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Repeated Injections of Botox into the Masseter Muscle... A Longitudinal Study

The authors of this study examined mandibular bone before and after subjects received Botox injections into each masseter muscle. These volunteers were healthy adults (22-48 years old), both male and female, who wanted injections to slim their faces.

Washington Post Article on TMD

The Washington Post recently featured an article on Temporomandibular Disorders. Below is an excerpt from that article and a link to the full story.

Partnering to Improve Chronic Pain Care

The National Institutes of Health (NIH) held three meetings this summer with the goal of developing the first public-private partnership (PPP) to develop safe and effective treatments for chronic pain, as well as new treatments for opioid addiction and overdose.

TMJ Patient RoundTable Project: Status Update

The TMJ Association is acting as the catalyst to develop the TMJ Patient RoundTable, a broad initiative to advance the interests of patients with temporomandibular disorders (TMD). It encompasses collaborations with all stakeholders and

Educational Brochures on Chronic Overlapping Pain Conditions

This brochure addresses what are Chronic Overlapping Pain Conditions (COPCs), how COPCs are diagnosed, the complexity of the chronic pain experience, and how to work with your health care provider to develop a treatment plan. It is available by postal ma

TMJ News Bites, February March 2015

  • Apr 1, 2015

TMJA logo

 

TMJ NEWS BITES 

 

February/March 2015

 Volume 7, Issue 2 

 

 

 

SCIENTIFIC NEWS

 

Ethics of TMD Treatments

When we read an article by Drs. Kevin Reid and Charles Greene on the ethics of TMD treatment in the Journal of Oral Rehabilitation, we thought the message was so important that we asked them to write on this topic for our readers. We thank them for responding to our request.   

 

In both articles, the authors state that dentists should follow the latest scientific evidence when diagnosing and prescribing treatments for TMD patients, noting that the science strongly urges the use of conservative approaches. Nevertheless, we know there are patients and dentists who will swear to the efficacy of the diagnostics and treatments criticized in the articles, as well as a multitude of other advertised TMD treatments. But we also know, because you have told us, that many other patients have not only not improved, but have been irreparably harmed by misdiagnosis and treatments of all types.  

 

While current basic science reveals information that supports the Reid and Greene paper, the authors (and current science) do not address two important issues.  

  1. The harm caused by treatments that lack scientific scrutiny
  2. How to treat the patient when all conservative methods fail to alleviate pain and dysfunction

The treating community remains in chaos and controversy about TMD diagnostics and treatments. The advice we must still offer patients is - you may get better on treatments; you may be unaffected by treatments; you may even get better in spite of treatment, or you may get worse. We agree with the authors - be informed and beware. 

 

Click here to read the original article by Drs. Reid and Greene, Diagnosis and treatment of temporomandibular disorders: an ethical analysis of current practices. 

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Finding the Right Practitioner to Manage your TMD Problem - Combining Ethical Principles with Practical Considerations

K. I. REID1 and C. S. GREENE2

1Division of Orofacial Pain, Department of Dental Specialties, Mayo Clinic, Rochester, MN, USA

2Department of Orthodontics, University of Illinois at Chicago, College of Dentistry, Chicago, IL, USA

 

People who think they have symptoms of Temporomandibular Disorders (TMD) should consult with their medical doctor to rule out other medical conditions that may mimic TMD. Their doctor may then suggest that they see a "dental specialist who deals with facial pain problems." However, since there are no official American Dental Association-approved specialists in TMD, that referral may lead to many different kinds of dental offices and practitioners, among them are oral surgeons, endodontists, periodontists or even general dentists who claim to be experts on TMD. In some communities, there also may be oral medicine or orofacial pain specialists, who actually have had formal postgraduate training about TMD management in university settings, just as a physician would train to become an orthopedist or cardiologist. Officially, even those dentists are not TMD "specialists" despite the fact that they generally provide the best care for such problems.

 

In addition to these possibilities, there are dentists who advertise on their websites or in local media that they welcome "TMJ/TMD" patients in their practice. Since there are no established guidelines for TMD treatment, patients with exactly the same symptoms might receive completely different diagnostic workups and treatment recommendations. As a result, they will have very different experiences, based solely on which practitioner they see. Unfortunately, there is no assurance that the diagnostic process (evaluation) and the treatments proposed will be based on the best available scientific data. Indeed, it is just as likely that the evaluation and treatment recommendations will be rooted in outdated concepts that have been disproven or strongly challenged by contemporary standards of science. These scientifically unproven diagnostics and treatments may lead to invasive, irreversible, and sometimes very costly interventions.

 

At this time, there are serious controversies within the dental profession about all aspects of TMD. This situation makes it essential that a patient be well informed about what could happen when seeking care for TMD. In this article we hope to heighten awareness of potential pitfalls when seeking care for a painful TMD problem, and to provide information that may reduce the chances of a harmful outcome. Click here to read more.  

