Temporomandibular disorders (TMD) affect the hinge joint that connects the lower jaw to the skull. This joint is intended to be flexible to offer a full range of motion for daily activities including chewing or talking. There are multiple causes of TMD, which can include grinding or clenching the teeth, dislocation of the jaw, or even arthritis.

The American Pain Society has suggested several new treatments for TMD.

Patients were often prescribed non-steroidal anti-inflammatory drugs or NSAIDs to treat this pain, which is the 2nd most common complaint after low back pain. However, a new study by the University Of Connecticut Health Center suggests that cognitive behavioral therapy (CBT) can also be effective in treating TMD.

The researchers discovered that many patients whose TMD was non-responsive to traditional treatments also suffered from symptoms of depression. These patients did not possess typical coping methods and, in spite of not presenting a joint pathology indicative of TMD, they still experienced the pain in their face.

The authors hypothesized that certain CBT treatment-related outcomes, such as lower retention in treatment and less adaptive changes in coping, self efficacy, and catastrophizing, might be predictive of treatment non-response.

Cognitive behavioral therapy treatments focus on the patients’ thoughts and feelings about certain situations in their lives and teach them effective coping mechanisms for moving forward. The idea is to change negative behaviors that result from negative feelings into positive behaviors through actively changing the patient’s thought patterns.

Nonresponsive TMD patients may have success alleviating and eliminating their painful condition by engaging in behaviors that change the way they think about the pain they are experiencing. If the researchers’ findings are correct, this could change how healthcare professionals handle a number of similar conditions.

Do you think that some forms of TMD can be caused by depression and treated with cognitive behavioral therapy?

Image by Steve Snodgrass via Flickr


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