Many people are familiar with TMJ disorder and the problems
associated with it. But TMJ is actually just one of several disorders in
the category of TMDs, or tempromandibular disorders. Thus far dentists
have had much difficulty in determining who is at risk for developing
these terrible disorders, but new research can now provide some relief.
Researchers
at the Buffalo School of Dental Medicine have developed a set of
characteristics that they believe are the key risk factors for an
individual developing a TMD. These researchers hope that the new set of
clinical characteristics will help dentists to provide the best care for
their patients in the future by allowing them to better understand what
puts someone at risk for a TMD.
The research was published in the
November issue of the Journal of Pain. It is part of a larger study
called OPPERA, which stands for Orofacial Pain Prospective Evaluation
and Risk Assessment. This study is the largest that has ever been
conducted on pain conditions and their development.
Richard
Ohrbach, lead author on the paper, is an associate professor of oral
diagnostic sciences at the University of Buffalos School of Dental
Medicine. He has been studying TMD for decades. “The UB role in the
project was to develop well-designed examination procedures to help
dentists and other health care providers identify risk factors for TMD,”
Ohrbach said
The researchers on this study looked at both
patients who had never experienced TMD and those who were current
sufferers of TMD. The study was conducted through questionnaires
containing a large amount of questions about the patients current
health and symptoms as well as their health histories. Researchers also
conducted clinical exams on the patients to study their pain disorders.
Patients were studied from several states across the US, including North
Carolina!
The researchers looked at seventy one variables that
appeared to be associated with TMD, and discovered a positive
correlation for a high number of those variables, fifty nine. This means
that fifty nine of the seventy one variables that researchers thought
may be associated with TMD showed signs of being significantly
associated with TMD. “Our results indicate that individuals with TMD
differ substantially from the controls across almost all of the
variables we assessed,” said Ohrbach.
The variables that were most
significant in the TMD sufferers were patients with trauma to the jaw,
jaw locking and/or jaw noises, non-pain symptoms in the facial area, and
pain during regular jaw activities such as chewing and talking. Ohrbach
noted that some of these findings were very much expected, but there
were also some which researchers knew little about prior to the study.
Some
of the risk factors that researchers were not expecting are neural and
sensory medical conditions like earaches, hearing loss, fainting and
dizziness, and seizures and epilepsy. The research has also confirmed
previous theories about certain risk factors that had not yet been
proven with such a large scale and comprehensive study. One of these
factors is that patients who have other pain disorders are more likely
to find that they have TMD as well. But Ohrbach is unclear about exactly
which comes first in this scenario.
“Why are other pain disorders
more common in people with TMD?” he said. “Is it because those pain
conditions predispose them to develop TMD or do they develop TMD first
and does TMD lead them to then develop other pain disorders?”
The
research plans to continue in order to answer questions such as these.
The researchers hope to track the pain disorders and look at their
relevance to certain variables. The researchers hope that this will
provide society with a better understanding not only of TMD, but of pain
disorders as a whole.
Dr. Ohrbach had this to say: “How do we understand the pain?
How do we establish a reliable and clinically useful marker of pain so
that significant pain can be more readily diagnosed? To answer these
questions, we need to have a model that puts all of the pieces together,
that takes the findings from a clinical exam
, puts it into a rigorous
framework using the right assessment and diagnosis tools in order to
chart the nature of multiple physical disorders so that we can
ultimately understand how the pain is affecting the individual.”