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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). Read the study which assessed the current state of TMD research, education and training, the safety and efficacy of clinical treatments, and associated burden and costs. Read full article.

Have you seen the film Dark Waters?

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. Read more about PFOA, also known as C8, this man-made chemical used in the process of making Teflon and similar chemicals known as fluorotelomers. In the 1970s, Vitek Inc. created Teflon sheeting using DuPont’s Teflon FEP film, laminated to a porous composite material made from polytetrafluoroethylene (PTFE). These implants, usually no larger than a thumbnail, were manufactured individually or custom cut from sheets in the operating room by the surgeon and then sutured to the TMJ fossa or condyle. Read full article.

Drug Induced Bruxism

Bruxism is defined as ‘a repetitive jaw-muscle activity characterized by clenching or grinding of the teeth, or bracing or thrusting of the mandible.’ Read more about Bruxism which occurs in adults and children, with a systematic review reporting an incidence of 18.6% in adults. Orofacial consequences include jaw-muscle hypertrophy, tooth wear and crack development, fractures of tooth restorations and pain associated with the teeth and surrounding musculature. Read full article.

Stabilization Splints May Worsen Obstructive Sleep Apnea

This article deals with the question of whether the  stabilization splint, which is commonly used for treating TMJ and bruxism, may pose a risk of worsening obstructive sleep apnea in patients with that condition. While a few earlier studies have touched on this matter, this is the first study to use quantitative measures to answer the question. All subjects had 3 recordings done in a sleep laboratory while wearing a splint and 3 recordings without it. Also, it is the first one to use a randomized format in which each patient is his own control; half of the patients wore a splint first and then slept without it, while the other half followed the opposite protocol. Read full article.

Chronic Overlapping Pain Conditions: What do They Share in Common and What are the Risk Factors?

Heather Bowersox, a 36-year-old medical biller and single mother of a teenage son, lives with multiple pain conditions: temporomandibular disorder (TMD), migraine, back pain, and irritable bowel syndrome (IBS). While those conditions might seem unrelated, Bowersox believes they share common threads. Researchers, too, are looking for those recurring characteristics to link seemingly unrelated conditions that keep showing up together.
 
Bowersox is far from alone. For many people, one condition leads to another, so that they live with what have come to be called chronic overlapping pain conditions (COPCs). The growing list of COPCs that tend to cluster together includes fibromyalgia (FM), TMD, interstitial cystitis (IC)/painful bladder syndrome, IBS, endometriosis, vulvodynia, chronic low back pain, chronic migraine, and tension-type headache. People with chronic pain – and these COPCs in particular – also often suffer from non-pain conditions like sleep and mood disorders, cognitive dysfunction, and fatigue. Read full article.

Time to Eliminate the Third Pathway

As many TMJ patients already know from personal experience, the TMJ field is complicated by having so many diverse concepts of diagnosis, etiology, and treatment. As a result, it is difficult for a patient who maybe having a temporomandibular problem to find care – and to avoid the harmful procedures that are often recommended and carried out.

Dr. Charles S. Greene has provided us with a brief summary of a paper titled, Treating Temporomandibular Disorders in the 21st Century: Can We Finally Eliminate the “Third Pathway”?, which he recently co-authored with Professor Daniele Manfredini. The authors point out that the general management of joint and muscle problems by the medical orthopedic profession is based on a “Two-Track” system of medical and/or surgical treatments. Read full article.