A 45-year-old white female was referred for tinnitus (ringing or buzzing) in the left ear and facial pain that had been present for the previous two years. She had first sought treatment from her family doctor and an Ear, Nose, and Throat specialist. Both doctors had told her nothing could be done. She then went to a periodontist who thought her problem might be TMJ. An arthrogram (dye injected into the TM joint and an X-ray taken) was performed on the left TM joint and showed a disk perforation. The disk is a small piece of cartilage that cushions the upper part of the jaw bone as it meets the skull. The patient was then referred to several dentists and told that surgical treatment was necessary. The patient and her husband both had psychiatric treatment for depression earlier. The TMJ Scale Report for this patient reflected elevated overall TMJ symptoms, as well as heightened pain, pain on pressing, joint noises, and the teeth feeling ill-fitting. In addition, emotional problems, stress and the propensity for chronic illness were all highly elevated. A physical examination confirmed that multiple facial muscles and the TM joint were painful to the touch, and that both joints produced clicking at about 15 mm of opening. Crepitation or joint grinding sounds were also noted. These finding, combined with TMJ Scale results, led to a diagnosis of MPD–myofacial pain dysfunction, anterior disk displacement with perforation and tinnitus (see Glossary) Comment: This is an example of multiple TM disorders complicated by emotional factors and stress. This patient was undergoing treatment with a TMJ specialist. (Published in the TMJ Scale Manual)
Do Psychological Factors Affect Teatment Outcome in TMDs
There has been considerable controversy over the years regarding the importance of psychological factors in the diagnosis, etiology, progression and response to treatment in the field of temporomandibular disorders (TMDs). Few studies have looked carefully at the influence of psychological factors on different components of TMDs. For example, on disorders primarily involving the TM joint versus…
A Study of the Importance of Psychological Factors in Treatment Results for Temporomandibular Disorders
Psychological Factors and Temporomandibular Treatment Outcomes Wexler Gerald B and Steed Pamela A, Jour of Craniomandib Practice, (16)2: 72-77, 1998. This study examines the effect of psychological dysfunction as an etiological factor in temporomandibular disorder (TMD). It employs a thoroughly validated psychometric measurement system, the TMJ Scale (Pain Resource Center, Inc., Durham, North Carolina), to…
Are Temporomandibular Joint Disorders (TMDs) Self-Limiting?
There has been much contorversary and confusion over the years regarding the question as to whether temporomandibular joint (TMJ) disorders are self-limiting or not. This is a complicated issue of great concern to both patients and healthcare providers. The authors in the study below have found some prior studies attempting to address this issue to…
A Study of 10,000 Patients to Determine the Clinical Efficacy of the TMJ Scale and Explore Symptom Characteristics in the TMD Patient Population
Validating the TMJ Scale in a National Sample of 10,000 Patients: Demographic and Epidemiologic Characteristics. Levitt SR, McKinney MW, Jour of Orofacial Pain, 8(1):25-25, 1994. The accuracy and reliability of the TMJ Scale were originally determined in cross-validation studies on large, research-based patient samples. It had been assumed that the demographic characteristics and test responses…
TMD Resulting From Trauma vs Non-Trauma-A Large Scale Research Study
Steed PA, Wexler, GB, Temporomandibular Disorders-Traumatic Etiology vs. Nontraumatic Etiology: A Clinical and Methodological Inquiry into Symptomatology and Treatment Outcomes Jour of Craniomandib Practice, (19)3: 188-194, 2001 Abstract The purpose of this research is to investigate the distinctions relating to Presenting Symptoms and Treatment Outcomes between patients suffering temporomandibular disorder (TMD) as a result of…
A Large Prospective Research Study Addressing the Questions: Does Treatment for TMD Produce Symptom Improvement, Does Relapse Occur and Do Untreated Patients Improve Spontaneously Over Time?
This is an example of a longitudinal, prospective research study using the TMJ Scale on a large number of patients in multiple clinical settings. This study was designed to investigate whether treated patients achieve both clinically and statistically significant levels of improvement relative to non-treated patients and whether there is any symptom relapse after treatment…
Research Study in Iraq using the TMJ Scale
In addition to previous posts on published international research studies involving the TMJ Scale in countries like Japan, Canada and Brazil, the following study was conducted in Iraq: Abstract Qasim WF, The Effectiveness of Occlusal Splint Therapy in Treatment of Iraqi Temporomandibular Disorder (TMD) Patients, J Med J, (40) 4:1-6, 2006. The effectiveness of an…
International Research Study in Brazil Involving the TMJ Scale-another in a series of published studies
In addition to the many published research studies over the years in the U.S. involving the TMJ Scale, studies in other countries and cultures have also been ongoing. Many have expressed an interest in reading about such studies. Therefore, this is one example of a study done in Brazil. Nasr MK, Bataglion C, Nunes L de…
International Research Studies Involving the TMJ Scale-Canada
In addition to the many published research studies over the years in the U.S. involving the TMJ Scale, studies in other countries and cultures have also been ongoing. Many have expressed an interest in reading about such studies. Therefore, this is one example of a study done in Ottawa, Canada. Wexler GB, McKinney MW. Assessing Treatment…
