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Dentists in Distress

Fear of the dentist is practically a rite of passage in youth. Growing up, I wasn't exactly afraid of the dentist; rather, any excuse to leave school early was a powerful incentive. These days, I have a more complicated relationship with dentistry: I go to get answers and try to feel better, but I always pop a prophylactic ibuprofen or two in case my jaw protests from the oral gymnastics.

Patients in Los Angeles or New York City Needed for Clinical Study - Comparative Study of Women Considering or Currently Receiving Botox© Injections for TMJ Pain

Are you a woman with "TMJ" pain in facial muscles, who has either: a. recently had Botox© injections for your pain or b. not had Botox© for your pain but has thought about such treatment? If either is true for you, you may qualify for an observational research study centrally administered by the NYU College of Dentistry. It is funded by the National Institutes of Health (NIH). The purpose of this study is to understand potential health risks that may be caused by treating "TMJ pain" with Botox© injections.

Patients Front and Center at the 2018 TMJ Patient-Led RoundTable

It is still all too fresh in the minds of many patients. Fifty years ago, between the 1970s and 1980s, some 10,000 TMJ patients received Vitek jaw implant devices.

Funding Opportunities now available for the NIH Common Fund’s Acute to Chronic Pain Signatures program

The NIH Common Fund's Acute to Chronic Pain Signatures program aims to understand the biological characteristics underlying the transition from acute to chronic pain and what makes some people susceptible and others resilient to the development of chronic pain.

Opportunity to Voice Your Opinion: U.S. Government Officials Want To Hear from Patients with Pain

FDA Public Meeting on Patient-Focused Drug Development for Chronic Pain On July 9, 2018, FDA hosted a public meeting on Patient-Focused Drug Development for Chronic Pain. https://www.federalregister.gov/documents/2018/05/15/2018-10284/patient-focused-

TMJ SCIENCE OVERVIEW

  • May 22, 2018

TMJ Science Basics

Temporomandibular disorders  comprise a collection of medical conditions affecting one or both jaw joints and/or their associated muscles and other tissues. Symptoms include pain and difficulties in making normal jaw movements, such as those used in speaking, chewing, swallowing or forming facial expressions.

The two temporomandibular joints, located in front of the right and left ears, connect the lower jaw, the mandible, to the temporal bone of the skull. They are the most complex joints in the body, richly endowed with nerves and muscles that allow coordinated movements in three dimensions. Jaw injuries and various forms of arthritis can give rise to TMJ Disorders but in general, the cause or causes (etiology) of TMJ Disorders is unknown.

What is known that these disorders are more prevalent in women, occurring during the childbearing years, and that the female to male ratio of those affected increases with the severity of the disorder so that for patients with the most severe chronic and painful TMJ Disorders the ratio of females-to-males approaches 9:1.

Traditional Approaches

Traditionally patients with jaw problems have been seen by or referred to general dentists or oral surgeons, who have often sought to remedy the problem by altering the teeth or operating on the jaw. The TMJ Association (TMJA) was formed in 1986 as a patient support group in Milwaukee concerned with the lack of understanding of etiology and the multiple but unproven treatments in use—some of which caused even greater pain and disability. TMJA has since grown into a national nonprofit advocacy organization promoting research, education, and support of patients and their families. Through the Association’s efforts, the National Institutes of Health has issued a “less is best” recommendation urging patients to avoid invasive procedures such as jaw surgery, if at all possible, and has increased TMJ research. There is greater attention to the interplay of gender, genetics, environmental and behavioral factors in the etiology of TMJ Disorders and a major study is underway exploring risk factors.

Scientific Progress with TMJ Disorders

Over the decade, the Association has sponsored eight scientific meetings in conjunction with the National Institutes of Health aimed at expanding the base of TMJ science and making recommendations for further research. There is now consensus that the TMJ Disorders represent a complex family of disorders best studied with a systems approach in which investigators from many disciplines work as a team, exploring all aspects of the disorder from genes and molecules to the whole person living in an environment.

At one of our most recent meetings it explored the finding that many TMJ patients experience one or more other systemic conditions that also predominantly or exclusively affect women, including chronic fatigue syndrome, endometriosis, fibromyalgia, generalized pain conditions, interstitial cystitis, irritable bowel syndrome, rheumatoid arthritis, and vulvodynia. Scientists at the meeting were enthusiastic that discovering a common pathway linking these overlapping conditions would have the potential of leading to a therapy that might benefit all of them.

Research for Solutions

As research advances to understand more about TMD, many in the health care community are reassessing past treatments and ways in which they were developed. As noted earlier, there is a growing consensus of health professionals who consider TMD a complex family of conditions like hypertension or diabetes. In that regard, the TMD patient should not be seen as someone with an isolated dental or jaw condition but rather viewed as a whole individual subject to genetic, hormonal, environmental and behavioral factors that may be contributing not only to jaw pain and dysfunction, but to a range of other serious comorbid conditions.

In some cases, the patient may experience one condition initially and then go on to develop one or more comorbidities. In other cases, two conditions may occur together at the outset. Such a perspective can direct and inspire scientists to discover commonalities that can advance understanding and ultimately lead to beneficial therapies.

Research to understand why these conditions coexist is in its early stages, but it is already prompting leading investigators to propose a name change. “TMD” is not an apt term to describe the complex multisystem pains and dysfunctions that many patients experience. The thinking now is that these debilitating problems experienced in various parts of the body have their origin in pathology at the highest levels of the brain and central nervous system.

The TMJ Association continues to advocate for research for solutions to TMD and the medical conditions that frequently co-occur it, as well as for the development of safe and effective diagnostics and treatments. We will keep you updated on the latest scientific research findings through our website and we invite you to visit often.