A Paradigm Shift. We’ve argued for some time that Temporomandbiluar Disorders (TMD) are not just about teeth and jaws, but represent a family of painful disorders that can co-occur and interact with other painful conditions in the body, such as chronic fatigue syndrome, fibromyalgia, chronic headache, endometriosis, irritable bowel syndrome, and vulvodynia, to name a few. These are all complex conditions influenced by genes, sex, age and behavioral and environmental triggers. See the story on TMJA’s sixth scientific meeting.

OPPERA Act One. Biggest research news of the year was the publication of eight papers on TMD as a special supplement to the November issue of the Journal of Pain (see OPPERA: A Game Changer article). The investigators described these papers as only “Act One,” anticipating even more exciting findings to come as the data mounts and continues to be analyzed.

An Alliance of Friends. TMJA joined forces with the Chronic Fatigue and Immune Dysfunction Syndrome Association of America and the Endometriosis and National Vulvodynia Associations to form The Chronic Pain Research Alliance (CPRA) to advocate for research on these conditions as well as on Chronic Headache, Fibromyalgia, Interstitial Cystitis and Irritable Bowel Syndrome. Not only do these conditions primarily or predominantly affect women, they often occur together. If you have one, you are apt to get another or others. In May 2010, CPRA launched a Campaign to End Chronic Pain in Women on Capitol Hill to a standing room only crowd of legislators and staff. We showed a video and distributed a White Paper detailing the physical, psychological and financial impact of these conditions, the lamentable lack of research on them and the consequent cost of ineffective and even harmful treatments in the absence of quality science. You can view the video and read the White Paper on the website: www.EndWomensPain.org.

Institute of Medicine Input. The TMJ Association testified at the first public hearing in Washington DC of the Institute of Medicine Committee which drafted the Report on Pain in America. We gave examples of TMD patients’ experiences to emphasize the importance of research and the need for safe and effective treatments.

NIH Action. As a result of our 5th and 6th scientific meetings, the NIH has formed a trans-NIH committee to address TMD and comorbid conditions. A scientific meeting is planned for 2012.
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You tell us that when you talk about new scientific findings about TMJ to your healthcare provider—your family doctor, internal medicine specialist or other medical professional, he or she pleads ignorance.  At the same time, most dentists continue to treat TMJ problems the same way they have been doing for decades. It is as though research scientists live in one world and healthcare providers in another.

It is time for a change. We need to spread the word that TMDs are a complex family of conditions, often occurring in common with other painful conditions. We intend to explore all avenues of communication to make sure that the medical and dental communities are educated about the jaw joint and their role in treating TM Disorders. Patients deserve to receive the benefits of scientific discoveries in a timely manner.

You can help. To that end we will develop informational materials you can use to engage more actively with your healthcare professionals as well as enable you to make informed healthcare decisions.
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The first bioengineering conference on the TMJ was held in 2006. The report from that meeting stated: “The Temporomandibular joint is one of the least studied joints in the body, despite the large patient population and the significant morbidity related to a plethora of TMJ disorders.”

We aim to change that so that the Temporomandibular joint receives the same quality of scientific research as other joints in the body. We need fundamental knowledge of how the joint is designed to do the work it does so that safe and effective treatments can be developed when things go wrong. We have five strategies for 2012:

1. We will participate in a TM joint project under the auspices of the Cornell University Department of Biomedical Engineering. More about that when the project is set to begin.

2. Following FDA approval of clinical protocols to be developed by TMJ device manufacturers, we will convene a Round Table consisting of all interested parties: the manufacturers, representatives of FDA, NIH, The TMJ Association, and others. The intent of the Round Table is to provide an open exchange of ideas and build a body of data on implant performance, patient satisfaction, adverse events and complications. This information will empower patients to make better healthcare decisions as well as guide the design of future devices to yield optimal patient outcomes.

3. We will develop a TMJ Implant Patient Communication Center within our website for the exchange of information among TMJ implant patients so that they, and we, can be better informed about their needs and experiences.

4. We will convene a Bioengineering Advisory Council to obtain the professional expertise necessary as we move forward with TM joint initiatives.

5. We will encourage and facilitate interaction among the pertinent government agencies to evaluate the state-of-science of the Temporomandibular joint and recommend directions for future research. 

I hope you’re as excited as we are about our future plans. We look forward to another productive year with your support and participation.        
   
Terrie Cowley, President & Co-Founder