental work when you book the appointment so this can be planned in advance.

In most cases, no special preparation is needed. However:

• Remove all jewelry, earrings, hairpins, and dentures before the scan.
• Inform your radiographer if you have any dental implants, braces, retainers, or metal in your face or skull.
• You can eat, drink, and take your usual medications normally before the scan.

Most fixed dental work (such as fillings or crowns) is safe in the MRI but may cause small image distortions near the teeth. Braces and retainers may need to be removed if possible — your radiographer will advise.

The scan is painless. You will lie flat on your back on a padded table that slides slowly into the MRI scanner. A small device called a coil will be placed on each side of your face, near the jaw, to capture clearer images.

You will hear loud knocking and humming sounds, and earplugs or headphones will be provided. The radiographer will be in contact with you throughout the scan.

During the scan, you will be asked to open and close your mouth several times so that the radiographer can capture images of the joints in different positions. A small mouth-opening device may be placed between your teeth to hold the mouth open during certain sequences.

The scan usually takes 25 to 40 minutes. Imaging both joints in open- and closed-mouth positions takes longer than a single-position study.

The cartilage disc inside the TMJ moves every time you open and close your mouth. Many disc problems only show up in one position — for example, a displaced disc might slip into place when the mouth is open but be out of position when the mouth is closed. By imaging both positions, the radiologist can see how the disc moves and confirm exactly what is happening inside the joint.

It is normal to feel anxious. The radiographer will speak to you between sequences, and you will hold a squeeze ball to alert them if you need a break. If you are very claustrophobic, you can ask your doctor about a mild sedative or check if a wider-bore or open MRI machine is available at your center.

After the scan, a Radiologist will review the images and prepare a report for your doctor or dentist. Results are typically ready within a few hours to one day, depending on the diagnostic center. Your doctor will discuss the findings and recommend next steps, which may include a bite splint, physiotherapy, medication, or referral to a maxillofacial specialist.

It depends on what is found and who referred you for the scan. If a dentist or maxillofacial specialist requested the scan, they will usually review the results with you. If the scan was ordered by your doctor or an ENT specialist, they will explain the findings and may refer you on to a maxillofacial specialist if treatment is needed. The radiologist's report is sent to whoever ordered the scan — so the person who handed you the request form is the right person to discuss the results with first.

Yes. MRI does not use radiation, making it safe for both adults and children. TMJ MRI is often the preferred scan for younger patients with jaw pain. Pregnant women should consult their doctor first; if contrast is required, it is usually avoided during pregnancy unless absolutely necessary.

• RadiologyInfo: Musculoskeletal MRI
• ACR Manual on MR Safety
• FDA: MRI benefits and risks

A TMJ MRI is a safe, painless, and highly detailed way to investigate the source of jaw pain, clicking, or locking. By revealing the position and condition of the cartilage disc inside the joint, it provides the answers that no other scan can — guiding your doctor or dentist toward the right treatment plan.