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New Report on Temporomandibular Disorders: Priorities for Research and Care

Over a year and half ago, the National Academy of Medicine (NAM) began the most comprehensive study ever undertaken on Temporomandibular Disorders (TMD). The study assessed the current state of TMD research, education and training, the safety and efficacy of clinical treatments, and associated burden and costs.

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.

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.

Intimacy & TMJ Disorders

  • Jan 27, 2017

One of our readers recently brought to our attention a topic that arises occasionally from other TMD patients and we might add, their significant others—intimacy.

"Hi TMJA, I'm a big fan of your website and newsletters and have found both helpful and reassuring. I wonder if you could include something in a future newsletter about the romantic/sexual side effects of TMD which I feel aren't talked about much but are pretty relevant.

All the doctors I've seen about my jaw are older men, and as a young woman I'm not dying to talk about this aspect of it with them, but I would appreciate some acknowledgement of this impact. My case is minor, but at the same time I haven't open-mouth kissed my fiancé in about five years, let alone dreamed of performing oral sex. Anyway, I just thought this might be an issue people enjoy reading about since (at least for my relatively minor case at this point) it's one of the bigger consequences of TMD. Thanks for your consideration and all the work you're doing!"

In response to this question we asked our readers in our August 2013 issue of TMJ News Bites to submit their comments on this topic. The following are the comments we received:  

"I'm glad someone has brought this up and I look forward to what other readers have to say. I have had TMJ for over 25 years and have learned to manage it and live with it. I does affect my intimacy with my husband though. He is always very understanding but I feel bad sometimes though for not being able to do somethings with him. I cannot open mouth kiss very often or do oral. I try from time to time but usually pay the price later with a lot of pain. I also have endometriosis intercourse in painful sometimes as well. We have a very strong relationship but we both wish that our intimacy was not so painful for me."

"As a dental student in Scotland some 50 years ago I remember my professor telling the class that TMJ problems were found in young ladies who indulged in oral sex!"

"When I was a younger dentist I shied away from this subject when dealing with female patients but as matured I realised that it was important that patients understood the connection. I would  explain that any action that required the mouth to be wide open for any length of time ,such as kissing or a long visit to the dentist or dental hygienist, could aggravate the TMJ symptoms and hope that they would be able to make the connection with oral sex."

"Yes--I experience the same problems!!"

"41 yr old female with TMD who would never mention this to a physician--or anyone other than my spouse! But definitely appreciate knowing I am not the only one that struggles in this area!!!
Just another issue on a long list of the daily effects of living with a problem that is considered "minor" or even imagined to some in the medical field. Thanks so much!"

"I agree this is a very awkward subject to discuss but now that it's out there........I must say. Intimacy, when one has TMD is of the heart. It is most difficult enough without spousal and/or family support, esp. when it gets really bad. I have been married for 28 yrs with the last 13 yrs being extremely trying. On good days, I can eat yogurt, ice cream, oatmeal, etc. I am fortunate to kiss with a soft peck, as long as I can lift my head or if my husband squats down a bit. Forgot any other ideas. I do have additional complications with my low back, shoulders, etc. which eliminates intercourse. I feel very lucky, although I miss & long for the good old days. I do note that my head & body are not on the same playing field until I try to maneuver a situation. Then reality sets in. My husband says he is all good but I wonder."

"I read the TMJA's News Bites with excitement every time I see in it my e-mail inbox! It is so refreshing to hear stories about other people's experiences with TMD and stay abreast of current research. I was especially happy to see a brave reference to the intimate effects of TMD!"

