First Visit

What to expect at 1st visit

Due to the complex nature of pain in the head and face, the initial examination and consultation visit at the Texas TMJ & Pain management is approximately 1-1.5 hours.

This time spent with Dr. Virk is necessary to accurately diagnose your pain and/or dysfunction concerns and develop the most appropriate course of treatment.

The initial visit serves three main purposes:

  1. Virk is able to gather the necessary information to make an accurate, informed diagnosis of your concern. 
  2. He is then able to provide you information as to the nature and cause of your pain and/or dysfunction concern, and
  3. develop the most appropriate treatment strategies.

The visit begins with a consultation to explore in detail the history of your pain and/or dysfunction concerns, review your general health history and body systems, evaluate your sleep history, review past medical and dental treatments, review previous and current medications, and a discussion of previous treatments for the current concern. 

This session is followed by a clinical evaluation.

The clinical evaluation:

Additionally, we do an oral status examination, a thorough muscle palpation of the head, neck and facial muscles and a sleep breathing disorder assessment. These examinations are necessary to determine the cause or source of the pain and suggest the most effective treatment protocols.  A CT or MRI and blood tests may also be ordered as part of this comprehensive evaluation. Diagnosis and treatment of orofacial pain and sleep apnea requires medical codes and is not covered by dental insurance.

The clinical evaluation usually includes:

  • evaluation of blood pressure, temperature and pulse
  • eye, ear, nose and throat exam
  • neurological screening
  • vascular assessment
  • muscle function, strength and tone evaluation
  • joint mobility assessment for the jaw and neck
  • muscle provocation test
  • evaluation of jaw joint sounds
  • Orthopedic TMJ evaluation
  • parafunctional habits evaluation
  • intraoral hard & soft tissue assessment, including an oral cancer screening
  • bite evaluation and functional analysis

The post examination consultation:

  • a discussion of normal anatomy and how it compares to your current condition
  • If indicated a discussion of further diagnostic testing such as radiological imaging (CBCT, MRI) or blood work etc.
  • appropriate treatment strategies and expectations including self-care modalities
  • a discussion of diagnosis, treatment options, including risks, benefits and alternatives
  • potential escalated treatment strategies, should they become necessary


Please remember to bring the following items with you:

  1. Your medical insurance card.
  2. An updated list of your current medications (including dose and frequency).
  3. Any important information regarding the condition we are seeing you for (lab results, imaging, sleep study results, etc.).
  4. Any oral appliances that you currently use or have stopped wearing.

We understand that people have busy lives and that chronic pain may affect you to varying degrees. If you should need to cancel or reschedule your visit with us, please do so 48 hours prior to your visit so that we may make your appointment available to someone else in need of care. Failure to provide a 48 hour notice will result in a late cancellation fee.

We encourage you to contact us at (817) 251-9985 or [email protected] if you have any questions, need more information regarding our services/treatments or want to make an appointment.

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9:00 am - 3:00 pm (administrative hours only)


8:00 AM-5:00 PM


8:00 AM- 5:00 PM


8:00 AM-5:00 PM


8:00 AM-5:00 PM


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