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TMJ RoundTable Update - June 2017

From the time of the June 16, 2016 meeting, until last month, progress has been slow. However, over the past couple of months we have the following accomplishments to share with you.

Pain Drawings: An Important Tool for Health Care Practitioners

Last year we shared with you a study in which investigators found patients with more severe and chronic TMD are likely to experience other persistent pain conditions in other parts of the body, seemingly unrelated to problems in the jaw or face. Yet patients often do not mention these "overlapping" or "comorbid" pain conditions when they see a dentist or health care provider.

Primary Temporomandibular Disorders and Comorbid Conditions

The aim of this study is to evaluate the distribution of the most common comorbid conditions associated with chronic temporomandibular disorders, and the pharmacological agents which play an integral role in the overall management of temporomandibular joint disorders. Abstract: INTROD

Overdiagnosis and Unnecessary Therapy

Many dental practitioners continue to use radiographic or magnetic resonance imaging (MRI) findings in the temporomandibular joint (TMJ) as the sole means of establishing that there is a pathology present that requires treatment.

TMD Self-Management Programs

Self-management (SM) programs in temporomandibular disease (TMD) are a core component of pain management of TMD throughout its course and are often given to patients as a first essential step after diagnosis.

WHO TREATS TMD?

  • Oct 26, 2016

If you think you have a TMJ disorder, you may want to see a medical doctor to rule out some of the conditions that may mimic a TM disorder. For example, facial pain can be a symptom of many conditions, such as sinus or ear infections, decayed or abscessed teeth, various types of headache, facial neuralgia (nerve-related facial pain), and even tumors. If the medical doctor or your dentist gives you a diagnosis of a TMD, it is recommended that you consult our treatment section for guidance.

There is no medical or dental specialty of qualified experts trained in the care and treatment of TMD patients. As a result, there are no established standards of care in clinical practice. Although a variety of health care providers advertise themselves as “TMJ specialists,” the more than 50 different treatments available today are based largely on beliefs, not on scientific evidence.  Sir William Osler, the father of modern medicine, said "that when there are many treatments for a single condition, it is because none of them work."

Because there is no certified specialty in treating TMD in either dentistry or medicine, finding the right care can be difficult. The National Institutes of Health advises patients to look for a health care provider who understands musculoskeletal disorders (affecting muscle, bone and joints) and who is trained in treating pain conditions. Pain clinics in hospitals and universities are often a good source of advice, particularly when pain becomes chronic and interferes with daily life.

Complex cases, often marked by chronic and severe pain, jaw dysfunction, comorbid conditions, and diminished quality of life, will likely require a team of doctors from fields such as neurology, rheumatology, pain management and others to diagnose and treat this condition.

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