 

 

Research Trends

The two leading journals of pain research are The Journal of Pain, the communication of the American Pain Society, and the journal Pain, published by the International Association for the Study of Pain. Both journals cover the spectrum of research from basic to clinical studies. Rather than reporting on specific articles relevant to TMD as we often do, we thought it would be interesting to point to some trends we have observed in recently published papers. 

 

In general, pain researchers now acknowledge that an individual's experience of pain reflects ones' genetics, as well as one's sex, environment, temperament, behavior, and lifetime experiences, beginning in infancy. At the cellular and molecular level, investigators are also finding that with the use of new tools and techniques, the nervous system cells, chemical transmitters, and networks representing pain pathways and centers are more complex, interacting with many other brain centers, such as those associated with emotion and cognition. The journals are also increasingly reporting studies of factors that contribute to the transition from acute to chronic pain, observing that this transition results in profound and deleterious changes in the central nervous system (the brain and spinal cord). These changes not only sustain, but also may magnify pain and give rise to the development of pain felt elsewhere in the body.

 

The TMJ Association (TMJA) has long affirmed these findings in relation to Temporomandibular Disorders (TMD). Experts invited to the scientific meetings held by the Association over the decade, have provided evidence that TMD represents a complex family of disorders involving genetics, sex, environment, and behavior. Moreover, the most recent TMJA scientific meetings have emphasized that patients with more severe and chronic TMD are likely to experience one or more comorbid pain conditions.

 

 

TMJA ADVOCACY

 

New NIH Funding Opportunities

NIAMS Musculoskeletal Biology and Medicine Resource-based Centers - http://grants.nih.gov/grants/guide/rfa-files/RFA-AR-16-004.html

 

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) requests applications for the NIAMS Resource-based Centers Program (P30) for research areas within its mission in musculoskeletal biology and medicine. The Resource-based Centers will provide critical research infrastructure, shared facilities, services, and/or resources to groups of investigators conducting research on musculoskeletal biology and medicine, enabling them to conduct their independently-funded individual and/or collaborative research projects more efficiently and/or more effectively, with the broad overall goal of accelerating, enriching, and enhancing the effectiveness of ongoing basic, translational, and clinical research and promoting new research within the NIAMS mission.
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Exploratory Technologies to Understand the Control of Organ Function by the Peripheral Nervous System for SPARC (U18) - http://grants.nih.gov/grants/guide/rfa-files/RFA-RM-15-002.html

This NIH Funding Opportunity Announcement (FOA), supported by funds from the NIH Common Fund (Common Fund) and managed by the Office of the Director and participating NIH Institute(s) and Center(s) of the Stimulating Peripheral Activity to Relieve Conditions (SPARC) program, solicits U18 Research Demonstration Cooperative Agreement applications to develop new and/or enhance existing tools and technologies tailored to elucidate the neurobiology and neurophysiology underlying autonomic control of internal organs in health or disease, which will ultimately inform next generation neuromodulation therapies. These awards will establish feasibility for further technology development in any future SPARC initiatives.  Additionally, the technologies developed through these awards are expected to lay the groundwork for more systematic facilitation of biological mapping activities in any future SPARC initiatives. 

 

 

Additional TMD Funding Opportunities  

The following are previously announced NIH funding opportunities. 

 

Biology of the Temporomandibular Joint in Health and Disease (R01) http://grants.nih.gov/grants/guide/pa-files/PA-14-358.html 

 

Biology of the Temporomandibular Joint in Health and Disease (R21) http://grants.nih.gov/grants/guide/pa-files/PA-14-359.html       

 

Pharmacogenomics of Orofacial Pain Management (RO1) http://grants.nih.gov/grants/guide/rfa-files/RFA-DE-16-001.html      

 

Research on Chronic Overlapping Pain Conditions (R01) http://grants.nih.gov/grants/guide/pa-files/PA-14-244.html   

 

Research on Chronic Overlapping Pain Conditions (R21)  http://grants.nih.gov/grants/guide/pa-files/PA-14-243.html

Building Genetics and Genomic Knowledge about Dental, Oral, and Craniofacial Diseases and Disorders (R01) http://grants.nih.gov/grants/guide/pa-files/PA-14-347.html#sthash.viviyVB9.dpuf 

 

Blueprint Neurotherapeutics Network (BPN): Small Molecule Drug Discovery and Development for Disorders of the Nervous System (UH2/UH3)
http://grants.nih.gov/grants/guide/pa-files/PAR-14-293.html

Blueprint Neurotherapeutics Network (BPN): Small Molecule Drug Discovery and Development for Disorders of the Nervous System (U44)
http://grants.nih.gov/grants/guide/pa-files/PAR-14-292.html 

 

 

PATIENT EDUCATION & AWARENESS

 

Patient Spotlight:  Ann

This week ha

 
s been a pretty painful week and whenever I have bad days I usually end up here so that I can read other people's stories.  It doesn't really help the pain, but it helps me stop feeling so sorry for myself for a while when I read the stories of people whose suffering far surpasses mine. I keep waiting for some conclusion to my jaw problems before I tell my story, but I am beginning to think that if I wait, it will never be told.

