The nation’s first large multicenter prospective clinical study will search to the genes for the origins of debilitating jaw and neck pain and relief for those who have an umbrella of maladies described as temporomandibular joint and muscle disorders (TMJDs), an estimated 5 to 15 percent of Americans.
The $19.1 million seven-year international study, a cooperative agreement between the National Institute of Dental and Craniofacial Research and the University of North Carolina at Chapel Hill (UNC), will track 3,200 healthy volunteers from three to five years to see how many develop TMJD and how it develops. The multicenter research will involve researchers at the University of Florida in Gainesville, directed by Roger Fillingim, PhD; University at Buffalo-State University of New York, directed by Dr. Richard Ohrbach; University of Maryland, Baltimore, directed by Joel Greenspan, PhD, and Dr. Ronald Dubner; and UNC, directed by Dr. William Maixner, the study’s principal investigator.
"This is a timely study that will greatly enhance the scientific underpinnings of research on TMJDs," said Dr. Lawrence Tabak, director of NIDCR, one of the National Institutes of Health (NIH) and lead funding agency for research on oral, dental and craniofacial health. "Most importantly, it will accelerate the pace of the science and seed valuable new leads that impact virtually every aspect of care for the disorders."
"This study represents an important step forward not only for TMJD research but pain research in general," said Elias Zerhouni, MD, NIH director. "It marks one of the first—if not the first—prospective clinical studies to identify risk factors for a chronic pain condition. It’s quite possible that some of the findings that arise from this study will be applicable to other musculoskeletal pain conditions."
In essence, it’s a study of pain and sensitivity, of "the burly truck driver who feels the pain or the woman who doesn’t," said a UNC spokesperson. "Is she tough or just responding to what her genes are telling her?"
Although TMJDs vary in duration and severity, pain is a chronic companion of some people who have TMJDs and an exercise in frustration for patients and doctors. In the absence of generally accepted, science-based guidelines for managing TMJDs, health professionals have tried to help patients using a variety of approaches, often with unsatisfactory results, said the NIH statement announcing the study in tandem with UNC.
The study, Orofacial Pain: Prospective Evaluation and Risk Assessment, looks forward in time, tracking volunteers to monitor the onset and natural course of disease. Researchers expect several hundred volunteers to develop TMJD during the study.
"Our initial purpose is to identify the biological, psychological and genetic risk factors that contribute to pain and dysfunction associated with TMJD," said Dr. Maixner, professor and director of the new Center for Neurosensory Disorders at the UNC School of Dentistry. "This is an extremely common disorder that afflicts millions of people worldwide and ranks second only to headache in producing craniofacial pain and dysfunction in the U.S. population."
Study participants include biogenetics and statistical core researchers at North Carolina State University and UNC; Battelle Memorial Institute, Columbus, Ohio; senior scientists and staff at NIDCR and the National Institute on Alcohol Abuse and Alcoholism; and researchers at the University of Adelaide, South Australia.
Further information on TMJDs is available on ADA.org. See the Temporomandibular Disorders Oral Health topic and other TMD/TMJ information.
