Building on findings from the 2020 National Academies report on TMD, members of the multidisciplinary NASEM TMD Forum emphasized in a recent publication in BMC Global Public Health the urgent need to improve recognition and management of TMD within the U.S. healthcare system. Although TMD affects millions of Americans and contributes to significant pain, disability, and economic burden, care is often fragmented because medical and dental providers operate in separate silos.
This commentary advocates for bridging the medical and dental divide to better address the complex needs of individuals with TMD and reduce the public health burden of these conditions.
Key points from the article include:
- High public health impact: Approximately 4.8% of U.S. adults experience TMJ region pain, yet coordinated, evidence-based care is lacking.
- Medical–dental gap: Medical clinicians frequently overlook TMD in broader musculoskeletal care, while dentists often lack training to manage comorbid medical conditions or make appropriate medical referrals. This divide leaves many patients navigating care independently.
- Outdated paradigms: Historically, dental occlusion was overemphasized as a primary cause of TMD, leading to invasive treatments with limited evidence. Contemporary understanding recognizes TMD as a set of multifactorial conditions requiring biopsychosocial care models.
- Care pathway proposal: The authors propose a structured, interdisciplinary care pathway that:
- Allows entry through dental, medical, or allied health clinicians,
- Uses standardized tools for early assessment and conservative management,
- Facilitates clear referral protocols for complex cases or specialist care.
- Goals of the framework: Improve early identification, reduce unnecessary interventions, enhance provider training across disciplines, and ensure evidence-based, patient-centered care for people with TMD.
Source: Prodoehl J, Cowley A, Durham J, Lodes M, Rindal B, Mackey S. Bridging the medical-dental divide: a public health imperative for temporomandibular disorders. BMC Glob Public Health. 2025 Nov 4;3(1):97. doi: 10.1186/s44263-025-00217-y. PMID: 41189035; PMCID: PMC12587699.