{"id":220914,"date":"2024-04-05T17:28:18","date_gmt":"2024-04-05T17:28:18","guid":{"rendered":"https:\/\/michigandigitalnews.com\/index.php\/2024\/04\/05\/the-horrors-of-tmj-chronic-pain-metal-jaws-and-futile-treatments\/"},"modified":"2025-06-25T17:19:14","modified_gmt":"2025-06-25T17:19:14","slug":"the-horrors-of-tmj-chronic-pain-metal-jaws-and-futile-treatments","status":"publish","type":"post","link":"https:\/\/michigandigitalnews.com\/index.php\/2024\/04\/05\/the-horrors-of-tmj-chronic-pain-metal-jaws-and-futile-treatments\/","title":{"rendered":"The horrors of TMJ: Chronic pain, metal jaws, and futile treatments"},"content":{"rendered":"<p> [ad_1]<br \/>\n<\/p>\n<p>A TMJ patient in Maine had six surgeries to replace part or all of the joints of her jaw.<\/p>\n<div>\n<p>Another woman in California, desperate for relief, used a screwdriver to lengthen her jawbone daily, turning screws that protruded from her neck.<\/p>\n<p>A third in New York had bone from her rib and fat from her belly grafted into her jaw joint, and twice a prosthetic eyeball was surgically inserted into the joint as a placeholder in the months it took to make metal hinges to implant into her jaw.<\/p>\n<p>\u201cI feel like Mr. Potato Head,\u201d said Jenny Feldman, 50, of New York City, whose medical records show she\u2019s had at least 24 TMJ-related surgeries since she was a teenager. \u201cThey\u2019re moving ribs into my face, and eyeballs, and I feel like a toy \u2026 put together [by] somebody just tinkering around.\u201d<\/p>\n<div class=\"wp-block-image\" style=\"margin:auto;max-width:1024px\"><span style=\"box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative\"><span style=\"box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:75%\"\/><img alt=\"\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover;background-size:cover;background-position:0% 0%;filter:blur(20px);background-image:url(&quot;data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAYAAAAfFcSJAAAADUlEQVR42mO8fv1mPQAIHAMIsIR6agAAAABJRU5ErkJggg==&quot;)\"\/><noscript><img alt=\"\" loading=\"lazy\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover\" sizes=\"100vw\" srcset=\"https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman_01-e1712324945461.jpg?w=320&amp;q=75 320w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman_01-e1712324945461.jpg?w=480&amp;q=75 480w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman_01-e1712324945461.jpg?w=576&amp;q=75 576w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman_01-e1712324945461.jpg?w=768&amp;q=75 768w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman_01-e1712324945461.jpg?w=1024&amp;q=75 1024w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman_01-e1712324945461.jpg?w=1280&amp;q=75 1280w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman_01-e1712324945461.jpg?w=1440&amp;q=75 1440w\" src=\"https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman_01-e1712324945461.jpg?w=1440&amp;q=75\"\/><\/noscript><\/span><figcaption>Jenny Feldman, of New York, has had at least 24 TMJ<br \/>\n\u2013<br \/>\nrelated surgeries since she was a teenager but<br \/>\nsays she remains in<br \/>\nconstant pain and struggles to eat solid food. Photographed at her home on Jan.<br \/>\n19, 2024.<\/figcaption><p>Anna Werner \/ CBS News<\/p>\n<\/div>\n<p>These are some of the horrors of temporomandibular joint disorders, known as TMJ or TMD, which afflict up to 33 million Americans, according to the National Institutes of Health. Dentists have attempted to heal TMJ patients for close to a century, and yet the disorders remain misunderstood, under-researched, and ineffectively treated, according to an investigation by KFF Health News and CBS News.<\/p>\n<p>Dental care for TMJ can do patients more harm than good, and a few fall into a spiral of futile surgeries that may culminate in their jaw joints being replaced with metal hinges, according to medical and dental experts, patients, and their advocates speaking in interviews and video testimony submitted to the FDA.