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GAO-08-454R 1 (2008-04-04)

handle is hein.gao/gaocrptawkk0001 and id is 1 raw text is: i Accountability * Integrity * Reliability United States Government Accountability Office Washington, DC 20548 April 4, 2008 The Honorable Edward M. Kennedy Chairman Committee on Health, Education, Labor, and Pensions United States Senate Dear Mr. Chairman: Subject: Temporomandibular Joint and Muscle Disorders: NIH Supports a Wide Range of Research 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.2 However, a small number of individuals develop significant, long-term problems, including persistent and debilitating pain and loss of jaw function.3 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 'In this report, we use the acronym TMJDs to be consistent with the terminology preferred for this set of conditions by the National Institutes of Health (NIH). Other common acronyms include TMJ and TMD. 2Although NIH previously reported that TMJDs may affect as many as 10 million Americans, this estimate is based on papers presented at the Technology Assessment Conference on TMJDs in 1996. NIH officials told us that additional epidemiological research is needed to validate the number of Americans affected by TMJDs. 3Artificial temporomandibular joint implants have been used to replace the jaw joint in an effort to decrease pain and increase jaw function for some individuals in this latter group. Experts recommend that conservative treatments be used to relieve symptoms before irreversible treatments-such as implants-are used. Conservative treatments can include taking pain medications, using a splint or bite guard, applying ice packs, or eating soft food. See GAO, Medical Devices: FDA's Approval of Four Temporomandibular Joint Implants, GAO4)7-996) (Washington, D.C.: Sept. 17, 2007). GAO-08-454R Temporomandibular Joint and Muscle Disorders

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