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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.

Estrogen Plunge Before Menstruation Linked to Migraine

  • Jan 26, 2017

Our 2016 TMJA online survey results show that 26% of respondents suffer from migraine
headaches; they are one of the overlapping chronic pain conditions associated with

Women who experienced a steeper decline in estrogen levels prior to menstruation
were more likely to experience migraines, researchers found.

In an analysis of data collected as part of the long-term longitudinal Study of Women's
Health Across the Nation (SWAN), migraineurs' urinary estrogens (E1c) declined in the
2 days before the period peak at a faster absolute rate than nonmigraineurs and at a
higher percent change than nonmigraineurs (40% versus 30%), Jelena Pavlovic, MD,
PhD, of the Albert Einstein College of Medicine in New York City, and colleagues
reported in Neurology. The study authors did not find significant differences in the
groups when they looked at absolute peak and daily hormone values, and they found
no significant differences in the time period around the ovulatory phase.

As part of a secondary analysis within the migraineurs' group, the authors determined
that hormone patterns were similar regardless of whether the woman had a migraine
that cycle. As a result, Pavlovic and her team formed a "two-hit" hypothesis in which
women with rapid estrogen level dips before menstruation are more sensitive to
migraine triggers, such as stress, lack of sleep or a glass of wine. It's a combination of
the estrogen drop and the additional triggers that result in a migraine.

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Overlapping Conditions


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