<\/p>\n<p>TMJ disorders cause pain and stiffness in the jaw and face that can range from discomfort to disabling, with severe symptoms far more common in women. Dentists have commonly treated the disorder with splints and orthodontics. And yet these treatments are based on \u201cstrongly held beliefs\u201d and \u201cinadequate research\u201d \u2014 not compelling scientific evidence nor consistent results \u2014 according to the National Academies of Sciences, Engineering and Medicine, which reviewed decades of research on the topic. The NIH echoes this message, warning that there is \u201c<a href=\"https:\/\/www.nidcr.nih.gov\/health-info\/tmd\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">not a lot of evidence<\/a>\u201d that splints reduce pain and recommends \u201cstaying away\u201d from any treatment that permanently changes the teeth, bite, or jaw.<\/p>\n<p>\u201cI would say that the treatments overall have not been effective, and I can understand why,\u201d said Rena D\u2019Souza, director of the NIH\u2019s National Institute of Dental and Craniofacial Research. \u201cWe don\u2019t understand the disease.\u201d<\/p>\n<p>For this investigation, journalists with KFF Health News and CBS News interviewed 10 TMJ patients with severe symptoms who said they felt trapped by an escalating series of treatments that began with splints or dental work and grew into multiple surgeries with diminishing returns and dwindling hope.<\/p>\n<p>In every interview, the patients said the TMJ pain worsened throughout their treatment and they regretted some, if not all, of the care they received.<\/p>\n<p>\u201cThe grand irony to me is that I went to the doctor for headaches and neck pain, and I\u2019ve had 13 surgeries on my face and jaw, and I still have even worse neck pain,\u201d said Tricia Kalinowski, 63, of Old Orchard Beach, Maine. \u201cAnd I live with headaches and jaw pain every day.\u201d<\/p>\n<div class=\"wp-block-image\" style=\"margin:auto;max-width:768px\"><span style=\"box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative\"><span style=\"box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:133.33333333333331%\"\/><img alt=\"\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover;background-size:cover;background-position:0% 0%;filter:blur(20px);background-image:url(&quot;data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAYAAAAfFcSJAAAADUlEQVR42mO8fv1mPQAIHAMIsIR6agAAAABJRU5ErkJggg==&quot;)\"\/><noscript><img alt=\"\" loading=\"lazy\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover\" sizes=\"100vw\" srcset=\"https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-College-e1712325300328.jpg?w=320&amp;q=75 320w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-College-e1712325300328.jpg?w=480&amp;q=75 480w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-College-e1712325300328.jpg?w=576&amp;q=75 576w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-College-e1712325300328.jpg?w=768&amp;q=75 768w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-College-e1712325300328.jpg?w=1024&amp;q=75 1024w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-College-e1712325300328.jpg?w=1280&amp;q=75 1280w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-College-e1712325300328.jpg?w=1440&amp;q=75 1440w\" src=\"https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-College-e1712325300328.jpg?w=1440&amp;q=75\"\/><\/noscript><\/span><figcaption>Jenny Feldman is photographed before a TMJ-related surgery during her college years. Feldman says her mother would take her picture before every surgery and encourage her to \u201csmile while you can.\u201d<\/figcaption><p>Janice Ginsburg<\/p>\n<\/div>\n<p>TMJ has become an umbrella term for about 30 disorders that afflict roughly 5% to 10% of Americans. Minor symptoms may not require treatment at all, and many cases resolve by themselves over time. Severe symptoms include chronic pain and may limit the ability to eat, sleep, or talk.<\/p>\n<p>In a\u00a0<a href=\"https:\/\/nap.nationalacademies.org\/catalog\/25652\/temporomandibular-disorders-priorities-for-research-and-care\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">comprehensive study of TMJ disorders<\/a>\u00a0by the national academies, including input from more than 110 patients, experts found that most health care professionals, including dentists, have received \u201c<a href=\"https:\/\/www.documentcloud.org\/documents\/24429027-nasem-2020-tmd-consensus-study#document\/p273\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">minimal or no training<\/a>\u201d on TMJ disorders and patients are \u201coften harmed\u201d by \u201coverly aggressive\u201d care and the lack of proven treatments.