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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.

OPPERA - A Game Changer

  • Oct 27, 2016

The  Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study is the long-range comprehensive study of 3,200 volunteers 18 to 44 years old who were free of TMD at the outset but some of whom developed TMD in the course of the years of the study. There is also a subset of patients who had already been diagnosed with TMD who are being followed. Now we are excited to report that the first papers analyzing the wealth of data that has accumulated have just been published as a supplement to the November issue of the Journal of Pain.

The key findings are:

  1. In women, the risk for chronic TMD increases between the ages of 18 and 44, the range evaluated in the study. In young men (ages 18-44), age was unrelated to TMD incidence.
  2. Unlike other chronic pain conditions, chronic TMD incidence does not correlate with low socio-economic status.
  3. Chronic TMD seems to be associated with alterations in some parts of the nervous system that control pain perception.
  4. TMD patients frequently experience many more chronic pain conditions, such as lower back pain, headaches, and fibromyalgia. Evidence of abnormal jaw function associated with teeth grinding and clenching was also observed.

The papers nail down in no uncertain terms the complexity of TM Disorders and what factors may make some people more susceptible. The findings will go far to include TMJ patients in the medical disciplines and eliminate the stigma patients experience when they seek care from them and it will be a wake-up call to the dental community to re-evaluate the ethics and scientific bases of current practices.

Dr. William Maixner, the Director of the Center for Neurosensory Disorders at the University of North Carolina, and a member of TMJA’s Scientific Advisory Board, is the Principal Investigator of this multimillion dollar study which was funded by the National Institute of Dental and Craniofacial Research (NIDCR).

NIDCR grant administrator, Dr. John Kusiak stated in a National Institutes of Health radio clip regarding the OPPERA findings "There are, we believe anyway, a fair number of subjects that not only have just TMJD but also other chronic pain conditions like fibromylgia, chronic fatigue syndrome, irritable bowel syndrome, and it would be really important to try to identify the specific risk factors for those individuals as well." Dr. Maixner stated in the NIH radio clip there is no single risk factor for TMJD. "The notion that we are dealing with just the head and neck oral-facial condition I think is being laid to rest...it is becoming clearer and clearer through research that TMJD should be looked at with a global view...This is really a condition associated with a constellation of conditions that impact almost every region of the body in one way or another."

Dr. Samuel Dworkin, Guest Editor of the Journal of Pain special issue, has provide comments and a summary of the 8 papers for TMJ News Bites and we appreciate his help.

As an organization that has long advocated for scientific research to understand Temporomandibular Disorders in all their complexity and develop treatments that work and don’t harm patients, we congratulate Dr. Maixner and his colleagues for conducting this elegant study. We are grateful also to the National Institute of Dental and Craniofacial Research for supporting the study in every way. On behalf of the millions of TMJ patients, thank you!

TMJ Disorders

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In Treating TMJ

To view or order a free booklet about TMJ Disorders, visit the National Institutes of Health website.

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
National Institutes of Health
National Institute of Dental and Craniofacial Research
Office of Research on Women's Health