Researchers lead landmark study to transform jaw pain treatment

Despite decades of research, the mechanisms underlying TMD-related pain remain elusive, and treatment outcomes are often inconsistent. As Dental Tribune International has reported, recent research into TMD has shown that it affects women more than men and may be increasing in prevalence. Investigating its aetiology is thus a highly timely undertaking.

The University of Pittsburgh project is being led by Dr Alejandro Almarza, associate professor of oral and craniofacial sciences at the university’s dental school, and Dr Michael Gold, professor of neurobiology at the medical school. It will collect and analyse an extensive range of biological, neurological and psychosocial data from 1,000 individuals with TMD and 300 pain-free controls across five national research sites. This will involve brain imaging, RNA sequencing, epigenomic and proteomic profiling, and microbiome analysis, offering unprecedented insight into the complex mechanisms of chronic jaw pain.

Speaking about the research in a university press release, Dr Almarza said: “It’s the first time that we’ll be able to recruit this many patients with TMDs and try to understand their pain condition.” Prof. Gold explained that the project takes “an integrated, whole-person view of the problem, and that adds complexity, both in the factors influencing the manifestation of the pain syndrome but also in its management”.

The research will build on earlier work from the landmark Orofacial Pain Prospective Evaluation and Risk Assessment study, extending the focus from identifying who develops TMD to understanding the nature and persistence of ongoing pain. The data collected will support detailed patient phenotyping, helping to identify biomarkers that can guide precision treatment approaches and improve outcomes.

By refining preclinical models and establishing causal links between biological and environmental factors, the study aims to develop more effective, personalised therapies. The collaborative approach is essential given the relative rarity and diversity of TMD conditions. The project also emphasises education and training and will integrate dental and medical students in hands-on research and curriculum development to embed new findings into clinical practice.