<\/p>\n<p>The\u00a0<a href=\"https:\/\/www.ada.org\/\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">American Dental Association<\/a>, which represents about 160,000 dentists nationwide and establishes guidelines for the profession, declined an interview request. In a written statement, ADA President Linda Edgar said that TMJ disorders are \u201coften managed rather than cured\u201d and that it sees \u201cgreat potential\u201d in new efforts to research more treatment options.<\/p>\n<p>Terrie Cowley, a longtime TMJ patient who leads the TMJ Association, an advocacy group that has spoken with tens of thousands of patients, said she was so disillusioned with dental care for TMJ that she advises many patients to avoid treatment entirely, potentially for years.<\/p>\n<p>\u201cAlmost 100 years this has been in dentistry, and look at what we have,\u201d Cowley said. \u201cA whole ton of people pretending they know everything, and we don\u2019t know anything.\u201d<\/p>\n<h2 class=\"wp-block-heading\"><strong>\u2018Not taken seriously\u2019<\/strong><\/h2>\n<p>Scientific studies have found that TMJ disorders arise\u00a0<a href=\"https:\/\/www.cell.com\/cell-reports-medicine\/pdf\/S2666-3791(21)00057-4.pdf\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">up to nine times as often in women<\/a>, particularly those in their 20s and 30s, leading to theories that the cause may be linked to reproductive hormones. But a true understanding of TMJ disorders remains elusive.<\/p>\n<p>Kyriacos Athanasiou, a biomedical engineering professor at the University of California-Irvine, said it was because TMJ disorders are more prevalent among women that they were historically dismissed as neither serious nor complex, slowing research into the cause and treatment.<\/p>\n<p>The resulting dearth of knowledge, which is glaring when compared with other joints, has been \u201ca huge disservice\u201d to patients, Athanasiou said. In a 2021 study he co-authored, researchers found that the knee, despite being a much simpler joint, was the subject of about six times as many research papers and grants in a single year than the jaw joint.<\/p>\n<p>D\u2019Souza agreed that TMJ disorders were \u201cnot taken seriously\u201d for decades, along with other conditions that predominantly affect women.<\/p>\n<p>\u201cThat has been a bias that is really long-standing,\u201d she said. \u201cAnd it\u2019s certainly affected the progress of research.\u201d<\/p>\n<p>Patients have felt the effect too. In interviews, female patients said they felt patronized or trivialized by male health care providers at some point in their TMJ treatment, if not throughout. Some said they felt blamed for their own pain because they were viewed as too stressed and clenching their jaw too much.<\/p>\n<p>\u201cWe desperately need research to find the reasons why more women get TMJ disease,\u201d wrote Lisa Schmidt, a TMJ Association board member, in\u00a0<a href=\"https:\/\/tmj.org\/wp-content\/uploads\/2021\/11\/TMJ-News-Bites-Issue-4-2021.pdf\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">a 2021 newsletter from the organization<\/a>. \u201cAnd surgeons need to stop blaming this condition on women.\u201d<\/p>\n<p>Schmidt, 52, of Poway, California, said she was diagnosed with TMJ disorder in 2000 due to headaches, and an orthodontist immediately recommended her for a splint, braces, and surgery.<\/p>\n<p>After wearing the splint for only three days, Schmidt said, she was in \u201cexcruciating pain\u201d and could no longer open her mouth far enough to eat solid food. Schmidt said she spent the next 17 years stuck on a \u201csurgery carousel\u201d with no escape, and eventually was in so much pain she abandoned her career as an aerospace scientist who worked alongside NASA astronauts.