Many treatments and surgeries for patients with temporomandibular joint disorders lack supporting evidence of effectiveness and may even make pain worse, according to a recent investigation by KFF Health News and CBS News.
The two news organizations interviewed patients who had surgeries performed to alleviate pain associated with their TMJ disorders and also spoke with professionals in the industry about TMJ treatments.
Here are eight notes from the investigation:
1. Ten patients who had multiple surgeries to address their TMJ pain told KFF and CBS that the procedures made their pain worse.
2. Rena D’Souza, DDS, PhD, director of the NIH’s National Institute of Dental and Craniofacial Research, told KFF and CBS that treatments have been overall ineffective because the disease is not well understood.
3. A 2020 study by the National Academies of Sciences, Engineering, and Medicine concluded that most healthcare professionals, including dentists, have received "minimal or no training" on TMJ disorders. It also found patients can be harmed by "overly aggressive" care and lack of proven treatments.
4. NASEM also found that some professionals still follow beliefs about the disorder that lack supporting evidence. The organization also found that patients were often steered toward costly and ineffective treatments instead of being taught to manage pain through strategies and therapies with "good evidence."
5. Terrie Cowley, president and co-founder of the TMJ Association, told the news organizations that she advises many patients to avoid treatment entirely.
6. Kyriacos Athanasiou, PhD, a biomedical engineering professor at the University of California-Irvine, said bias has slowed research on TMJ disorders due to cases not being taken seriously because the disorders are more prevalent among women.
7. NASEM previously called for better education about TMJ disorders across the medical and dental fields, as well as more NIH funding to support additional research.
8. Since NASEM published its 2020 report, several initiatives have been launched to support research and education of TMJ disorders, including the NIH's TMJ research collaborative and new training standards required for dental schools to be accredited.