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Consider Including the TMJA in Your Financial Planning

We were recently contacted by Tom P. who informed us that he was including The TMJ Association (TMJA), in his financial planning. Tom wrote the following for us to share with our readers:

The Scoop on TMD Pharmaceuticals

Let's say the National Institutes of Health just handed us a multi-million dollar grant to get to the bottom of TMD and find a cure once and for all. I mean, we could start handing out heating pads left and right, but that kind of relief can only get us so far. Whenever I try a different form of therapy or medication, I like to think about the biology, right down to the cellular and molecular level. Why are the cells that make up my jaw region being such jerks?

Join Us AT TMJ Cafe

The TMJ Association is pleased to partner with Inspire to bring you the TMJ Cafe, a free online support network and discussion community for those with Temporomandibular Disorders (TMD). We invite you to meet others like you, share experiences and tips for getting through the day, and give and receive support.

Sustained and Repeated Mouth Opening Leads to Development of Painful Temporomandibular Disorders Involving Macrophage/Microglia Activation in Mice

Temporomandibular disorder (TMD) is a set of heterogeneous musculoskeletal conditions involving the temporomandibular joint (TMJ) and/or the masticatory muscles. Up to 33% of the population has had at least one symptom of TMD with 5-10% of them requiring treatment. Common symptoms include limited jaw movement, joint sound, and pain in the orofacial area. Once TMD becomes chronic, it can be debilitating with comorbidities that greatly reduce one's overall quality of life. However, the underlying mechanism of TMD is unclear due to the multicausative nature of the disease.

Prevalence of TMD in Sjӧgren Syndrome Patients

Sjӧgren's Syndrome seems to play a role in temporomandibular joint disorders.

Are you a TMD patient with Tinnitus?

  • Dec 6, 2017

It's a ringing sound, a buzzing, a hiss.... It can be soft or loud, intermittent or present all the time, affecting one ear or both. In whatever way it affects you, it's damned annoying, unpleasant, distracting. Indeed, it is considered the worst problem affecting human beings after pain and dizziness. What it is is tinnitus, a sound in your ears that seems to come out of nowhere that you hear and sometimes other people can hear as well. And it's mysterious.

For generations, hearing specialists have speculated about what causes the sound. They know that tinnitus increases with age (up to a point, after which it peters out) and it can occur in association with various diseases or with the use of certain drugs. Researchers have come up with theories, but as yet no hard and fast evidence has established what actually generates the sounds. One theory says that tinnitus is caused by abnormal firing (hyperactivity) of the auditory sensory cells in the inner ear. Another says that disease or damage to these cells causes a "phantom" sound to be transmitted to the brain. Still a third neuromuscular theory suggests that abnormal stimulation of the muscles that control the ear drum and bones of the middle ear is at fault. Sadly, there are as yet no truly effective treatments for tinnitus. What has emerged over the years, however, from what many patients have told The TMJ Association and from clinical studies, is that the risk for tinnitus is higher among TMD patients than people without TMD.

TMD subgroups

Now comes a study to suggest that not all TMD patients have the same degree of risk. The study makes use of the fact that TMD diagnosis has grown more refined over the years, using criteria that enable classifying patients into three major subgroups. The groups are based on whether symptoms primarily involve pain in the chewing muscles associated with the TM joint (called MPD for myofascial pain diagnosis); whether symptoms chiefly relate to displacement of the disc that separates the head of the mandible from the skull (called DD for disc displacement)), or whether the joint itself is affected by degenerative arthritic changes (called DJD for degenerative joint disease). These are not mutually exclusive groups, since patients can have symptoms spanning all three categories.

The study conducted by Susee Ravuri of the University of Washington Dental School was based on a large number of volunteers seen at three sites (the Universities of Washington, Minnesota and Buffalo). Of the initial 705 subjects seen, 614 met the diagnostic criteria for TMD and were classified according to the three TMD subtypes. They were also assessed for the presence of tinnitus and answered other health and behavior questions. The remaining 91 subjects served as controls. Tinnitus was reported by 41 percent of the TMD population compared to only 5.5 percent in the controls. However, when analyzed by subtype, the rate of tinnitus in the MPD group was 48 percent, compared to 15.6 percent in the non-MPD group (who had been diagnosed as either DD, DJD or both). Patients diagnosed with MPD only had the still higher tinnitus rate of 64.3 percent.

Risk factors

The study also considered whether other factors might contribute to the risk of tinnitus, such as pain when mild pressure was applied to various sites in and around the TM joint, the presence of oral habits like tooth clenching or grinding, headaches in the temporal region, and psychological symptoms such as anxiety and depression. Here the factor that stood out in relation to tinnitus was headaches in the temporal region. Thirty-seven percent of patients with a diagnosis of MPD only (no DD and no DJD) had tinnitus, but that percentage increased to 52 percent if they also had temporal headaches. MPD patients overall experienced a higher number of painful pressure sites compared with the other subgroups, and if they also reported tinnitus, they scored higher on scales of anxiety, pain intensity, and interference of pain with daily activity. Interestingly, oral habits such as clenching or grinding or other abnormal jaw movements were not found to be associated with tinnitus.

A follow-up study

The original subjects were followed for a period of 7.8 years and then follow-up studies were conducted on 388 subjects. Of this smaller-sized and older-aged group, 279 subjects were diagnosed with TMD and classified by subtype, but the rate of tinnitus had dropped to 28 percent compared with the 41 percent in the baseline study (consistent with studies that show declines in tinnitus with age). In the follow-up group, the highest tinnitus rate (30 percent) was found in the MPD subgroup.

Summary

The availability of diagnostic criteria to classify TMD patients into three distinct but not mutually exclusive subgroups has enabled an analysis indicating different risks for tinnitus per subgroup. The risk for tinnitus is greatest in patients who present with MPD (pain in the masticatory or chewing muscles associated with the TM joint). If these patients also report headaches in the temporal region, their risk for tinnitus is at least three times higher for tinnitus than MPD patients without headaches. These findings lend some support to the neuromuscular theory as a basis for tinnitus, the idea that excessive tension or other dysfunctional stimulation of the masticatory muscles affects nearby ear muscles leading to the generation of tinnitus sounds.  

Reference

TINNITUS AND TEMPOROMANDIBULAR JOINT DISORDER SUBTYPES  

RAVURI, SUSEE PRIYANKA

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology , Volume 124 , Issue 3 , e194 - e195

TMJ Disorders

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