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New Report on Temporomandibular Disorders: Priorities for Research and Care

Over a year and half ago, the National Academy of Medicine (NAM) began the most comprehensive study ever undertaken on Temporomandibular Disorders (TMD). The study assessed the current state of TMD research, education and training, the safety and efficacy of clinical treatments, and associated burden and costs.

Statement by NIDCR Acting Director on the National Academies of Sciences, Engineering, and Medicine Report on Temporomandibular Joint Disorders

I am pleased to announce the release of the National Academies of Sciences, Engineering, and Medicine (NASEM) report, Temporomandibular Disorders: Priorities for Research and Care. As underscored by the comprehensive report, temporomandibular joint disorders (TMJDs) are a diverse and still poorly understood set of complex, painful conditions affecting the jaw muscles and tissues, temporomandibular joints, and associated nerves. Clearly, there is much more to be understood, and these conditions continue to confound medical and dental health care providers and researchers.

Have you seen the film Dark Waters?

The Film. Dark Waters is about attorney Robert Billott's real-life 20 year legal battle against DuPont chemical for releasing toxic waste - perfluorooctanoic acid, or PFOA - into Parkersburg, West Virginia's water supply, with devastating health effects on the townspeople and livestock. PFOA, also known as C8, is a man-made chemical. It is used in the process of making Teflon and similar chemicals known as fluorotelomers.

Online TMD Diet Diary Research Project

Online TMD Diet Diary Research Project The TMJ Association received the following request from Professor Justin Durham and his research team at Newcastle University. We encourage TMJ patients to participate in this project as it is an under researched

Drug Induced Bruxism

The authors of this article state that orofacial movement disorders (bruxism) are treated typically by dental professionals and not by those specialists (neurologists) researching and treating the other movement disorders (Parkinson's disease, Huntington's disease, tremors, etc.). Again, this is more evidence of the complexity of TMD and the need for multidisciplinary research and treatment in TMD.

Overdiagnosis and Unnecessary Therapy

  • Mar 2, 2017

We grateful to Dr. Daniel Laskin, Adjunct Clinical Professor and Chairman Emeritus at Virginia Commonwealth University School of Dentistry, Oral and Maxillofacial Surgery, for summarizing the following article for our readers.
  
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 pathology present that requires treatment. These findings include the position of the intra-articular disc in relation to the mandibular condyle, the location of the condyle relative to the glenoid fossa, the depth of the glenoid fossa, and flattening of the condylar surface. In this study the MRIs of two groups of asymptomatic general population individuals differing in age by 20 years were analyzed for these factors.

In both groups, condylar position was characterized by great variability. Whereas those dentists who use condylar position as a criterion of pathology believe that the condyle should be centered in the glenoid fossa, this study found only 49% of the subjects had condyles in that position and, of these, an absolute centric position was present in less than 4%. In females, a posterior position was present in 52%, while in men, 57% were in a centric position. Neither age nor gender had any influence on location of the condyle.

In three-fourths of the subjects the intra-articular disc, described in textbooks as normally having its posterior band at the twelve o'clock position, was in a more forward position. This anterior location was twice as frequent in females as in males, in conjunction with the more common finding of TMJ clicking in women. The depth of the fossa was decreased in both age groups.

Based on the findings in this study, it is evident that eccentric condylar position is not an indicator of an abnormal TMJ and should not be used as a reason for treatment. Moreover, it is clear that one cannot rely solely on imaging evidence of an anteriorly positioned disc as an indicator of joint pathology and that it must be accompanied by clinical symptoms of TMJ pain and/or limitation of jaw movement for this to be considered. Painless clicking alone is also not an indication for treatment. Although the authors did not specifically study changes in the condylar surface, they do discuss this issue and point out that although loss of normal contour and flattening of the condyle may be an indication of osteoarthritis, it also may represent a normal sign of aging and/or adaptive remodeling and require no treatment.

Disc displacement, eccentric condylar position, osteoarthritis - misnomers for variations of normality? Results and interpretations from an MRI study in two age cohorts. Turp JC, Schlenker A, Schroder J, Schmitter M. BMC Oral Health (2016) 16: 124.  
TMJ Disorders

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In Treating TMJ

To view or order a free booklet about TMJ Disorders, visit the National Institutes of Health website.

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