"I am a 30 year old woman and I have had TMD since my freshman year in college. I have always had the issue of intimacy and TMD on my mind, but have never been able to express myself to my doctors who were all older men. Part of me knew the only advice a doctor could give is that oral sex should be limited because rest is an important part of pain management. However, I believe the intimate side effects should be discussed with patients. They can have a huge impact on a relationship and as a woman, it especially hard to make the right choices when society has told us that it is sexy to acquiesce.I had one relationship in particular that occurred simultaneously with the worst pain I have every experience from my TMD. I regularly preformed oral sex on my boyfriend, only thinking of the moment, and not the consequences. Young people are not the best decision makers, and I lacked the foresight about how my actions would impact my long term recovery and pain. I wish a doctor had mentioned the obvious. Then at least I could have told my boyfriend, "my doctor told me not to." This could have effectively ended the pressure that my caring, but young and horny boyfriend was putting on me. My jaw locked open one evening and that was enough to scare us both away from indulging in that way sexually (me more than him). TMD has effected more than my ability to perform oral sex. I also cannot sustain an open mouth kiss with my husband for more than a few seconds. When I am reaching orgasm I have to be mindful I am not opening my mouth too wide (I would really rather just enjoy the moment). He also gets very little traditional oral sex. But the worst of all is that after a long day of talking, I often cannot engage in conversation with my husband because my jaw begins to click loudly in my ear in the evenings. That makes me the saddest - the lost conversations. Having had TMD through my formidable years, I have come up with my own technique to pleasuring my husband orally. It helps that I am 100% honest with him about the needs of my jaw, and we have both agreed to put those needs before his sexual needs. My advice for people facing the intimate consequences of TMD is to be honest with your partner, and prioritize your jaw health above the needs and desires of your partner. Then the fun part of figuring out how to pleasure your partner without hurting yourself comes in. That takes lots and lots of practice! Thank you for including this topic in your newsletter! I can't wait to read other people's experiences and thoughts on this issue!"

"Well finally this subject is being broached! I think I have been at both ends of the gamut here.  I have been in very severe states with my TMJ…to the degree that I couldn’t even lie flat on my back to sleep, let alone lay down for anything else.  I have been in situations where the “jarring impact” of sex affected my jaw so much that I couldn’t have sex for a period of time.  Oral sex was completely out of the question…as was any form of kissing…because at any given moment my jaw would just get stuck!  Eventually it got to the point where I had ZERO level of intimacy with the person that I had been involved with for five years.  (I later discovered that I simply didn’t want to be “involved” whatsoever with him…but that is a whole n’other story for a different time!)  Bring you to the present day, and life right now is not nearly as bad.  The partner I am with has learned to kiss me gently (even open-mouthed)…the only rule I have is that he can’t “GRAB” my face while kissing me (any pressure on the jaw just hurts)…our sex life is great, there as well we go about as however we want, but if my jaw starts to tweak out on me, all I have to say is “jaw” and he will be gentler.  And lastly, oral sex, honest to goodness, I am now of the belief that oral sex is actually good for my TMJ!!!  The running joke between my partner and I now is, when my jaw is hurting, he will say “it must be time for more oral sex”…because I really do believe that the act of oral sex actually helps stretch and strengthen and ultimately relaxes my jaw muscles!  It’s the most bizarre concept, I know…but if I can catch the pain early on…this “act” seems to improve my level of pain rather than increase it! 
In conclusion, for me, all is good in this department for now…despite having very serious TMJ problems…so I am very happy!  But I certainly have experienced the other extreme…where I went through a horrible period of time with it and really thought that I might never experience intimacy again."

"Thank you for agreeing to publish information about sexual limitations with TMJ.  Oral sex with my husband is very painful for my jaw after about three minutes, which is very frustrating for both of us. I would like to know how other TMJ sufferers are handling this, or at least see something published so that I can prove to him that I'm not the only one and I'm not just being "lazy"!"

"This is one of the issue's I encountered and thought I was the only one!  I never talked about it. I could not kiss my husband more than a "peck"!  It was devastating to our sex life! On top of all the pain, inability to eat, laugh, talk etc… this was another horrible impact. I'm better now, but my discomfort lasted almost a year! Thanks for bringing this up!"

