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Metal Implants and Dental Amalgam: The FDA Announces Public Meeting and Paper

The U.S. Food and Drug Administration (FDA) announced a paper on metal-containing implants and a panel meeting as part of ongoing efforts to evaluate materials in medical devices to address potential safety questions.

Drug Induced Bruxism

The authors of this article state that orofacial movement disorders (bruxism) are treated typically by dental professionals and not by those specialists (neurologists) researching and treating the other movement disorders (Parkinson's disease, Huntington's disease, tremors, etc.). Again, this is more evidence of the complexity of TMD and the need for multidisciplinary research and treatment in TMD.

Cervical Muscle Tenderness in Temporomandibular Disorders and Its Associations with Diagnosis, Disease-Related Outcomes, and Comorbid Pain Conditions

To analyze cervical tenderness scores (CTS) in patients with various temporomandibular disorders (TMD) and in controls and to examine associations of CTS with demographic and clinical parameters.

You, Your Esophagus and TMD

The esophagus is a roughly ten-inch hollow tube that descends from your throat through the diaphragm into the stomach. Normally, it is a one-way street transporting food you swallow to the stomach for digestion. But in GERD— Gastroesophageal Reflux Disease— the flow can reverse so that stomach contents (including gastric acids) are regurgitated upwards to cause a burning sensation (heartburn), nausea, pain and other distressing symptoms.

It's Time to Be Part of the Solution

The National Academy of Medicine (NAM) Study on Temporomandibular Disorders (TMD) is well underway. We strongly encourage everyone affected by TMD to write to the NAM committee letting them know what it is like to live with TMD and your experiences with getting care.

DIAGNOSING YOUR TMD

  • Jul 11, 2019

To aid health care providers, the The American Association for Dental Research recommends that a diagnosis of TMD or related orofacial pain conditions should be based primarily on information obtained from the patient’s history and a clinical examination of the head and neck. They may note, for example, whether patients experience pain when mild pressure is applied to the joint itself or to the chewing muscles. The patient’s medical history should not be restricted to the dentition (the teeth and their arrangement) or to the head and neck, but instead should be a complete medical record, which may reveal that the patient is also experiencing one or more of the comorbid conditions found to occur frequently in TMD patients. Blood tests are sometimes recommended to rule out possible medical conditions as a cause of the problem. Before undergoing any costly diagnostic test, it is always wise to get an independent opinion from another health care provider of your choice (one who is not associated with your current provider).

In addition to a detailed history and careful clinical examination, imaging studies of the teeth and jaws may sometimes be helpful as a diagnostic tool. These include:

  • Routine Dental X-rays and Panoramic Radiographs. These show the teeth and provide a screening view of the bony structures of the TM joint.
  • Computed Tomography (CT or CAT scan). This provides greater detail of the bone but a somewhat limited view of the disc and soft tissues. It is indicated when a screening radiograph of the TM joint shows some bony changes. More info on CT scans by FDA.
  • Magnetic Resonance Imaging (MRI). This provides images of the disc as well as the muscles and other soft tissues surrounding the joint.
  • Scintigraphy (Bone scan). This involves the injection of a radioactive substance that is absorbed by the bone cells and shows whether a pathologic process is in an active or inactive state.

As a patient, you should discuss your concerns with your primary care physician or internist to help rule out any other conditions which could be causing  symptoms as well as to help get your pain under control.

Articles of Interest

Conditions Which May Produce Similar Signs and Symptoms as TMJ Disorders

Conditions that may produce similar signs and symptoms as TMJ disorders (pain and/or jaw dysfunction) and can lead to misdiagnosis include:

  • Atypical (vascular) neuralgia.

  • Hypo- and hyperkinesia (abnormal jaw movements).

  • Giant cell arteritis.

  • Lyme disease.

  • Myositis (muscle inflammation).

  • Myositis ossificans (calcification in a muscle).

  • Otitis (earache).

  • Parotitis (salivary gland inflammation).

  • Scleroderma (chronic hardening of the skin).

  • Sinusitis.

  • Temporal arteritis (inflammation of the temporal artery).

  • Toothache.

  • Trigeminal neuralgia.

  • Trotter's syndrome (nasopharyngeal carcinoma).