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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.

Can the Brain Make TMD Worse?

  • Dec 25, 2013

The chronic pain of Temporomandibular Disorders (TMD) can be debilitating and interfere significantly with daily life.

Physical pain, whether from TMD or another condition, may also trigger emotional stress that can exacerbate symptoms, causing elevated anxiety that further increases pain, only to create a positive feedback loop of more pain leading to more stress and more pain. This process has been described as “somatic amplification,” and may contribute to the hypersensitivity to pain that characterizes a newly described nervous system syndrome known as the Central Sensitization Syndrome (CSS). The condition provides a clinical model that is being used to test a new hypotheses about TMD. CSS is also being used to tie TMD to conditions such as chronic fatigue syndrome, lower back pain, and irritable bowel syndrome which are known to occur in TMD patients at a far greater frequency than would be expected by mere coincidence alone.

CSS was first used to describe the development of pain and symptoms including sleep disorders, diminished mental acuity, forgetfulness, and bowel disorders in patients with CFS or fibromyalgia. It is now being applied to other chronic conditions where pain is a prominent symptom, such as irritable bowel syndrome and vulvodynia. The biological mechanisms that underlie CSS symptoms have not been identified.

A recent study drew 250 acute TMD patients from dental clinics published in the journal Pain Practice confirms the importance of CSS in mediating pain in some TMD patients. Using diagnostic criteria that classifies TMD patients into three categories: Group I muscle disorders, Group II disc displacements; and Group III bone deficiencies, the researchers found that the patients with the most CSS symptoms were drawn from Group I (muscle disorders) or were individuals with more than one TMD diagnostic category. In addition, individuals with more than one TMD diagnosis had more symptoms of fibromyalgia, CFS and female pelvic pain. Interestingly, patients classified in the other two TMD diagnostic subgroups do not appear to be as strongly influenced by CSS.

These findings provide a foundation for future studies by basic researchers and clinicians aiming to understand the causes of TMD and develop more effective methods for the management and treatment. Finally, this report clearly adds support to the emerging evidence indicating altered central nervous system functions in pain pathways in individuals with TMD muscle disorders and co-morbid pain conditions.

Source: Lorduy, K. M., Liegey-Dougall, A., Haggard, R., Sanders, C. N. and Gatchel, R. J. (2013), The Prevalence of Comorbid Symptoms of Central Sensitization Syndrome Among Three Different Groups of Temporomandibular Disorder Patients. Pain Practice. doi: 10.1111/papr.12029

TMJ Disorders

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