TMJ Association

Practitioners Rethinking "Noncompliance" in Patient Care

The term "noncompliant" is often used in healthcare to describe patients who don't follow medical advice, but this label may oversimplify their decisions and fail to acknowledge valid reasons behind their choices. Dr. Stacey Regis shares a personal experience of realizing that a patient, initially labeled as noncompliant, had made a thoughtful decision based on family needs. This incident reminded her that healthcare providers must pause and understand the reasoning behind a patient's actions before labeling them. By doing so, we can improve patient care and avoid unfair assumptions. Dr. Regis urges her colleagues to adopt a more empathetic approach in these situations.

Source: Stacey C. Regis, MD. "Patient Noncompliance: Time to Discard This Label." The Annals Fresh Look Blog, 18 June 2024.

Could Your Diet Worsen TMJ Pain? Study Links Omega-6 Fatty Acids to Increased Risk 🥩

A recent study examined the link between diet and painful temporomandibular disorder (TMD) among Hispanic/Latino adults. Researchers focused on long-chain polyunsaturated fatty acids (PUFAs), which can influence inflammation and pain. They analyzed dietary data from over 13,000 participants in the Hispanic Community Health Study/Study of Latinos.

The findings showed that a higher intake of a specific omega-6 fatty acid (arachidonic acid, found in foods like red meat and some vegetable oils) was linked to an increased likelihood of having painful TMD. However, taking omega-3 supplements (such as fish oil) was associated with lower odds of experiencing TMD pain.

This study suggests that diet, particularly the balance of omega-6 and omega-3 fatty acids, may play a role in managing TMD-related pain. More research is needed to explore how dietary changes or supplements could help reduce pain for those affected by TMD.

Source: Sanders AE, Cai J, Daviglus ML, Garcia-Bedoya O, and Slade GD (2025). Long-chain PUFA and painful temporomandibular disorder in the Hispanic Community Health Study/Study of Latinos. Public Health Nutrition 28: e41, 1–10. doi: 10.1017/S1368980025000102

Millions Take Antidepressants for Chronic Pain - But There's Little Evidence the Most Commonly Prescribed Drugs Work 💊

Approximately one in five people worldwide live with chronic pain, making it a frequent reason for visiting a doctor. In the UK, chronic pain accounts for one in five general practitioner appointments.

Due to the increasing caution around prescribing opioids because of their addiction potential, many doctors are turning to other "off-label" medications to treat long-term pain, with antidepressants being a popular choice.

In the UK, doctors can prescribe the following antidepressants for "chronic primary pain" (pain without a known underlying cause): amitriptyline, citalopram, duloxetine, fluoxetine, paroxetine, and sertraline. Additionally, amitriptyline and duloxetine are recommended for nerve pain, such as sciatica.

However, a scientific review of studies on the effectiveness of antidepressants for treating chronic pain found evidence supporting only one of these drugs: duloxetine.

Read full article at: https://theconversation.com/millions-take-antidepressants-for-chronic-pain-but-theres-little-evidence-the-most-commonly-prescribed-drugs-work-229682

NIH-funded Research Team Tailors New Drug Targeting a Pain Sensation Pathway 💊

Study of Cannabanoid 1 Receptor has Potential for Pain Treatment

A research team funded by the National Institutes of Health (NIH) has developed a medication that shows promise in treating acute and chronic pain. The drug, known as VIP36, targets the body’s cannabinoid receptor type 1 (CB1). It was found to be effective in three different animal models for pain and does not appear to cause the harmful side effects that have frustrated other efforts to target CB1. These results enhance understanding of how to design safer and more effective drugs targeting cannabinoid receptors and are an important step towards developing novel, non-addictive treatments for pain.

CB1 receptors can be found throughout the body and are particularly dense in the brain’s pain circuitry. They have long been considered a potential target for non-opioid-based pain treatment; however, previous attempts to target this pathway have been met with two challenges. First, repeated exposure to a drug leads to tolerance that limits its efficacy. Second, the dose required to reduce pain in the periphery tends to be high enough for the drug to make its way into the central nervous system (the brain and spinal cord). In humans, this can cause unwanted changes in mood, cognition, or emotional state.

To overcome these issues, researchers leveraged computer modeling of the CB1 receptor to design molecules that better interact with CB1, much like a key fitting into a lock. The newly designed drug, VIP36, is more “peripherally restricted” compared to previous drugs, meaning that much less of it leaks into the central nervous system where it can cause unwanted side effects. VIP36 also interacts with CB1 differently than treatments tested previously and in a way that reduces tolerance.

