Stigmatizing Attitudes and Beliefs about TMJ
The 2020 National Academy of Medicine report acknowledges the significant impact of stigma experienced by people with TMJ disorders.
“Stigmatizing attitudes and beliefs about TMDs can originate both internally—from the beliefs and attitudes of the individual experiencing a TMD—and externally—from the beliefs and opinions held by others, including family members, friends, health care professionals, employers and coworkers, the general public, and the media. Chronic and complex TMDs represent a form of chronic pain that can profoundly affect interactions as fundamental to human existence as smiling, laughing, speaking, eating, and intimacy.
Patients with TMDs reported that they often do not feel believed by romantic partners, relatives, and friends. Practitioners may think that the chronic pain is imagined or exaggerated; leading patients to feel blamed, misled, or abandoned (De Ruddere and Craig, 2016). Employers, family members, and friends may dismiss pain as psychological. In testimony to the committee, some TMD patients reported that they experienced hostility from their work colleagues and a lack of understanding of the severity of their pain.
Additionally, when seeking care, patients reported that they were often sent from dentists to physicians and back again or reported being dismissed without care and with little information on suggested next steps. Patients expressed their frustration at not knowing where to turn for quality care and noted that their primary care physicians and general dentists often did not know how to help them locate qualified specialists.
The opportunity for adequate treatment and follow-up of TMD care may be thwarted by the combination of uncertain diagnosis and the stigma perceived by the patient, family member, or public. Individuals with a TMD may hold back on sharing their symptoms, thoughts, or feelings with others because of concerns about stigmatization.
Stigma can lead to poorer physical and psychological well-being, diminished self-esteem, and a loss of dignity. Thus, stigma adds to the burden of the condition and significantly affects health and quality of life.” (NAM, 7-3)
The lack of credible information relayed to the public and professionals about the reality of impact that TMJ can have on one’s overall health and life results in patients continuing to suffer in silence and isolation because nobody – including family, friends, employers, etc. – can comprehend how multiple therapies, including years of treatments at exorbitant costs cannot fix or alleviate the problem but seem to worsen it. It is always the fault of the patient when things don’t work out like they were told it would. Leaving the patient to question what they did wrong.
Advertisements portray TMJ as a simple click and pop that can easily be fixed. TMJ is often trivialized by the dental and medical communities as an insignificant problem.
Adding to the stigma for many TMJ patients, are the physical changes to their face as a result of surgical “readjustments”, paralysis, etc. Many patients express despair that they don’t recognize themselves anymore. Patients have also told us that they are embarrassed to be seen or to eat in public, because chewing and swallowing are difficult, they choke, and/or food falls out of their mouths. Speaking and enunciating words properly is often difficult and also embarrassing. Facial paralysis and the inability to smile is often times misinterpreted as a foul personality.