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.
The study was funded by the Office of the Director of the National Institutes of Health (NIH) and the National Institute of Dental and Craniofacial Research (NIDCR).
From our perspective, the three most important issues are:
1. Patient involvement. "The committee also emphasizes the critical role that individuals with a TMD and their family members have played—and hopefully will continue to play—in bringing TMD issues to the attention of policy makers and health professionals and in moving the research and care agenda forward on multiple levels in the public and private sectors. These efforts are to be commended and are encouraged to continue and expand.
It is hoped that individuals with a TMD and their families will be able to partner with their health care professionals to find the best options for care, to continue to actively participate in patient support networks, to explore ways to be a participating voice in research efforts (such as serving as a patient representative in research design), and to be active advocates for improvements in care and services for themselves, their family members, and other people with a TMD." (NAM report, Section 8-2)
2. Multidisciplinary approach to research and care. "Over the past decade, research on TMDs has centered on the biological mechanisms underlying the development and persistence of orofacial pain and on the structure and function of the joint and its tissues, while more recent research has begun to examine the molecular genetics, biomarkers, and biopsychosocial risk factors of TMDs and common comorbidities.
Broadly, the research foundation relating to TMDs, as has been the case with other complex, stigmatized conditions, has suffered from the siloing of disciplines and from a lack of clear direction—thus stunting the potential clinical impact of the research. In the case of TMDs, these difficulties have been heightened by a significant dental–medical divide that affects both research and clinical care. Engagement by multiple stakeholders will be required to dismantle the siloes keeping research fields isolated and to advance TMD research and care." (NAM report, Summary 5)
3. A New TMD treatment Model. "Key to making a difference in improving care for individuals with a TMD will be pioneering pathways that span medicine, dentistry, physical therapy, and other fields of health care to provide holistic, comprehensive approaches to care—interprofessional and interdisciplinary efforts are of critical importance…" (NAM report, Summary 4)
Because the National Academy of Medicine report on TMD came out during the Covid-19 crisis, it did not get the attention that it would have normally received. If there is a positive to this, it is that we are using this time to review the 345 page report and develop working groups to address the many issues noted in the recommendations.
We are pleased that the report accurately reflects the state of TMD. However, the report will just hold a place on a shelf unless it is seriously reviewed and acted upon.
It is clear the patients will play a pivotal role in impressing upon the U.S. Congress, government agencies, and professional organizations that we are serious about seeing significant changes in the way TMD is researched, treated, and perceived.
We can't do this without your help! As we begin to work with various stakeholders to address the NAM recommendations, we will need your involvement and participation. We will continue to keep you informed of opportunities to add your voice.