Chewing, yawning, and talking are movements all made possible by the joints, muscles and ligaments that make up our temporomandibular region. Unfortunately for many, severe pain and discomfort in this area—popularly known as the area of the temporomandibular joint (TMJ)—can be incredibly disruptive to everyday life.
Whereas surgical treatments are available to treat pain in the area of the TMJ, surgery is often not the best option. Researchers at UConn Health are looking to non-surgical approaches—and offering free treatment through a federally funded clinical trial.
Temporomandibular pain disorders (TMD) are a collection of disorders that can cause pain and disfunction in the TMJ and muscles that control jaw movement. According to the National Institute of Dental and Craniofacial Research (NIDCR), 11-12 million adults in the United States had pain in the region of the temporomandibular joint, with it being twice as common in women than in men.
Dr. Mark Litt, professor of Behavioral Sciences and Community Health at UConn Health received funding through the NIDCR to test two non-surgical treatments for orofacial pain. The clinical trial is currently open and accepting participants.
While TMD pain can include TMJ problems, most of these disorders do not involve the joint. Even though people may experience joint disfunction, Litt explains, it is usually not the cause of pain.
“Most of the pain in these conditions is myofascial, or muscular in origin,” says Litt. “We can deal with 70 percent of TMDs because we know how to deal with myofascial pain, as it is stress related.”
Myofascial pain, being stress-related, is the direct result of muscles clenching and inflammation, not necessarily muscle damage. Because of the relation to stress, invasive surgical methods may not be necessary.
In the study—before and during treatment, participants use a smartphone app to record their pain levels, mood, and surroundings several times per day to complete an individualized assessment. The result is a detailed view of the person’s pain experience and the circumstances that make the pain better or worse. Treatment involves teaching skills to deal with these circumstances.
“Although this is a chronic pain condition, almost everyone experiences fluctuations of pain,” Litt says. “The pain may never go away, but there are times when it is worse, and sometimes its better. If there is any variation at all, we can exploit that and find out the times when its better and find out what’s going on during those times. When it’s worse, we can find out what the person is doing at those times.”
The two treatment methods tested have been proven to be effective for people with TMD pain. In addition to the weekly monitoring, both methods involve an X-ray, a mouth guard and anti-inflammatory drugs to help alleviate pain, and 6 weekly sessions with a counselor. One treatment method involves a therapist teaching skills that include relaxation and meditation, problem solving, managing emotions, developing social support networks, and resolving relationship problems that may make pain worse. The second treatment entails a therapist using detailed recordings of thoughts, feelings, behaviors, and situations to determine exactly what is contributing to pain, and helping the patient develop and use skills that will help manage that pain.
As the study is currently underway, Litt reports that so far, the patients appreciate the non-invasive approach to managing TMD pain.
“Anecdotally speaking, the patients like the program and feel like it’s helping,” said Litt. “They also like that it doesn’t involve surgery.”
To volunteer for this study, please call 860-679-2745 or email TMDstudy@uchc.edu. For more information, visit the study website.
