Though not advertised to the general public, the FDA has decided to start taking a closer look at medical conditions that can have significant impact on an individual’s quality of life. As TMD problems have been estimated to impact the lives of 35 million Americans, organizations like The TMJ Association have made efforts in the hope that TMD problems will be selected amongst 20 diseases that will be the focus of public meetings in 2016-2017. The goal of these meetings will be to determine the impact of the chosen diseases on daily life, and to look at the scope of services that are available to treat these conditions.
The impetus for this FDA initiative is that realization the chronic pain problems such as TMD, rarely occur as a single entity. Rather it has been estimated that over 85% of TMD patients have other chronic pain conditions. They include chronic headache, endometriosis, fibromyalgia, interstitial cystitis, irritable bowel syndrome, chronic fatigue syndrome, sleep disorders, and vulvodynia. In addition, TMD and these associated conditions are commonly stigmatized making it difficult for patients to know where to turn to get care that is based on logical assessment and sound scientific principles.
As the majority of TMD sufferers that seek care are women, it is even more important that this condition be scientifically validated. Unfortunately, too many patients arrive at my office having been told that they will never get better and that their problem is in “their head.”
If TMD is one of the conditions chosen by the FDA, the best outcome would be that more information would ultimately be made easily available to the public. This information would emphasize these facts:
1. TMD problems are orthopedic problems
2. TMD problems may be initiated or aggravated by rheumatologic, autoimmune and neurologic conditions.
3. Women present more commonly with TMJ symptoms as a result of specific biologic predispositions, some of which are hormone driven.
4. Common TMJ problems may be initiated by traumas, overuse behaviors, chronic postural strain, sleep bruxism, and persistent muscle tension driven by emotions and life challenges. These factors are common; they are only risk factors and not absolutely causal.
5. Treatment for TMJ disorders should be of a reversible nature and not focus on the teeth. The ultimate goal should be tissue healing and adaptation. Patient participation is likely as important as anyone other treatment effort.
6. Getting better typically will lead to less pain, less medication, better function and increased optimism in patients that had expected a lifetime of suffering. Just like with other orthopedic problems, the end point of treatment may occur despite lingering discomfort, joint noises, or limited jaw motion. It is essential that the treating doctor/health care provider stress that these residuals may be the best that can be accomplished.
It is welcome news that organizations like the FDA have recognized that it is time for conditions like TMD to be validated. All sufferers will be benefitted from this initiative.