Recently, the National Institutes of Health funded an unprecedented research study on TMJ and related orofacial pain conditions. The study, dubbed OPPERA (Orofacial Pain:Prospective Evaluation and Risk Assessment), looked at more than 6,000 individuals, some with TMJ at the beginning of the study, but nearly half of them without, and attempted to determine what a large population study could tell us about many contributing factors to TMJ, such as lifestyle, environment, genetics, and more. The data was collected at four sites across the East, from Florida to New York.

In order to bring all the data together and glean insights, a central analysis facility was required, and that was Battelle Memorial Institute right here in Columbus, OH. Through a powerful data analysis, we were able to discover many startling insights about TMJ.

young adult woman holding her jaw in pain

Who Gets TMJ?

Probably the most data-intensive section of OPPERA was determining what characteristics led to a person developing TMJ. In order to identify this data, more than 2700 individuals were followed for a five-year study, each of them filling out a questionnaire every three months. The individuals also underwent genetic analysis based on blood samples, and were asked about psychological conditions as well as physical ones.

Looking at this data revealed a more complete portrait of who develops TMJ.

Women and Men

One of the most surprising insights from OPPERA is that men develop TMJ at about the same rate as women. Previous studies, based on who seeks treatment, have shown that perhaps six times as many women sought treatment for TMJ than men. There are two possible conclusions we can take from this. Either there are many men who develop this condition and just don’t seek treatment, or female hormones contribute to the change in TMJ from first onset to chronic problem.

Comorbid Conditions

Another key insight from OPPERA is that people who develop TMJ are likely to have multiple related conditions as well. In particular, people were much more likely to develop TMJ if they had other painful conditions, including headache and body pain. This may mean that people develop TMJ partly because they are more sensitive to pain in general, or it may mean that TMJ is just one manifestation of a much larger condition that affects the entire body.


Although OPPERA was not able to identify a gene or genes responsible for causing TMJ, by looking at 358 genes associated with pain regulation, the study did identify many genes that seemed to be associated with the condition. Of particular interest, the genetic study was able to isolate two genes that were strongly associated with TMJ and had previously been linked to related conditions.

From Insight to Practice

Now our next challenge is how to develop new clinical practice out of our new insights. One of the first priorities seems to be learning to treat TMJ as part of its complex of comorbid conditions. It can’t be viewed as an isolated disorder, but TMJ patients likely require a diverse array of care to address the full range of conditions suffered.

Along with this, we need further genetic analysis to hone in on the specific causes that contribute to developing TMJ problems. This will allow us better identify at-risk individuals and develop preventive treatments that can stop TMJ before it happens.

As TMJ treatment continues to evolve, we at Firouzian Dentistry will continue to adopt the current best treatment practices. For advanced TMJ treatment in Columbus, please call 614-648-5001 for an appointment with a TMJ dentist today.