<\/p>\n<p>Schmidt said her low point came in 2016. In an attempt to restore bone that had been cut away in prior surgeries, a surgeon implanted long screws into Schmidt\u2019s jaw that protruded downward out of her neck. Schmidt said she was instructed to tighten those screws with a screwdriver daily for about 20 days, lengthening the corners of her jaw to restore the bone that had been lost. It didn\u2019t work, Schmidt said, and she was left in more pain than ever.<\/p>\n<p>\u201cEvery time you have a surgery, your pain gets worse,\u201d Schmidt said. \u201cIf I could go back in time and go talk to younger Lisa, I would say \u2018Run!\u2019\u201d<\/p>\n<div class=\"wp-block-image\" style=\"margin:auto;max-width:1024px\"><span style=\"box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative\"><span style=\"box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:52.1484375%\"\/><img alt=\"\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover;background-size:cover;background-position:0% 0%;filter:blur(20px);background-image:url(&quot;data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAYAAAAfFcSJAAAADUlEQVR42mO8fv1mPQAIHAMIsIR6agAAAABJRU5ErkJggg==&quot;)\"\/><noscript><img alt=\"\" loading=\"lazy\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover\" sizes=\"100vw\" srcset=\"https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Schmidt-Distraction-Hardware-Collage-e1712325404252.jpg?w=320&amp;q=75 320w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Schmidt-Distraction-Hardware-Collage-e1712325404252.jpg?w=480&amp;q=75 480w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Schmidt-Distraction-Hardware-Collage-e1712325404252.jpg?w=576&amp;q=75 576w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Schmidt-Distraction-Hardware-Collage-e1712325404252.jpg?w=768&amp;q=75 768w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Schmidt-Distraction-Hardware-Collage-e1712325404252.jpg?w=1024&amp;q=75 1024w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Schmidt-Distraction-Hardware-Collage-e1712325404252.jpg?w=1280&amp;q=75 1280w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Schmidt-Distraction-Hardware-Collage-e1712325404252.jpg?w=1440&amp;q=75 1440w\" src=\"https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Schmidt-Distraction-Hardware-Collage-e1712325404252.jpg?w=1440&amp;q=75\"\/><\/noscript><\/span><figcaption>Left: Lisa Schmidt, who has been treated for TMJ disorders for decades, in 2017 uses a screwdriver to twist screws implanted in her jaw in an effort to restore bone that was cut away in previous  TMJ-related surgeries. Right: A medical scan shows the screws and other TMJ-related hardware implanted in Schmidt\u2019s face as of 2017.<\/figcaption><p>Left: Provided by Mark Schmidt. Right: Medical scan provided by Lisa Schmidt; image created by Brett Kelman, KFF Health News, with RadiAnt DICOM Viewer software<\/p>\n<\/div>\n<h2 class=\"wp-block-heading\"><strong>Lack of sufficient evidence<\/strong><\/h2>\n<p>Many of the shortcomings of TMJ care were laid bare in the\u00a0<a href=\"https:\/\/www.documentcloud.org\/documents\/24429027-nasem-2020-tmd-consensus-study?responsive=1&amp;title=1\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">426-page report\u00a0<\/a>published by the national academies in March 2020 that received limited public attention amid the coronavirus pandemic. The report\u2019s 18 authors include medical and dental experts from Harvard, Duke, Clemson, Michigan State, and Johns Hopkins universities.<\/p>\n<p>Sean Mackey, a Stanford professor who co-led the team, said it found that patients were often steered toward costly treatments and \u201cpathways of futility\u201d instead of being taught to manage their pain through strategies and therapies with \u201cgood evidence.\u201d<\/p>\n<p>\u201cWe learned it\u2019s a quagmire,\u201d Mackey said. \u201cThere is a perverse incentive in our society that pays more for things we do to people than [for] talking and listening to people. \u2026 Some of those procedures, some of those surgeries, clearly are not helping people.