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Developing Research Capacity in Temporomandibular Disorders and Orofacial Pain Research

Integrative Biology and Infectious Diseases Branch
Division of Extramural Research

The overall goal of this Initiative is to expand the community of researchers engaged in research on temporomandibular disorders (TMJD) and orofacial pain. Several centers of excellence in TMJD research exist. However, an expansion of this field is necessary to reach a critical mass of scientists with new and complementary expertise who will be able to leverage recent advances in genetics, bio-engineering, and bio-behavioral research. The objectives of this Initiative are to 1) increase the number of basic and clinical investigators who are trained in TMJD or orofacial pain research, 2) facilitate and improve the mentoring of this new group of scientists, 3) expand the expertise and scientific disciplines that can be applied to TMJD and orofacial pain research. The expected outcome of this Initiative will be an increased number of multidisciplinary research teams led by new, young investigators. These new teams will form a robust research community applying novel approaches to TMJD and orofacial pain research that will enhance our understanding of the disorders and lead to effective treatments for patients.
Orofacial pain conditions are a group of complex disorders including acute and chronic inflammatory dental pain, disorders of the temporomandibular joint and muscles, and trigeminal neuropathies. They are complex in that they are influenced by genetic, behavioral, and environmental influences and the interactions of these factors. In addition, several of these disorders are comorbid with other chronic pain conditions. They are difficult to treat because we do not understand completely the underlying etiologies and pathologies of these disorders. Furthermore, some of these conditions are transient. Acute conditions may be relieved with no or minimal interventions and we do not understand why some patients transition to chronic disorders.
In part because of this complexity, biomedical research on these conditions has not advanced as rapidly as in other fields. Distinctive features of the trigeminal and orofacial and craniofacial systems require unique research approaches. Standard models and measures of pain currently used in other pain conditions may not apply to the trigeminal system. For these reasons, some researchers are reluctant to enter this field. Clearly, this field would benefit from an influx of new investigators with novel scientific expertise and approaches to address research questions of importance. Advancing biomedical research on TMJD and orofacial pain is a mission of the NIDCR and we can facilitate and foster the expansion of this research field.
The TMJD and orofacial pain research community is relatively small and does not appear to be self-sustaining. Only a few centers of research excellence exist that primarily address orofacial pain conditions. NIDCR efforts in the past to increase awareness of the problem and fund additional research have relied on solicited research proposals (FOAs). These FOAs have addressed topics such as pathobiology of TMJD, comprehensive approaches to examining mechanisms of orofacial pain, neuronal glial interactions in orofacial pain, and new models of pain relevant to the trigeminal system. These FOAs have attempted to attract pain researchers from outside the orofacial pain field as well as other researchers with complementary knowledge and expertise. Few of the successful applicants to these initiatives have continued in TMJD or orofacial pain research activities; thus, a sustained effort in orofacial pain research has not occurred. Very few unsolicited applications have been received. A new approach is needed to attract basic and clinical investigators who are willing to join the TMJD and orofacial pain field, establish new teams of multidisciplinary researchers, and develop a successful career in this area. The long term payoff will be the development of a sustainable, vibrant research community.
The Molecular and Cellular Neuroscience Program will work with the Research Training and Career Development Branch to develop a new approach to this problem. An opportunity exists to attract and retain early stage investigators who are contemplating a career in TMJD and orofacial pain by providing mentored support, training, and career development. Integral to this effort will be the development of a group of mentors and young mentored investigators. Paired mentors, one with TMJD or orofacial pain expertise and one with complementary expertise outside these areas will be sought. Expanding the scope of mentors beyond traditional dental school faculty is a priority. Expertise in genetics/genomics, computational biology, bioengineering and biobehavioral research, and other areas will be needed.

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This page last updated: July 08, 2014