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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

From Functional Pains to Central Sensitivity Syndromes

The following article in Medscape refers to TMD and some of its overlapping pain conditions as functional pains and proposes to change that description. Medscape is the leading online resource for physicians and healthcare professionals worldwide, offeri

Are TMD Patients More Pain Sensitive? Maybe. But It's Complicated

TMD patients come in many different varieties. Some experience pain and dysfunction confined only to the jaw and/or the associated chewing muscles. Other TMD patients have jaw pain plus one or more other painful conditions elsewhere in the body. Scientis

TMJA's 8th Scientific Meeting

TMJA celebrated its 8th biennial scientific meeting this fall provocatively challenging scientists to answer, "How Can Precision Medicine Be Applied to Temporomandibular Disorders and its Comorbidities?" For three days scientists from fields

Introducing our TMD Nutrition Guide

The pain and jaw dysfunction associated with Temporomandibular Disorders (TMD) can impact your ability to chew and swallow food. How and what you are able to eat can seriously compromise your nutritional and health status - an aspect of TMD that is often

Painful Temporomandibular Disorder: Decade of Discovery from OPPERA Studies

  • Sep 21, 2016

Slade GD, Ohrbach R, Greenspan JD, Fillingim RB, Bair E, Sanders AE, Dubner R, Diatchenko L, Meloto CB, Smith S, Maixner W., Painful Temporomandibular Disorder: Decade of Discovery from OPPERA Studies, J Dent Res. 2016 Sep;95(10):1084-92. doi: 10.1177/0022034516653743. Epub 2016 Jun 23.

In 2006, the OPPERA project (Orofacial Pain: Prospective Evaluation and Risk Assessment) set out to identify risk factors for development of painful temporomandibular disorder (TMD). A decade later, this review summarizes its key findings. At 4 US study sites, OPPERA recruited and examined 3,258 community-based TMD-free adults assessing genetic and phenotypic measures of biological, psychosocial, clinical, and health status characteristics. During follow-up, 4% of participants per annum developed clinically verified TMD, although that was a "symptom iceberg" when compared with the 19% annual rate of facial pain symptoms. The most influential predictors of clinical TMD were simple checklists of comorbid health conditions and nonpainful orofacial symptoms. Self-reports of jaw parafunction were markedly stronger predictors than corresponding examiner assessments. The strongest psychosocial predictor was frequency of somatic symptoms, although not somatic reactivity. Pressure pain thresholds measured at cranial sites only weakly predicted incident TMD yet were strongly associated with chronic TMD, cross-sectionally, in OPPERA's separate case-control study. The puzzle was resolved in OPPERA's nested case-control study where repeated measures of pressure pain thresholds revealed fluctuation that coincided with TMD's onset, persistence, and recovery but did not predict its incidence. The nested case-control study likewise furnished novel evidence that deteriorating sleep quality predicted TMD incidence. Three hundred genes were investigated, implicating 6 single-nucleotide polymorphisms (SNPs) as risk factors for chronic TMD, while another 6 SNPs were associated with intermediate phenotypes for TMD. One study identified a serotonergic pathway in which multiple SNPs influenced risk of chronic TMD. Two other studies investigating gene-environment interactions found that effects of stress on pain were modified by variation in the gene encoding catechol O-methyltransferase. Lessons learned from OPPERA have verified some implicated risk factors for TMD and refuted others, redirecting our thinking. Now it is time to apply those lessons to studies investigating treatment and prevention of TMD.  

The full article is available at: http://jdr.sagepub.com/content/95/10/1084.full.pdf+html.  

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