\u201d<\/p>\n<p>Among its many findings, the national academies said it has been widely assumed in the field of dentistry that TMJ disorders are caused by a misaligned bite, so treatments have focused on patients\u2019 teeth and bite for more than 50 years. But there is a \u201c<a href=\"https:\/\/www.documentcloud.org\/documents\/24429027-nasem-2020-tmd-consensus-study#document\/p69\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">notable absence of sufficient evidence<\/a>\u201d that a misaligned bite is a cause of TMJ disorders, and the belief traces back to \u201cinadequate research\u201d in the 1960s that has been repeated in \u201cpoorly-designed studies\u201d ever since, the report states.<\/p>\n<p>Therefore, TMJ treatment that makes permanent changes to the bite \u2014 like installing braces or crowns or grinding teeth down \u2014 has \u201cno supporting evidence,\u201d according to the national academies report. The\u00a0<a href=\"https:\/\/www.nidcr.nih.gov\/health-info\/tmd\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">NIH warns<\/a>\u00a0that these TMJ treatments \u201cdon\u2019t work and may make the problem worse.\u201d<\/p>\n<p>Dental splints, the most common TMJ treatment, also known as night guards or mouth guards, are removable dental appliances that are molded to fit over the teeth and can cost hundreds or even thousands of dollars out-of-pocket, according to the TMJ Association. Like most medical devices, splints generally go through the FDA\u2019s 510(k) clearance process, which does not require each splint to be proven effective before it can be sold, according to the agency.<\/p>\n<p>The national academies\u2019 report states that splints produce \u201cmixed results\u201d for TMJ patients, and even when splints succeed at reducing jaw pain it is not understood why they work. Hundreds of splint designs exist, the report states, and some dentists reject research that challenges the use of splints unless it focuses on the specific design they prefer.<\/p>\n<p>\u201cBecause of the hundreds of variations in [splint] design, it is unlikely that any study could ever be conducted that will be considered sufficient to a particular dentist with a pre-existing belief about the effectiveness of one appliance,\u201d the report states.<\/p>\n<p>Other treatments fare no better. The FDA has not labeled any drugs specifically for TMJ disorders, and\u00a0<a href=\"https:\/\/tmj.org\/living-with-tmj\/treatments\/medications\/\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">pain medicines can be too weak or addictive<\/a>\u00a0to be a long-term solution, according to the TMJ Association. Botox injections may ease pain but have\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26672706\/\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">raised concerns about bone loss<\/a>\u00a0during animal testing. The NIH warns that minor surgeries that flush the jaw with liquid bring only temporary pain relief and that more complex surgeries should be reserved for severe cases because they have yet to be proved safe or effective in the long term.<\/p>\n<p>To improve care, the national academies called for better education about TMJ disorders across medicine and dentistry and more research funding from the NIH, which has a \u201cripple effect\u201d on research and training across the nation.<\/p>\n<p>Since the 2020 report, the NIH has launched a\u00a0<a href=\"https:\/\/www.nidcr.nih.gov\/grants-funding\/funding-priorities\/future-research-initiatives\/tmd-collaborative-improving-patientcentered-translational-research-tmd-impact\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">TMJ research collaborative<\/a>\u00a0and increased annual research funding from about $15 million to about $34 million, D\u2019Souza said. TMJ care was added to\u00a0<a href=\"https:\/\/coda.ada.org\/-\/media\/project\/ada-organization\/ada\/coda\/files\/2022_predoc_standards.pdf?rev=6ba3493809bc402e9d38b188357ff84d&amp;hash=1BB4A33682F6DBCD96C8694D516FAACF\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">the standards that dental schools<\/a>\u00a0must teach to be accredited in 2022. The national academies launched an\u00a0<a href=\"https:\/\/www.nationalacademies.org\/our-work\/forum-on-temporomandibular-disorders\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">ongoing forum on TMJ disorders<\/a>\u00a0last year.