 

I have suffered from jaw pain for several years. In the beginning it was only bad during, and a few days after, a trip to the dentist. Over the past couple of years, the ability to open my mouth wide has gotten worse and worse until the dentist I was using got verbally upset with me when I could not open my mouth wide enough to do a rou

 
tine cleaning.  Prior to this I had complained of pain in a tooth that he said was dead and there was no way I could feel pain in it.  He ridiculed me and dismissed my concerns. I shopped around and found a dentist that is very sympathetic and helpful. He is patient and kind, but had no real experience with treating jaw pain, so suggested that I go to my doctor and get a referral for an oral surgeon, which I did. The oral surgeon had a beam-cone scan and x-rays done and then stated that there was nothing to be found. He scheduled me for arthrocentesis and when that did not help, he said there was nothing more to be done. Click here to read more of Ann's story.  

 

 

 

Our Thanks to Face Caddy for their Donation

In the January issue of TMJ News Bites we announced the donation of 10 Face Caddy wraps. The TMJA received 40 requests and we thank everyone who responded to this donation. John Lucas, owner of Face Caddy, provided us with the following statement: "I'm so happy that Face Caddy can help these folks. I really wish I could send you more, but I'm such a small business, I can't do that right now. What I can do, however, is to continue to offer the discount code for TMJA members. That discount is for $5 off any order. All members need to do is put "TMJA" in the coupon code area when they order. It's all made clear on the page: www.facecaddy.com/tmja 

 

 

Free Educational Brochure: A Resource Guide for Temporomandibular Disorders 

This brochure is a straightforward, easy-to-read guide for patients making health care decisions. The brochure is available by mail  or as a PDF on our website. We encourage you to share this brochure with your friends, health care professionals, and family.

 

 

New Free TMD Nutritional Guide Booklet 

TMD Nutrition and You, a nutritional guide booklet, is specifically aimed at people with compromised oral function to help them maintain a healthy diet in spite of their oral disability. Click here to download a free copy of our booklet or e-mail us with your name and mailing address to receive a hard copy by mail.

 

 

Free Pain Resource Booklet  

The Handbook for People with Pain: A Resource Guide, 5th edition is now available. This resource will help you on your day-to-day journey as you face challenges so often encountered by those who suffer from pain. This resource will provide you with a variety of information, ideas, and tools. Click here to learn more. 

 

 

 

SUPPORT YOUR TMJA

 

The TMJ Association is the only patient advocacy organization fighting for the best science that will lead to greater understanding of Temporomandibular and related disorders and safe and effective treatments. We need YOUR help in these efforts.

Please consider contributing to The TMJ Association. We offer a number of ways you can do this. If you a
re already a member of the TMJA family, you have our heartfelt thanks. We invite everyone to join us in changing the face of TMJ.

 

General Donation

Donate online via our donation service, GiveDirect, Paypal, or by check.

 

Other Ways to Donate Online   

AmazonSmile

If you purchase items from Amazon, you can now help raise money for The TMJ Association with every purchase.  Amazon will donate 0.5% of the price of your eligible AmazonSmile purchases to The TMJ Association. It's like regular Amazon, but with the wonderful bonus of helping to raise money for us.

 

iGive

With over 700 stores in the iGive Mall, access to hundreds of exclusive coupons, free shipping deals and sales, iGive is the smart way to shop. Up to 26% of each purchase benefits The TMJ Association at no cost to you! Join iGive at www.iGive.com/TMJA.  

 

eBay Giving Works

Buy and sell on eBay Giving Works to support The TMJ Association. As a seller, you can opt for a portion of your sale to be donated to The TMJ Association. As buyers, you can look for items that support a great cause!  Click here to shop or sell on eBay to support The TMJ Association. 

 

Donate By Searching! What Could Be Easier?

Use GoodSearch.com for your next Internet search and enter TMJ Association under "Who Do You GoodSearch For?" Every time you use GoodSearch money is generated for The TMJ Association. Every completed search raises approximately $0.01 for us! And since GoodSearch is powered by Yahoo, you will get proven, high-quality search results.

 

Donate Your Vehicle

The TMJA participates in the vehicle donation program for nonprofits. Click here to learn more.

 

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