CB1 is part of a wide-ranging class of receptors known as G-protein-coupled receptors, which are involved in countless functions throughout the body including smell, vision, mood regulation, immune system responses, autonomic nervous system responses such as blood pressure and heart rate, and growth and metastasis of some tumors. In addition to their implications in pain care, the findings of this study could also help spur the design of other drugs that target similar receptors involved in other conditions.

Source: Rangari VA et al. “A cryptic pocket in CB1 drives peripheral and functional selectivity” Nature. March 5, 2025. DOI: 10.1038/s41586-025-08618-7(link is external)

Source: Rangari VA et al. “A cryptic pocket in CB1 drives peripheral and functional selectivity” Nature. March 5, 2025. DOI: 10.1038/s41586-025-08618-7

We’re proud to share that our article, "How dental teams can help patients with temporomandibular disorders receive general dental care," was named a Top 10% Most-Viewed Article in the Journal of Oral Rehabilitation in 2023!

Huge thanks to the co-authors: James R. Allison, Elizabeth Offen, Terrie Cowley, Deanne Clare, Suzie Bergman, Jennifer Ginsburg Feldman, Lisa Marie Schmidt, Tricia Kalinowski, Jens C. Türp, Daniele Manfredini, Donald R. Nixdorf, Ann-Marie C. DePalma & Justin Durham.

In loving memory of our founder, Terrie Cowley, whose vision and advocacy continue to inspire us.

🔗 Read the article: https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.13444

We urge you to take action for increased funding in TMD research. Millions suffer from Temporomandibular Disorders, yet research remains severely underfunded. By sharing your experiences, we can push for vital support from federal agencies like the NIH and FDA. Advocacy is crucial for advancing treatments and improving care. Join us in making a difference.

https://conta.cc/4j9g7Yu

Hai Yao, PhD, Clemson University, and Janice Lee, PhD, National Institute of Dental and Craniofacial Research, organized a special symposium titled: Salute to Terrie Cowley: An Indefatigable Leader for TMJ Research on March 12, 2025, at the American Association for Dental, Oral, and Craniofacial Research’s Annual Meeting and Exhibition in New York, NY. The session highlighted Terrie’s invaluable contributions to temporomandibular (TMD) research and advocacy.

Eric Granquist, DMD, MD, University of Pennsylvania, presented CT Imaging Morphology to Predict Outcomes Following TMJ Arthoplasty.

Join Health and Medicine Division, April 17-18, for a hybrid public workshop exploring pain identification strategies, treatments, management tactics, outcomes, and disability determination implications for individuals living with chronic pain. Register here.

Exploring the Treatment and Management of Chronic Pain and Implications for Disability Determinations: A Workshop Register for this event from the National Academies of Sciences, Engineering, and Medicine.

Hai Yao, PhD, Clemson University, and Janice Lee, PhD, National Institute of Dental and Craniofacial Research, organized a special symposium titled: Salute to Terrie Cowley: An Indefatigable Leader for TMJ Research on March 12, 2025, at the American Association for Dental, Oral, and Craniofacial Research’s Annual Meeting and Exhibition in New York, NY. The session highlighted Terrie’s invaluable contributions to temporomandibular (TMD) research and advocacy.

Laura Iwasaki, DDS, PhD, MSc, Oregon Health and Science University, presented Mechanobehavior Scores for Prediction of TMJ Growth and Degeneration.

Hai Yao, PhD, Clemson University, and Janice Lee, PhD, National Institute of Dental and Craniofacial Research, organized a special symposium titled: Salute to Terrie Cowley: An Indefatigable Leader for TMJ Research on March 12, 2025, at the American Association for Dental, Oral, and Craniofacial Research’s Annual Meeting and Exhibition in New York, NY. The session highlighted Terrie’s invaluable contributions to temporomandibular (TMD) research and advocacy.

Don Nixdorf, DDS, MS, University of Minnesota, presented Updates Related to MR Imaging of the TMJ.

Hai Yao, PhD, Clemson University, and Janice Lee, PhD, National Institute of Dental and Craniofacial Research, organized a special symposium titled: Salute to Terrie Cowley: An Indefatigable Leader for TMJ Research on March 12, 2025, at the American Association for Dental, Oral, and Craniofacial Research’s Annual Meeting and Exhibition in New York, NY. The session highlighted Terrie’s invaluable contributions to temporomandibular (TMD) research and advocacy.

Millie Embree, DMD, PhD, Columbia University, presented Stem Cells in TMJ Growth and Disease.