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Jaw joint disorders likely coexist with other conditions

Friday 25 March 2011

Milwaukee Journal Sentinel

From the Milwaukee Journal Sentinel:


Jaw joint disorders likely coexist with other conditions, Medical College study finds

By John Fauber of the Journal Sentinel
March 2, 2011

Temporomandibular joint and muscles disorders are likely to coexist with any of many other conditions and are treated with a variety of measures, according to a new study by researchers at the Medical College of Wisconsin.

The report noted that TMJD, which can range from mild jaw pain to intractable pain and jaw dysfunction, affects between 10 million and 36 million Americans, 90% of whom are women.

The study was based on a survey of 1,511 people who were part of a registry maintained by the TMJ Association, a Brookfield-based national patient advocacy organization.

While TMJD affects the jaw joint and surrounding tissue, people with the condition also were more likely to have any number of other conditions, including headaches, allergies, depression, fatigue, arthritis, fibromyalgia, autoimmune disorders, sleep apnea and gastrointestinal complaints. Many of those other conditions were as much as six times more likey to occur in TMJD patients than individuals who did not have TMJD.

Treatments also varied widely.

Of the 1,511 TMJD patients in the survey, 394 had undergone major surgery to treat their symptoms and many of them had undergone multiple surgeries.

Pharmacological treatments were common, including anti-inflammatory agents, non prescription pain relievers and opioid pain medication.

However, one of the most common and effective treatments was the use of hot and cold compresses, which was used by 65% of TMJD patients. Orthotic splints and jaw exercises also were common.

“For most patients, TMJ is not about teeth and jaws, but a far more complex medical pain condition among others that primarily affect women in their child bearing years," said co-author Terrie Cowley, a patient herself and president and co-founder of the TMJ Association.

"The fact that billions of dollars are spent annually by TMJ patients on treatments, when hot and cold packs are the most effective remedy, tells us that we must fall back, re-trench and direct research, and professional education about these conditions toward a multidisciplinary medical model if we are to improve the health care and quality of life of the millions of TMJ patients.”

Cowley and the other authors concluded that TMJD is a complicated disorder.

"A multidisciplinary system approach will be necessary to advance our understanding of this complex disease and a major paradigm shift needs to occur in the way TMJD are viewed in the scientific and clinical communities," they concluded.

The study was published in the Clinical Journal of Pain.


The above originally appeared here.

And this is the study the article referred to:


Temporomandibular Disorders and Associated Clinical Comorbidities

Hoffmann, Raymond G. PhD*,†; Kotchen, Jane Morley MD*,‡; Kotchen, Theodore A. MD*; Cowley, Terrie BA∥; Dasgupta, Mahua MS*,†; Cowley, Allen W. Jr PhD*,§


Objective: Temporomandibular joint and muscle disorders (TMJD) are ill-defined, painful debilitating disorders. This study was undertaken to identify the spectrum of clinical manifestations based on self-report from affected patients.

Methods: A total of 1511 TMJD-affected individuals were recruited through the web-based registry of patients maintained by The TMJ Association, Ltd, a patient advocacy organization, and participated in the survey as well as 57 of their nonaffected friends. Results were also compared with US population for questions in common with the National Health and Nutrition Examination Survey.

Results: The TMJD-affected individuals were on average 41 years of age and predominantly female (90%). Nearly 60% of both men and women reported recent pain of moderate-to-severe intensity with a quarter of them indicating interference or termination of work-related activities. In the case-control comparison, a higher frequency of headaches, allergies, depression, fatigue, degenerative arthritis, fibromyalgia, autoimmune disorders, sleep apnea, and gastrointestinal complaints were prevalent among those affected with TMJD. Many of the associated comorbid conditions were over 6 times more likely to occur after TMJD was diagnosed. Among a wide array of treatments used (46 listed), the most effective relief for most affected individuals (91%) was the use of thermal therapies—hot/cold packs to the jaw area or hot baths. Nearly 40% of individuals affected with TMJD patients reported one or more surgical procedures and nearly all were treated with one or many different medications. Results of these treatments were generally equivocal. Although potentially limited to the most severe TMJD affected individuals, the survey results provide a comprehensive dataset describing the clinical manifestations of TMJD.

Discussion: The data provide evidence that TMJD represent a spectrum of disorders with varying pathophysiologies, clinical manifestations, and associated comorbid conditions. The findings underscore the complex nature of TMJD, the need for more extensive interdisciplinary basic and clinical research, and the development of outcome-based strategies to more effectively diagnose, prevent, and treat these chronic, debilitating conditions.


The study originally appeared here.


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