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It's Time to Be Part of the Solution

The National Academy of Medicine (NAM) Study on Temporomandibular Disorders (TMD) is well underway. We strongly encourage everyone affected by TMD to write to the NAM committee letting them know what it is like to live with TMD and your experiences with getting care.

New CME on Chronic Overlapping Pain Conditions

The Chronic Pain Research Alliance, an initiative of The TMJ Association, in partnership with the International Pelvic Pain Society, is pleased to announce the release of our newly developed Continuing Medical Education (CME) program on Chronic Overlapping Pain Conditions.

And the Committee heard from the American Association of Oral and Maxillofacial Surgeons

At the end of the NAM meeting, Dr. Gregory Ness, representing the American Association of Oral and Maxillofacial Surgeons (AAMOS) gave the following comments: “AAMOS welcomes the interest and support of the Academies, the NIH, NIDCR, FDA and The

What Allen Told the Committee

Allen Cowley addressed the second open-to-the-public meeting of the National Institute of Medicine's (NAM) Committee on Temporomandibular Disorders (TMD) held on March 28, 2019 in Washington, DC. No stranger to the world of TMD, Dr. Cowley is the hus

Some Thoughts on Depression

It is hardly surprising that the chronic pain and limitations in function that many long-time TMJ patients experience can be accompanied by a state of depression, a sense of exhaustion and hopelessness.

National Academy of Medicine Study on Temporomandibular Disorders: From Research Discoveries to Clinical Treatment

  • Mar 19, 2019

An ad hoc committee, under the auspices of the National Academies of Sciences, Engineering, and Medicine's Health and Medicine Division, has been convened to study temporomandibular disorders (TMD) in a project entitled From Research Discoveries to Clinical Treatment. The members will address the current state of knowledge regarding TMD research, education and training, safety and efficacy of clinical treatments of TMD, and burden and costs associated with TMD.

The members will identify approaches to advance basic, translational, and clinical research in the field. Their findings, conclusions, and recommendations will also inform development of policies related to evidence-based treatment and clinical management of TMD patients. 

Specifically, the committee's task calls for members to:  

Review and estimate the public health significance of TMDs, including prevalence, incidence, burden and costs; and review challenges to data collection and reliability.

Evaluate the evidence base for assessment, diagnosis, treatment, and management of acute and chronic TMD. Recognizing that TMDs are diverse and multifactorial conditions influenced by genetics, sex and gender, environmental, physiological, and psychological factors, this effort will:

  • Address patient heterogeneity and challenges to patient stratification to better target therapies toward patients.
  • Identify similarities and differences between chronic TMD, other chronic pain states (as well as chronic overlapping pain conditions), and other joint disorders such as phenotypic features that might predict responsiveness to treatments.
  • Identify and characterize other non-pain comorbidities that diminish quality of life, including those that affect etiology and influence resilience, such as nutritional challenges and other neurological, metabolic, and mental health conditions (e.g. anxiety, depression).
  • Examine the evidence-base for defining chronic TMD as a multi-system disorder that necessitates multidisciplinary research and interventions.

Identify barriers to appropriate patient-centered TMD care, in the presence and absence of an evidence base, and strategies to reduce these barriers along the continuum of TMD pain. This effort will:

  • Evaluate elements and outcomes of patient-centered TMD care.
  • Identify challenges to dissemination and implementation of evidence-based treatments and prevention strategies that are safe and effective.
  • Determine and characterize health inequities in clinical TMD management.

Review the state of science for TMD and provide an overview of basic, translational, and clinical research for TMD. This effort will:

Examine existing or emerging TMD animal models and their preclinical utility.

Identify gaps and opportunities in TMD research relating to central and peripheral mechanisms, genetic/epigenetic contributions, heterogeneity of molecular mechanisms, joint mechanics, neuroimmune processes, endocrine influences, role of the microbiome, and endogenous mechanisms of resilience.

  • Assess the intersection of sex differences in immune/neuroimmune and inflammatory responses in chronic TMD with other autoimmune diseases that are more prevalent in females or males.
  • Assess progress on identification and validation of targets and biomarkers (genetic, neuroinflammation, neuroimaging, proteomic, behavioral, etc.) for use in establishing risk, diagnoses, treatment, outcomes, and reoccurrence.
  • Identify potential approaches to using artificial intelligence for pattern recognition in patient datasets (e.g., genetic, biological, psychological, social traits, electronic health records, and patient-reported outcomes) to distinguish disease subtypes, develop individualized clinical decision support, and predict patient responses.
  • Identify new and rapidly evolving tools and technologies with potential to significantly advance research, diagnosis, and treatment of TMD.

Identify opportunities and challenges for development, dissemination, and clinical implementation of safe and effective clinical treatments for TMD, including pharmacological agents, regenerative medicine, behavioral interventions, and complementary and integrative approaches.

Identify scientific and clinical disciplines needed to advance TMD science and the development, dissemination, and implementation of safe and effective treatments; as well as strategies to enhance education and training in these disciplines.

Identify multidisciplinary/interdisciplinary research approaches necessary in the short-and long-term to advance basic, translational, and clinical TMD research and to improve the assessment, diagnosis, treatment, and management of TMDs.

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The first meeting of the Committee was held on Tuesday, January 29, 2019 at the National Academy of Sciences building in Washington, D.C.

Terrie Cowley, President and Co-Founder of The TMJ Association, was asked to address the meeting. Click here to view her presentation before the committee.

The next National Academy of Medicine meeting will be held on March 28 and 29 in Washington D.C. and will include an open session to the public both days. More details are available at: http://www.nas.edu/hmd/Activities/PublicHealth/TemporomandibularDisorders/2019-MAR-28.aspx

 

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