Temporomandibular disorders (TMDs), are a set of more than 30 health disorders associated with both the temporomandibular joints and the muscles and tissues of the jaw. TMDs have a range of causes and often co-occur with a number of overlapping medical conditions, including headaches, fibromyalgia, back pain and irritable bowel syndrome. TMDs can be transient or long-lasting and may be associated with problems that range from an occasional click of the jaw to severe chronic pain involving the entire orofacial region. Everyday activities, including eating and talking, are often difficult for people with TMDs, and many of them suffer with severe chronic pain due to this condition. Common social activities that most people take for granted, such as smiling, laughing, and kissing, can become unbearable. This dysfunction and pain, and its associated suffering, take a terrible toll on affected individuals, their families, and their friends. Individuals with TMDs often feel stigmatized and invalidated in their experiences by their family, friends, and, often, the health care community. Misjudgments and a failure to understand the nature and depths of TMDs can have severe consequences — more pain and more suffering — for individuals, their families and our society. Temporomandibular Disorders: Priorities for Research and Care calls on a number of stakeholders — across medicine, dentistry, and other fields — to improve the health and well-being of individuals with a TMD. This report addresses the current state of knowledge regarding TMD research, education and training, safety and efficacy of clinical treatments of TMDs, and burden and costs associated with TMDs. The recommendations of Temporomandibular Disorders focus on the actions that many organizations and agencies should take to improve TMD research and care and improve the overall health and well-being of individuals with a TMD.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON TEMPOROMANDIBULAR DISORDERS (TMDs): FROM RESEARCH DISCOVERIES TO CLINICAL TREATMENT
• Reviewers
• Preface
• Summary
  • CHALLENGES IN CARE: PATIENT EXPERIENCES
  • COMPLEXITY OF TMDs
  • NEXT STEPS AND RECOMMENDATIONS
  • OPPORTUNITIES FOR ACTION
• 1. Introduction
  • COMPLEXITY OF TMDs
  • CHALLENGES IN CARE: PATIENT EXPERIENCES
  • IDENTIFYING THE APPROPRIATE MODEL FOR TMD CARE AND RESEARCH
  • KEY THEMES
  • ORGANIZATION OF THIS REPORT
  • REFERENCES
• 2. Definitions and Scope: What Are TMDs?
  • TERMINOLOGY: WHAT TERM SHOULD BE USED FOR THIS SET OF DISORDERS?
  • DIAGNOSTIC CRITERIA TO CATEGORIZE TYPES OF TMDs
  • TYPES OF TMDs
  • UNDERSTANDING THE ETIOLOGIES OF TMDs
  • FACTORS IN THE DISEASE COURSE OF A TMD
  • WHAT CAN BE LEARNED FROM OTHER PAIN CONDITIONS?
  • WHAT CAN BE LEARNED FROM OTHER ORTHOPEDIC CONDITIONS?
  • CONCLUSIONS AND RESEARCH PRIORITIES
  • REFERENCES
• 3. Individual and Societal Burden of TMDs
  • PREVALENCE OF TMDs
  • INCIDENCE OF TMDs
  • BURDEN AND COSTS OF TMDs
  • COMORBIDITIES
  • RISK FACTORS FOR TMDs
  • CONCLUSIONS AND RESEARCH PRIORITIES
  • REFERENCES
• 4. State of the Science on TMDs
  • RECENT BIOMECHANICAL AND BIOENGINEERING RESEARCH ON THE TMJ
  • NEUROBIOLOGY OF OROFACIAL PAIN AND TMDs
  • NEUROIMMUNE INTERACTIONS AND TMDs
  • NEUROENDOCRINE INTERACTIONS, STRESS RESPONSE, AND TMDs
  • BIOMARKERS AND MOLECULAR GENETICS OF TMDs
  • NEUROIMAGING OF THE CNS: EXPLORATION OF TMD PHENOTYPES
  • PSYCHOSOCIAL FACTORS UNDERLYING TMDs
  • APPLICATION OF DATA SCIENCE METHODOLOGIES AND NOVEL TECHNOLOGIES TO TMD RESEARCH
  • TMD RESEARCH FUNDING
  • MOVING THE RESEARCH ENTERPRISE FORWARD
  • A NATIONAL COLLABORATIVE RESEARCH CONSORTIUM AND FRAMEWORK FOR ACTION
  • CONCLUSIONS
  • REFERENCES
• 5. Caring for Individuals with a TMD
  • FIRST, DO NO HARM
  • PREVENTION AND EARLY DETECTION
  • ASSESSMENT AND DIAGNOSIS OF TMDs
  • TMD TREATMENTS
  • IMPROVING AND DISSEMINATING EVIDENCE
  • CONCLUSIONS
  • REFERENCES
• 6. Improving TMD Health Care: Practice, Education, Access, and Coverage
  • TMD HEALTH CARE PATHWAYS
  • IMPROVING INTERPROFESSIONAL EDUCATION AND COLLABORATION
  • STRENGTHENING EDUCATION AND TRAINING
  • IMPROVING ACCESS TO SPECIALTY CARE
  • IMPROVING PAYMENT AND COVERAGE
  • CONCLUSIONS AND RESEARCH PRIORITIES
  • REFERENCES
• 7. Improving Patient, Family, and Public Education and Awareness About TMDs
  • OVERCOMING STIGMA
  • INCREASING PATIENT AND FAMILY EDUCATION AND IMPROVING COMMUNICATION WITH HEALTH CARE PROFESSIONALS
  • RAISING PUBLIC AWARENESS AND KNOWLEDGE ABOUT TMDs
  • CONCLUSION AND RESEARCH PRIORITIES
  • REFERENCES
• 8. Next Steps and Recommendations
  • BUILD AND SUSTAIN COLLABORATIVE AND MULTIDISCIPLINARY RESEARCH
  • IMPROVE ACCESS TO AND QUALITY OF TMD HEALTH CARE
  • IMPROVE HEALTH CARE PROFESSIONAL EDUCATION ABOUT TMDs
  • RAISE AWARENESS, IMPROVE EDUCATION, AND REDUCE STIGMA
  • OPPORTUNITIES FOR ACTION
  • REFERENCES
• Appendix A. Workshop and Open Session Agendas
• Appendix B. Committee Biographical Sketches
• Appendix C. Prevalence, Impact, and Costs of Treatment for Temporomandibular Disorders
• Appendix D. Masticatory System: Anatomy and Function

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2020. Temporomandibular disorders: Priorities for research and care. Washington, DC: The National Academies Press. https://doi.org/10.17226/25652.

Digital Object Identifier: https://doi.org/10.17226/25652

Library of Congress Control Number: 2020934005

Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

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