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Statement by NIDCR Acting Director on the National Academies of Sciences, Engineering, and Medicine Report on Temporomandibular Joint Disorders

I am pleased to announce the release of the National Academies of Sciences, Engineering, and Medicine (NASEM) report, Temporomandibular Disorders: Priorities for Research and Care. As underscored by the comprehensive report, temporomandibular joint disorders (TMJDs) are a diverse and still poorly understood set of complex, painful conditions affecting the jaw muscles and tissues, temporomandibular joints, and associated nerves. Clearly, there is much more to be understood, and these conditions continue to confound medical and dental health care providers and researchers.

New Report on Temporomandibular Disorders: Priorities for Research and Care

With support from the Office of the Director of the National Institutes of Health and the National Institute of Dental and Craniofacial Research, the National Academies of Sciences, Engineering, and Medicine appointed a committee to address the current state of knowledge regarding TMD research, education and training, safety and efficacy of clinical treatments, and associated burden and costs.

Have you seen the film Dark Waters?

The Film. Dark Waters is about attorney Robert Billott's real-life 20 year legal battle against DuPont chemical for releasing toxic waste - perfluorooctanoic acid, or PFOA - into Parkersburg, West Virginia's water supply, with devastating health effects on the townspeople and livestock. PFOA, also known as C8, is a man-made chemical. It is used in the process of making Teflon and similar chemicals known as fluorotelomers.

Online TMD Diet Diary Research Project

Online TMD Diet Diary Research Project The TMJ Association received the following request from Professor Justin Durham and his research team at Newcastle University. We encourage TMJ patients to participate in this project as it is an under researched

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.

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).