Research studies on temporomandibular disorders (TMD) consist of two different subjects
One is the prevalence (frequency) of the occurrence of various symptoms reported by patients seeking treatment for TMD and examination findings. The other type of research deals with a variety of treatment modalities used.
Published research studies on symptoms are plentiful and involve large and small populations in different geographical areas or countries, including students or groups of people insured by an insurance carrier.
The term TMD includes a group of disorders that can involve symptoms, such as pain in the face, jaw, mouth, ears, head and neck, with extensions or co-existence of other adjacent areas, together with various forms of functional compromises in the jaw such as limited jaw movements or difficulty chewing and clinical signs.
Research on the occurrence of TMD is sometimes generalized and studies may not exactly duplicate those of other authors. Often authors attempt to categorize the “typical” patient who suffers from a TMD.
There are tremendous variations between patients; some with many symptoms and signs and others with only a few significant ones.
The severity of symptoms is in the perception of patients, not doctors. Many symptoms reported by patients who have TMD may also be caused by other disorders, such as ear ache, headache, dizziness or dental pain. Despite this, much research has been published throughout the world on TMD signs and symptoms in both medical and dental journals.
The subject of treatment is much more complex for two reasons
Those who believe that TMD has no physical but only a psychological basis, test their patients with written questionnaires to determine their emotional and psychological status. Their treatment includes counselling, relaxation techniques and the prescription of a variety of medications.
Success of treatment requires a subjective (personal) assessment (opinion) by the TMD patient either in verbal or via questionnaire and/or the treating doctor in determining that the treatment has been successful or has not. This does not produce hard data required for high quality scientific publishable research. Articles are plentiful in dental journals about this type of “successful” treatment for TMD.
Dentists who treat the physical/structural/functional disorder referred to as TMD also publish a great deal in the medical and dental literature. The weakness in this area of research lies in the variety of approaches to treatment.
Most dentists believe in dental occlusion, the way the teeth fit together, is at the basis of most patients’ TMD condition. The exceptions include trauma, like a blow to the face or head which may damage the bones of the head and jaw, muscles, temporomandibular joints (TMJ) or teeth. Depending on the condition, treatments vary including surgery, jaw muscle exercises, mouth appliances of various designs, oral and injectable medications.
Because of the variety of different conditions under the term TMJ, research has been done on some of the treatment types. Once again, the limitation of the studies is often how success of treatment is measured. If it is only “how do you feel and function” or “how does the doctor think you feel and function”, the results are not scientific and not reproducible by other doctors performing research.
With the use of computerized devices which can objectively measure some of the parts of the functioning jaw, head and neck, good scientific research on what constitutes each patient’s function before and after therapy is possible. Excellent scientific research studies have been performed and their results published internationally.
In these cases, the creation of a Neuromuscular Dental Occlusion as a treatment for patients with temporomandibular disorders has been proven to be overwhelmingly successful. This is the proven successful treatment technique taught by ICCMO to its members throughout the world.
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