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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.

When It Hurts to Chew

  • Dec 21, 2017

As many TMD patients know, it often hurts to bite down hard on foods, so they resort to a soft diet and less strenuous bite forces when their TMD pain kicks in. Now, a team of investigators led by Dr. Wolfgang Liedtke at Duke University Medical Center in Durham, NC have taken advantage of that observation to detail changes in the brain that can account for that reduced biting force.

Using a mouse model, they injected a chemical compound into the TM joint that is well known to generate joint inflammation and associated pain. The animals were then injected with either an NSAID or a TRPV4 inhibitor. Dr. Liedtke suspected that the protein, TRPV4, found on the surface of sensory nerve cells in the trigeminal ganglion of the brain (which supplies the TM joint) might be critical. He had discovered the protein in the year 2000 and noted its involvement in response to mechanical stimulation and also in response to pain and inflammation.

TRPV4 is an ion channel, which, when activated, allows calcium to enter a nerve cell, exciting it to fire an electric charge. It turns out that in response to joint inflammation and pain, not only was there increased expression of the TRPV4 ion channels on sensory neurons in the brain in parallel with the severity of inflammation and pain, but when the mice were tested using a bite force measuring apparatus, they showed a reduction in bite force in comparison with controls.

In contrast, when the mice were injected with an agent that blocked TRPV4 ion channels, the biting forces returned to more normal levels. As a further test of the key role of the TRPV4 channel, the Duke team tested mice genetically engineered to lack the gene (called TRPV4) that codes for the protein. These mice also were resistant to the effects of TM inflammation on bite force. The researchers also determined that the presence of TRPV4 had the effect of re-programming the trigeminal ganglion to be more “pro-pain” and also acted as a “switch-on”mechanism in pain-sensing neurons in the ganglion.

The bottom line is that the TRPV4 protein appears to be an attractive target for the development of new drugs to treat TMD.

Source: Chen Y, Williams SH, McNulty AL, Hong JH, Lee SH, Rothfusz NE, Parekh PK, Moore C, Gereau RW 4th, Taylor AB, Wang F, Guilak F, Liedtke W., Temporomandibular joint pain: A critical role for TRPV4 in the trigeminal ganglion, Pain.2013 Aug;154(8):1295-304.

TMJ Disorders

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