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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.

Honor Families Who Bravely Battle TMD

If you haven't done so already, please join me in making a year-end contribution to The TMJ Association (TMJA) in the honor of families like mine and yours who bravely battle this disease each and every day. Since my daughter, Alexandra, b

TMJ News Bites, June 2015

  • Oct 27, 2016


 
TMJ NEWS BITES 
June 2015  
 Volume 7, Issue 4   
 
SCIENTIFIC NEWS
Further Evidence that Botulinum Toxin (Botox®) Injections Cause Bone Loss in the Jaw

An article published online in the journal Bone by a team of French investigators confirms that injecting Botox® into jaw muscles leads to significant bone loss in adult rats. Two jaw-closing muscles--the right masseter and right temporalis, were treated, and the rats were compared with control animals that had salt solution (saline) injected into the same muscles. The authors were primarily interested in the mandible and whether it would lose bone when these muscles were injected with Botox®, which is a neurotoxin that causes temporary muscle paralysis. (This is similar to the bone loss experienced by astronauts in spaceflight conditions because bone is not subject to normal gravitational forces.) The Botox® rats evidently had some trouble chewing, because they lost a little weight, whereas the saline animals gained during the study.  Click here to read more about this study.

Patient Bone-Related Safety of Botox® for Treatment of TMD
Karen Raphael, PhD, a long-time TMD researcher now at the New York University College of Dentistry, has provided the following commentary on the Susan Herring Botox® article, along with information on her plans for clinical studies of TMD patients who have been treated with Botulinum Toxin for TMD Pain.
 

As a clinical research scientist focusing on the causes and treatment of TMD disorders, I had long heard that some doctors and dentists have tried to reduce TMD muscle pain by injecting Botox® into the chewing (masticatory) muscles. Although this potent biological toxin, used in minute dosages, has been approved by the Food and Drug Administration (FDA) for certain muscle-related conditions since 1989, its injection into the masticatory muscles is considered off-label and unapproved by the FDA in terms of both safety and efficacy. In the past decade, TMD patients have increasingly asked: Is Botox® safe for use in this manner? Is Botox® effective? Are potential risks worth the potential benefits? In light of aggressively marketed continuing education courses, in which more and more health professionals are being trained to use Botox® to treat a variety of painful muscle conditions, these are critical questions.

 

The existing clinical research literature provides little help. The National Institute of Dental and Craniofacial Research (NIDCR) still lists Botox® as a treatment option, but notes that recent clinical trials have been inconclusive about its effectiveness for chronic TMD. Indeed, existing studies have been conducted on small samples, in which it is easy to 'miss' either a potentially clinically significant benefit or a clinically significant adverse effect. Thus, the benefit and risks of Botox® treatment for TMD have yet to be clearly established in an adequately sized, randomized and controlled clinical trial. Click here to read Dr. Raphael's full article. 

NIH Funding Opportunities 

The following are previously announced National Institutes of Health (NIH) funding opportunities still available:  

 

Immune System Plasticity in the Pathogenesis and Treatment of Complex Dental, Oral, & Craniofacial Diseases

R01: http://grants.nih.gov/grants/guide/pa-files/PAR-15-192.html  

R21: http://grants.nih.gov/grants/guide/pa-files/PAR-15-193.html 

 

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

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
Lyme Disease and Misdiagnosis  
It's that time of the year again - tick season. We bring this to your attention as a number of the symptoms of Lyme disease are similar to Temporomandibular Disorders (TMD) so it's possible that a misdiagnosis may occur.

We invite you to read the following stories featured in past issues of TMJ News Bites, that discuss two patients who were originally misdiagnosed and treated for TMD but later found out the true cause of their symptoms was Lyme disease.

John is a former Professor of Finance at American University in Washington D.C. He is married and has three children. The unpredictable nature of his TMJ symptoms put a strain on his family. In the Fall of 2001, John began to seek relief from TMJ pain-ultimately spending well over $10,000 on treatments that were ineffective. Read more here.


