When it comes to guidance for making health care decisions the Cochrane Collaboration is an outstanding authority. The Collaboration is an international organization that aims to provide the highest quality evidence-based information to healthcare professionals and the public. Cochrane experts conduct systematic reviews of the scientific literature on a given topic by compiling, evaluating and summarizing research results. One recent review, " Interventions for treating osteoarthritis in the temporomandibular joint," is of particular interest to TMD patients.
Researchers from Cochrane’s Oral Health Group looked at available therapies to manage osteoarthritis (OA) of the TMJ, the most common form of arthritis affecting the jaw. Current treatments range from non-surgical options such as prescription drugs, warm or cold packs, occlusal splints, irrigation, and steroid injections, to surgical joint repair or replacement.
Unfortunately, the team found only three clinical treatment trials out of 460 published studies that met the rigorous criteria Cochrane employs. The trials measured a range of patient outcomes as a result of treatment, including reductions in pain and jaw sounds, improved jaw movements, overall quality of life and patient satisfaction. The authors found “weak evidence” showing that injections of sodium hyaluronate and betamethasone were equally effective in reducing pain and discomfort, as were the dietary supplement glucosamine compared with ibuprofen. Pain was similarly reduced in patients using occlusal devices compared to diclofenac sodium (an anti-inflammatory drug). In the conclusion, the researchers argued for better studies and a wider range of interventions for jaw osteoarthritis. They were also concerned that too many studies had mixed groups of patients: individuals with osteoarthritis, but also other TMJ disorders.