"Hi, I read this particular message with tears in my eyes. I am a TMJ replacement patient & have suffered chronically for the last 8 years or so but have had the condition since a year after my middle child was born 22 years ago. Unfortunately my replacements have not solved anything & if anything else, my pain is worse than ever. This lady touches on what I consider a big problem in TMJ sufferers & I know this has seriously affected my personal & intimate relationships resulting in a divorce & now with my long term partner, who I have to say is an absolute angel with the patience of a saint. I have had problems making love with him as no position is pain free & causes terrible pressure in my head, my partner is considerate enough to not put any pressure on me but I get so angry & frustrated (not sexually) by it all. I cannot remember the last time I was able to kiss him passionately or give oral sex. I suffer with terrible depression & have suicidal thoughts just about every day. My doctors ask me to talk to them but being unable to see the same doctor twice & with such little knowledge or understanding of TMJ & its 'side effects' it is difficult to talk to them & i see their eyes wander to the computer & start tapping away.....what a conversational put off!! I did have a councilor who was a little more understanding.....until it came to the physical side of my relationship with my partner & I have now been referred to a psychiatrist......I'm not sure if this was a brush off or was done with the best of intentions.I would like it made compulsory for doctors & dentists to be made aware of TMJ & some of the terrible side effects or leaflets made available to them. It's harder being in the UK as even less research is being done & we have no-one at all to talk to or ask for help & no UK website either & if the initials TMJ are mentioned the usual answer is "what's TMJ?" & so the same vicious circle begins again.I hope I haven't bored you too much.....wouldn't want you yawning lol.Thank you for listening."

"My TMD has greatly impacted my romantic life. Make out sessions are reduced to almost and oral sex is out if the question. When my jaw tries to lock up, the first thing my body wants it to do is snap shut. Pretty sure that wouldn't end well."

"I am so glad that someone took the time to write about this topic. TMJD really does change a relationship both physically and emotionally. It is nice to not feel alone and be able to openly discuss issues like this that are so personal. I have a very understanding husband, but I know I feel like less of a wife at times when I can't do things that you should be able to do with the one you love." 

"I am very glad that this point will be addressed!  I’ve found that my TMJ pain also interferes with far more than just eating. I find myself being limited in the amount of time my boyfriend and I can spend kissing, which always ends up being a buzzkill. Not only does the pain force me to stop, but he can hear my jaw popping and it ruins the mood. Regarding oral sex, it’s not something I’m willing to give up so I find myself suffering through it and suffering through the worsened pain for the next few days. I feel like it is damaging my jaw more in the long run by continuing this, but I’d hate for a joint to hold me back in areas of intimacy.  I would greatly appreciate any help with this issue I can get. Thanks!"

"I seem to remember the intimacy issue being brought up in open discussion at the Natcher Auditorium conference some years back, and quietly acknowledged as being a significant issue. Years earlier, on one of the editions of Saturday Night Live! , comedian Jane Curtin did a skit with one of the guys—threatening “no more fellatio”….. On the more serious side, you also do know there have been some serious remarks/publications “blaming the victim”  by saying promiscuity-associated introduction of Chlamydia microbes to the jaw joint were responsible for painful symptoms in the first place…..   unlikely, but proposed …a whole lot to be discussed here…".

"It is important to discuss the issues TMJ sufferers have with intimate activity. It hurts to kiss my husband if he puts any pressure against my mouth. I can gently kiss him open mouthed, but my opening is limited. We can do nothing passionate or aggressive in our kissing. Also, oral sex is impossible, since keeping my mouth open for a while is painful. I had a problem with keeping my mouth open for an MRI on my jaw."

"Since myofascial pain is comorbid with (likely caused by) my TMD, I am unable to become aroused at all. I have become all but asexual. Because I have now developed (in the last three or four months) a much higher sensitivity to pain, the smallest, child-sized scapula that my OBGYN used for my recent PAP test hurt a lot, so you can probably imagine how much worse it feels to have anything larger than that put in there.  I have also been having extremely painful periods. I have had a pelvic ultrasound, and everything has come back clean. I showed my OBGYN the recent research from Iran about a possible link between too-low levels of progesterone and TMD, and while he said they can't test hormone levels for normalcy in just one person (apparently, medicine is even less advanced than I had already understood), I could try birth control pills. I have researched and found that the pill will either make me feel a whole lot worse or somewhat better based on what other TMD sufferers have reported.  I hope it is the latter, and I also hope it will bring back at least the simplest kind of sex into my life -- my husband has been so patient, and I really miss it, too."

"It is real difficult to give oral sex it makes your jaw throb like crazy and you forget that it is supposed to help turn you on by doing it and all you can feel is pain and want it to be over ASAP."

TMJ Disorders


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