Gillian had a filling done, after which she developed severe jaw pain, a locked jaw and neck and shoulder pain. Several months later, she developed swollen joints in her fingers, toes and severe foot pain. This was accompanied by chronic migraine headaches, muscle pain and severe fatigue. Read more here. 
TMJ Patient Input: Important and Needed 

According to the Institute of Medicine patient-centered care is "providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions." There is an explosion of "Patient Centeredness" in health care today with various stakeholders, such as, pharmaceutical companies, app software companies, scientists, clinicians, and so forth asking for patients' opinions or experience on their respective conditions. Hence, the increased numbers of requests for patients to take surveys.

 

We are respectful of your time, energy and sometimes emotion when we ask you to participate in a survey. We also weigh the value of the information gleaned from the survey to you as a TMJ patient. That is an introduction to letting you know that over the next two months we will be asking for your participation in three surveys.

 

The first one arose from a study conducted by Johns Hopkins on medications questioning whether what the pharmaceutical companies were looking for in clinical trials were what the patients wanted as a result of taking medication. They asked us to survey our TMJ patients and we will soon be sending that survey out to a select group of patients - those who routinely open our electronic newsletter. It will be very interesting to see the results of what YOU, the TMJ patients feel are important to you when you take a medication or engage in other therapies. We will receive the results of the survey and publish them in our News Bites. The TMJ Association will receive by way of payment from Johns Hopkins, the costs associated with sending the emails.

 

Dr. Justin Durham of Newcastle University in the United Kingdom contacted us shortly after he received our News Bites introducing our new booklet on TMD Nutrition and You. He and several colleagues had just begun looking into how a person with an oral disability is able to eat and the resulting nutritional state of the person. He is currently conducting a face-to-face study with TMJ patients in the UK and would like to develop an electronic survey to collect similar data from US patients. With so little attention being paid to eating difficulties TMJ patients experience and their nutritional state, we can't help but feel this study will bring attention and research to this much ignored aspect of TMD. The TMJA will receive payment related to the costs associated with the mailing.

 

Each summer The TMJ Association conducts a survey of our News Bites readers. We do this as we prepare our annual application for approval to be involved in the Combined Federal Campaign (CFC). This is the organization through which federal employees contribute to nonprofit organizations, like employees of private companies contribute through United Way, etc. Taking this survey ensures that we will continue to be included in the CFC and receive some of our funding in this way. More importantly, we ask questions about how you feel about aspects of TMJ which help us better serve you.

 

Recently we asked some patients to take a survey on their opinions regarding their health care for pain. Soon, we will begin posting information that was gleaned from the survey.    

FDA Product Safety Alert: Unintentional Injection of Soft Tissue Filler in Blood Vessels in Face - Risk of Serious Patient Injury  
The FDA has reviewed information that suggests unintentional injection of soft tissue fillers into blood vessels in the face can result in rare, but serious side effects. Unintentional injection can block blood vessels and restrict blood supply to tissues. Sometimes this can result in embolization. This means the filler material has traveled to other parts of the body. This can cause vision impairment, blindness, stroke and damage and/or death of the skin (necrosis) and underlying facial structures. See safety communication and MedWatch Safety Alert.

Soft Tissue Fillers, also known as injectable facial implants, dermal fillers, or wrinkle fillers, are medical device implants approved by the Food and Drug Administration (FDA) for use in helping to create a smoother and/or fuller appearance in the face, including nasolabial folds, cheeks and lips. The materials used in soft tissue fillers include:
  • Collagen
  • Hyaluronic acid
  • Calcium hydroxylapatite
  • Poly-L-lactic acid
  • Polymethylmethacrylate beads (PMMA microspheres)
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 email 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

Please consider contributing to The TMJ Association. We offer a number of ways you can do this. If you are 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 our mission.

 

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.

DONATE TO THE TMJA

Did you know The TMJ Association is a recipient of the Independent Charities of America Seal of Excellence?  

 

The Seal is awarded to nonprofits that have been independently reviewed annually and certified to meet the highest standards of public accountability, program effectiveness, and cost effectiveness. Of the 1,000,000+ charities operating in the United States today fewer than 2,500 have been awarded this Seal.

 

Please support our mission with your donation today!
 

"The TMJA is a great organization. I am impressed by your objectivity and transparency. Thank you for your hard work."  -  Lisa, Hummelstown, PA

 

STAY CONNECTED
QUICK LINKS
The TMJ Association, Ltd. | info@tmj.org | P.O. Box 26770 Milwaukee, WI 53226

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