<\/p>\n<p>But TMJ funding still pales in comparison to other ailments. The NIH spends billions each year to research deadly diseases, like cancer and heart disease, that also afflict large numbers of Americans. It spends millions more on research of non-life-threatening conditions like arthritis, back pain, eczema, and headaches.<\/p>\n<p>Mackey noted that much of the NIH\u2019s spending is allocated by Congress.<\/p>\n<p>\u201cIf Congress comes in and says, \u2018We want to devote <a href=\"https:\/\/fortune.com\/company\/twitter\/\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">X<\/a> amount of money to [TMJ],\u2019 all of the sudden you will see an increase in money,\u201d Mackey said. \u201cSo that\u2019s my message to people out there: Raise your voices. Write your legislator.\u201d<\/p>\n<h2 class=\"wp-block-heading\"><strong>Total jaw replacements<\/strong><\/h2>\n<p>Plagued by TMJ symptoms, and after failed treatments, some patients turn to a last resort: replacing their jaw joint with synthetic implants. Surgeons might replace the cartilage disk at the core of the joint or use \u201ctotal joint replacement surgery\u201d to fasten a metal hinge to the bones of the skull.<\/p>\n<p>But the implants have a harrowing history: Several disk implants were recalled or discontinued in the \u201990s due to dangerous failures. The FDA now classifies TMJ implants among its\u00a0<a href=\"https:\/\/www.fda.gov\/medical-devices\/temporomandibular-disorders-tmd-devices\/fdas-role-approving-tmj-implants-and-monitoring-their-safety\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">most closely monitored medical devices<\/a>\u00a0because the products on the market today can cause \u201cadverse health consequences\u201d if the devices fail, according to the agency\u2019s website.<\/p>\n<div class=\"wp-block-image\" style=\"margin:auto;max-width:1024px\"><span style=\"box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative\"><span style=\"box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:54.4921875%\"\/><img alt=\"\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover;background-size:cover;background-position:0% 0%;filter:blur(20px);background-image:url(&quot;data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAYAAAAfFcSJAAAADUlEQVR42mO8fv1mPQAIHAMIsIR6agAAAABJRU5ErkJggg==&quot;)\"\/><noscript><img alt=\"\" loading=\"lazy\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover\" sizes=\"100vw\" srcset=\"https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-CBCT-Collage-with-Scar-e1712325600809.jpg?w=320&amp;q=75 320w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-CBCT-Collage-with-Scar-e1712325600809.jpg?w=480&amp;q=75 480w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-CBCT-Collage-with-Scar-e1712325600809.jpg?w=576&amp;q=75 576w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-CBCT-Collage-with-Scar-e1712325600809.jpg?w=768&amp;q=75 768w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-CBCT-Collage-with-Scar-e1712325600809.jpg?w=1024&amp;q=75 1024w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-CBCT-Collage-with-Scar-e1712325600809.jpg?w=1280&amp;q=75 1280w, https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-CBCT-Collage-with-Scar-e1712325600809.jpg?w=1440&amp;q=75 1440w\" src=\"https:\/\/fortune.com\/img-assets\/wp-content\/uploads\/2024\/04\/Feldman-CBCT-Collage-with-Scar-e1712325600809.jpg?w=1440&amp;q=75\"\/><\/noscript><\/span> <\/p>\n<p>Left: Medical scan provided by Jenny Feldman, image made by Brett Kelman and Eric Harkleroad\/KFF Health News; Right: Jenny Feldman<\/p>\n<\/div>\n<p>Two companies, Zimmer Biomet and <a href=\"https:\/\/fortune.com\/company\/stryker\/\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">Stryker<\/a>, make the only total jaw replacement implants currently sold in the U.S.<\/p>\n<p>Zimmer Biomet, which has made its implant for more than two decades, described it in email statements as \u201ca safe and efficacious solution\u201d for patients who need their jaw joint replaced, either due to TMJ disorders, failed surgeries, injuries, or other ailments. An FDA-mandated study completed in 2017 found about 14% of patients who get the Zimmer Biomet implant require additional surgery or removal within 10 years, said agency spokesperson Carly Pflaum.