**GAO-08-454R**                      Published: Apr 04, 2008. Publicly Released: Apr 04, 2008.                  

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## Highlights

Temporomandibular joint and muscle disorders (TMJD) include a heterogeneous group of disorders with overlapping--but not identical--signs and symptoms. Symptoms of TMJDs vary, but typically include pain in the jaw joint and surrounding muscles. Other symptoms may include limited or no movement of the jaw joint, clicking or grating in the jaw joint when opening or closing the mouth, headaches, and shoulder or back pain. Most people with TMJDs have relatively mild forms of these disorders with symptoms that diminish without treatment. However, a small number of individuals develop significant, long-term problems, including persistent and debilitating pain and loss of jaw function. Although some TMJDs are due to a specific known cause, such as jaw injury or arthritis, the causes of many TMJDs are unknown. While the level of understanding about these conditions has evolved with scientific advancements, diagnosis and treatment are difficult because the exact causes and patterns of symptoms remain unclear. The National Institutes of Health (NIH), an agency within the Department of Health and Human Services (HHS), funds research on the causes of, treatments for, and other aspects of TMJDs. The NIH is organized into 27 institutes and centers and the Office of the Director, each with its own mission and functions. Through these institutes and centers, NIH supports both extramural research--conducted at external research institutions by scientists who are awarded funds to support their work--and intramural research conducted by its own scientists. In 1996, NIH sponsored a Technology Assessment Conference that included a panel of experts from a variety of fields, including clinical dentistry, medicine, surgery, immunology, behavioral and social sciences, and pain management. The panel addressed, among other things, the effective management and treatment of patients with TMJDs and the most productive directions for future research, including both applied and basic research. The panel concluded there was a clear need for applied research on a number of issues, including the prevalence of TMJD symptoms, predisposing and precipitating conditions, diagnostic methods, and treatment outcomes. It also concluded that there was a need for basic research in areas such as pain and biomechanics. Noting that TMJDs continue to pose complex health problems for the American public, you expressed interest in the progress that has been made in acting on the panel's conclusions. GAO is reporting on (1) TMJD-related research activities that NIH supported from fiscal year 2002 through fiscal year 2006, and (2) NIH's plans to support future research on TMJDs.

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