Temporomandibular Disorders Priorities for Research and Care (2020) / Chapter Skim
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1 Introduction
1 Introduction
Pages 17-30
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From page 17... ...
TMDs have a range of causes and often co-occur with a number of overlapping medical conditions, including headaches, fibromyalgia, back pain, and irritable bowel syndrome. Both the range of causes and the overlapping conditions contribute to widespread misunderstandings regarding the importance and function of the jaw joints.
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From page 18... ...
To address the study's Statement of Task (see Box 1-1) , the National Academies of Sciences, Engineering, and Medicine appointed an 18-member committee with expertise in public health; pain medicine; basic, translational, and clinical research; patient advocacy; physical therapy; dentistry; self-management; TMDs and orofacial pain; oral and maxillofacial surgery; health care services; internal medicine; endocrinology; rheumatology; law; nursing; psychiatry; and communications.
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From page 19... ...
Recognizing that TMDs are diverse and multifactorial conditions influenced by genetics, sex and ender, envi g ronmental, physiological, and psychological factors, this effort will: o Address patient heterogeneity and challenges to patient stratification to better target therapies toward patients. o Identify similarities and differences between chronic TMD, other chronic pain states (as well as chronic overlapping pain conditions)
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From page 20... ...
o 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.
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From page 21... ...
TMD is not a single diagnosis, but requires 1 The committee uses the term "health care professionals" throughout the report to encompass all persons working in multiple health care fields including medicine, dentistry, nursing, physical therapy, dietary health, speech therapy, behavioral health, and complementary and integrative health.
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From page 22... ...
The committee received input from more than 110 individuals through in-person and online opportunities to testify at the committee's public workshop (see Appendix A) and through written submissions to the study's public access file.2 Among the many issues raised in these testimonies, several focused on the health care system and the care of individuals with a TMD.
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From page 23... ...
. Many of these implants were either recalled by the Food and Drug Administration or voluntarily withdrawn from the market after they caused a range of adverse health outcomes including severe pain and functional joint impairment (see Chapter 5)
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From page 24... ...
The diversity of concerns and symptoms often means that an inter professional approach spanning dentistry and multiple fields of medicine is required to ensure that a TMD receives appropriate diagnosis and treatment. While many disorders and conditions benefit from a biopsychosocial model, TMDs provide a unique opportunity to explore the bridging of medical and dental models of care to benefit individuals.
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From page 25... ...
The biomedical model of care generally focuses on assessing for a possible pathophysiology of the disease or disorder and identifying a treatment or care plan to alleviate or fix that problem. For TMDs, primary care clinicians may be less sure about the diagnostic approaches and the array of disorders requiring referrals to a specialist or specialists depending on the specific disorder.
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From page 26... ...
Many health fields are relevant for the care of patients with a TMD, including pain management, physical therapy, b ehavioral health and clinical psychology, chiropractic care, and integrative medicine. Specific dental and medical specialties need to take or share the lead in TMD care (see discussion in Chapter 6)
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From page 27... ...
TMDs are a complex, heterogeneous, multifactorial set of disorders with varying treatments depending on the specific disorder. Depend ing on the specific type of TMD and its course, an interdisciplinary approach to care is often needed that includes multiple health care clinicians across medicine, dentistry, physical therapy, behavioral health, and integrative health.
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From page 28... ...
. FIGURE 1-2 Multiple aspects of TMDs and the efforts needed to improve TMD care.
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From page 29... ...
Washington, DC: The National Academies Press. IPRCC (Interagency Pain Research Coordinating Committee)
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