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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.

Agency for Healthcare Research and Quality Report on TMJ Disorders

  • Apr 3, 2015

The Agency for Healthcare Research and Quality (AHRQ) contracted with The Lewin Group to conduct a study of the per-patient cost and efficacy/effectiveness of treatment for TMJ.

This study was carried out at the request of the Senate Appropriations Committee to further clarify the TMJ issue and to follow-up on relevant developments since the 1996 NIH Technology Assessment Conference.

The report prepared by the Lewin Group, April 30, 2001, confirms certain findings of the 1996 NIH Technology Assessment Conference and of certain other reviews of this subject. Their findings reinforce previous conclusions that few randomized clinical trials or other types of rigorous studies exist for determining the effectiveness of treatments for TMJ.

Published reports of clinical research on TMJ consist primarily of non-randomized uncontrolled trials, case series, case reports, and anecdotal descriptions of treatment techniques. Among the factors affecting the body of evidence on TMJ treatments are insufficient understanding or consensus regarding the etiology, course of disease, and diagnosis of TMJ. This report is available below:

Another study, conducted by the Emergency Care Research Institute (ECRI), a nonprofit Pennsylvania organization, found that most treatments for TMJ disorders lack sound research support for the surgeries, injections, splints, and other procedures for joint problems which TMJ patients undergo each year.

“The available evidence suggests that approximately half of the patients who initially develop TMD symptoms will experience significant improvement or spontaneous resolution of their symptoms within a period of weeks or months,” ECRI researchers concluded. “Although noninvasive procedures may provide an additional benefit for some patients, the evidence of benefit for splint therapy is weak.” The institute, formerly an emergency medicine research agency, has since the 1970s served as an independent organization committed to advancing the quality of health care.

The ECRI study found these conclusions:

  • Roughly half the patients with disc displacement without reduction in clinical trials of splints will improve within weeks or months without treatment.
  • Stabilization splints appear to provide little if any additional benefit over no treatment for patients with disc displacement without reduction.
  • Available evidence fails to address whether stabilization splints provide benefit to patients with disc displacement with reduction. Only one clinical trial was available.
  • In general, patients with disc displacement with reduction might benefit from arthroscopy (closed-joint surgery using a small incision).
  • There is insufficient evidence to determine whether patients with disc displacement with reduction will benefit from disc repair and repositioning procedures.
  • In general, patients with disc displacement without reduction benefit from arthroscopy and will benefit from arthrocentesis (a relatively noninvasive procedure using hypodermic needles to irrigate the joint).
  • In general, patients with disc displacement without reduction might benefit from disc repair and surgical repositioning procedures. The small number of studies made it difficult to determine statistical significance.

The ECRI Technology Assessment Report “Temporomandibular Articular Disorders: Selected Treatments” is available for purchase from ECRI at 5200 Butler Pike, Plymouth Meeting, PA 19462-1298. Telephone: (610) 825-6000. Unfortunately the ECRI report is very costly to obtain, costing several thousands of dollars.

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.

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National Institutes of Health
National Institute of Dental and Craniofacial Research
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