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Tempromandibular Joint Disorders (TMD/TMJ)

Temporomandibular Joint Disorders (TMJD), commonly called TMD or TMJ, are a collection of poorly understood conditions characterized by pain in the jaw and surrounding tissues accompanied by limitations in jaw movements.  Injury and conditions that routinely affect other joints in the body, such as arthritis, also affect the temporomandibular joint. Approximately 35 million people in the United States suffer from TMD.  While both men and women experience TMD, the majority of those seeking treatment are women in their childbearing years.

Used alone, biofeedback can improve pain, pain-related disability, and mandibular functioning (Gardea, Gatchel, & Mishra, 2001).  A meta-analysis of 13 studies of EMG biofeedback treatment showed biofeedback was superior to no treatment or psychological placebo control for patient pain reports, clinical exam findings, and/or ratings of global improvement (Crider & Glaros, 1999).

In a recent review of the literature, Crider, Glaros and Gevirtz (2005) report on 14 controlled and uncontrolled outcome evaluations of biofeedback-based treatments for TMD published since 1978.  The authors concluded that surface electromyographic (SEMG) training of the masticatory muscles combined with adjunctive cognitive-behavioral therapy (CBT) techniques is an efficacious treatment for TMD.  Myers (2007) reported on a systematic review of TMD treatments and, based on a collection of previously reviewed studies and yet-to-be-reviewed studies, concludes biofeedback has been shown to be consistently superior to placebo or no-treatment controls.  The texts Biofeedback ( Schwartz & Andrasik, 2003) and Mind-Body Medicine for Primary Care (Moss et al, 2003) can give a more detailed review and explanation of treating these disorders.

References:

Gardea, M., Gatchel, R., Mishra, K. (2001). Long-term efficacy of biobehavioral treatment of temporomandibular disorders. Journal of Behavioral Medicine, 24 (4), 34-59.

Crider, A., Glaros, A., & Gevirtz, R. (2005). Efficacy of biofeedback-based treatments for temporomandibular disorders. Applied Psychophysiology and Biofeedback, 30 (4), 333-345.

Crider, A., & Glaros, A. (1999). A meta-analysis of EMG biofeedback treatment of temporomandibular disorders. Journal of Orofacial Pain, 13 (1), 29-37.

 Myers, C. (2007). Complementary and alternative medicine for persistent facial pain. Dental Clinics North America, 51 (1), 263-274.

Moss, D. (2003). Anxiety. in D. Moss and A. McGrady Moss, McGrady, T. Davies, & I. Wickramasekera, (Eds.), Handbook of mind-body medicine for primary care, Thousand Oaks, CA: Sage, pp. 359-375.

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