<\/p>\n<p>Stryker, which in 2021 bought a company that made a total jaw replacement implant and now makes the implant itself, declined to comment. Although the NIH has advised TMJ patients to avoid surgery since at least 2022, Stryker launched a \u201c<a href=\"https:\/\/patients.stryker.com\/jaw-pain?cid=facebook\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">patient-facing website<\/a>\u201d for the implant last year and is recruiting surgeons to be added to a \u201csurgeon locator\u201d feature on the site, according to posts on <a href=\"https:\/\/fortune.com\/company\/facebook\/\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">Facebook<\/a> and\u00a0<a href=\"https:\/\/www.linkedin.com\/posts\/stryker-cmf_strykercmf-strykertmj-tmjconcepts-activity-7168968829505658881-Zk5X?utm_source=share&amp;utm_medium=member_desktop\" target=\"_blank\" rel=\"noopener\" class=\"sc-76811d68-0 jyYcOa\">LinkedIn<\/a>.<\/p>\n<p>A study of the Stryker implant\u2019s success rate was mandated by the FDA and completed in 2020, but the agency has yet to make the results public.<\/p>\n<p>D\u2019Souza, the NIH official, said that based on her professional experience, she estimates that most total jaw replacement surgeries are ultimately ineffective.<\/p>\n<p>\u201cThe success rate is low,\u201d D\u2019Souza said. \u201cIt is not very encouraging.\u201d<\/p>\n<p>Multiple patients provided KFF Health News and CBS News with medical records showing their total jaw replacement implants had to be removed due to malfunction, infection, or previously unknown metal allergies. Several patients said that since their implants were removed months or years ago, they have lived with no hinge in their jaw at all.<\/p>\n<p>Kalinowski, the TMJ patient in Maine, has had portions of her jaw joint replaced six times, including receiving four implants. Her medical records show that the cartilage disk on her right side was replaced in 1986 with an implant that was later recalled and again in 1987 with another that was later discontinued. Her left and right disks were replaced in 1992 with a muscle flap and rib graft, respectively, and her entire right joint was replaced with yet another implant that was later discontinued in 1998. Both joints were replaced again in 2015, her records show.<\/p>\n<p>Since then, Kalinowski said, her artificial jaw has functioned properly, although she remains in pain and cannot move her jaw from side to side. Her mouth hangs open when her face is at rest, and she drinks protein shakes for lunch because it\u2019s easier than struggling with solid food.<\/p>\n<p>But the \u201cworst part,\u201d Kalinowski said, is that her surgeries caused nerve damage on her lower face, and so she has not felt her husband\u2019s kisses since the \u201990s.<\/p>\n<p>\u201cIf there was one moment in my life I could take back and do over again, it would be that first surgery. Because it set me on a trajectory,\u201d Kalinowski said. \u201cAnd it never goes away.\u201d<\/p>\n<\/div>\n<p>[ad_2]<br \/>\n<br \/><a href=\"https:\/\/fortune.com\/well\/2024\/04\/05\/tmj-chronic-pain-metal-jaws-futile-treatments\/\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>[ad_1] A TMJ patient in Maine had six surgeries to replace part or all of the joints of her jaw. Another woman in California, desperate<\/p>\n","protected":false},"author":1,"featured_media":220915,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[149],"tags":[],"_links":{"self":[{"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/posts\/220914"}],"collection":[{"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/comments?post=220914"}],"version-history":[{"count":2,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/posts\/220914\/revisions"}],"predecessor-version":[{"id":330376,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/posts\/220914\/revisions\/330376"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/media\/220915"}],"wp:attachment":[{"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/media?parent=220914"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/categories?post=220914"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/tags?post=220914"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}