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

Statement by NIDCR Acting Director on the National Academies of Sciences, Engineering, and Medicine Report on Temporomandibular Joint Disorders

I am pleased to announce the release of the National Academies of Sciences, Engineering, and Medicine (NASEM) report, Temporomandibular Disorders: Priorities for Research and Care. As underscored by the comprehensive report, temporomandibular joint disorders (TMJDs) are a diverse and still poorly understood set of complex, painful conditions affecting the jaw muscles and tissues, temporomandibular joints, and associated nerves. Clearly, there is much more to be understood, and these conditions continue to confound medical and dental health care providers and researchers.

Have you seen the film Dark Waters?

The Film. 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. PFOA, also known as C8, is a man-made chemical. It is used in the process of making Teflon and similar chemicals known as fluorotelomers.

Online TMD Diet Diary Research Project

Online TMD Diet Diary Research Project The TMJ Association received the following request from Professor Justin Durham and his research team at Newcastle University. We encourage TMJ patients to participate in this project as it is an under researched

Drug Induced Bruxism

The authors of this article state that orofacial movement disorders (bruxism) are treated typically by dental professionals and not by those specialists (neurologists) researching and treating the other movement disorders (Parkinson's disease, Huntington's disease, tremors, etc.). Again, this is more evidence of the complexity of TMD and the need for multidisciplinary research and treatment in TMD.

Botox & Myofascial TMJ Pain Study

  • Oct 27, 2016

Our sincere thanks to Dr. Susan Herring of the University of Washington in Seattle  for providing the following summary of a recent article in the profressional journal, Pain.

Efficacy of botulinum toxin type A for treatment of persistent myofascial TMD pain: a randomized, controlled, double-blind multicenter study
Ernberg M., Hedenberg-Magnusson B., List T., Svensson P.
In press, Pain (2011), doi:10.1016/j.pain.2011.03.036.
 
Botox blocks the release of neurotransmitters from nerve endings.  Although chiefly used to stop muscle contraction, it might also relieve pain by preventing nerves from releasing inflammatory molecules. This clinical trial investigated whether Botox injection of the masseter was an effective treatment for patients with persistent myofascial TMJ pain.
 
The 21 patients (19 female) all met rigorous criteria and were recruited from 4 Danish and Swedish clinics. The study was very well-controlled in that (1) patients served as their own controls and were injected twice, once with Botox and once with saline, but in random order (crossover design) and (2) investigators as well as subjects were blinded as to which substance was injected (double blinding).  Patients were carefully examined for pain and other variables 1 month and 3 months after the injections.

Side effects reported in the first week after injections included headache and fatigue, but were similar for Botox and saline; side effects were gone by 1 month. This suggests that subjects were not able to tell which injection was the Botox.

Surprisingly, pain intensity was reduced after both Botox and saline injections, although more so for Botox.  However, the number of patients that experienced significant (defined as 30% decrease) pain reduction was about the same for both treatments.

The investigators concluded that there was a strong placebo effect, which means that less well-controlled studies may not be valid. While there was a slightly better outcome for Botox than for saline, it was small and was not experienced by all patients.  The authors recommended against the use of Botox as an adjunct to conservative treatment of persistent myofascial pain on the basis of its high cost and lack of efficacy. 

TMJ Disorders

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