Precision Medicine Overcomes Painful TMD Treatment

Brian Meshkin


Temporomandibular disorder (TMD), one the most painful and difficult to treat disorders facing the dental profession, currently plagues roughly 10 million Americans, according to the National Institute of Dental and Craniofacial Research. Perhaps the most frustrating element of TMD is the way it affects every patient differently. 

Without a common blueprint for treatment, dentists and oral surgeons, for years, have labored over just how to handle this elusive condition—mainly relying on self-reported pain as the main determining factor for prescribing medication and, in some serious cases, performing surgeries.

But with recent advances in precision medicine testing, there are now efficient, evidence-based methods of determining the pathways underlying each individual patient’s TMD pain and what treatment options are predicted to be the most effective, with the lowest risk of side effects.

Recent Developments

The world of precision medicine testing is swiftly evolving. Completed in 2003, the Human Genome Project has provided an incredible understanding of our DNA. With a general map to the biological makeup of all humans, the medical world now has an invaluable guide for diagnosing and treating a host of illnesses, disorders, and conditions.

Moreover, in just the last decade or so, scientists and physicians have finally begun to bring healthcare’s understanding of DNA to the next level, uncovering specific biomarkers that can help evaluate an individual’s predisposition for certain health issues, along with varying levels of pain and symptoms.

As a result, the industry has been able to create effective assessment tools, such as precision medicine profiles, to assist in the management of painful ailments, like TMD, despite the fact that it manifests differently from patient to patient.

Today’s Patients

Dental professionals spend a tremendous amount of time each year working with patients who complain of TMD, comprising between 5% and 12% of their caseload, with many of them fitting into a “younger persons” category. Without the use of vital precision medicine information about these individuals, most practitioners are playing a guessing game when it comes time for treatment.

In most cases, the go-to solution for pain is opioids, a risky choice that, if not prescribed carefully, can compound the existing health problem with the potential of addiction or even overdose. The process of trial and error becomes an arduous and time-consuming method for physicians and patients that often leaves unnecessary damage in its wake. With a very serious opioid epidemic at our nation’s doorstep, accounting for thousands of overdoses each year, the timing for a safer treatment path could not be any more perfect.

With symptoms that include pain in the jaw muscles, pain in the neck and shoulders, headaches, vision problems, and beyond, TMD can seriously disable its sufferers. However, while these symptoms are easily detected, TMD itself may be caused by a variety of hard-to-evaluate, underlying causes or conditions.

Therefore, simply “throwing” pain pills at the diagnosis, without strong knowledge of the pathways underlying the individual’s pain, may not lead to a therapeutic response. Furthermore, it is possible to use precision medicine to detect a predisposition towards addiction or the potential to react poorly to certain medications.

The Role of Precision Medicine

Taking all this into account, recent advances in medical science have made it easier to navigate around the pitfalls of treatment. With an array of successfully tested precision medicine profiles, top research and development companies such as Proove Biosciences have been able to take on individualized care and help dental practitioners avoid unnecessary opioid prescriptions or surgeries.

Professionals using modern precision medicine profile assessors can determine if the resulting pain is widespread or localized and if there is general sensitization that contributes to the problem. Through a proprietary algorithm that elucidates the underlying mechanisms involved in TMD pain, including genetic variants in the adrenergic and serotonergic pathways, dentists and oral surgeons can now offer personalized treatment options that include dosing recommendations based on pharmacokinetics.

One such effective tool, already in use by hundreds of physicians across the country, is the Proove TMD Profile, developed with the commercial license to resulting data of the National Institute of Health’s largest prospective clinical studies on chronic pain (OPPERA 1 and OPPERA 2). As a result, it has successfully influenced how the condition is treated in patients, resulting in effective pain management, avoidance of surgical procedures, and improved quality of life.

The Proove TMD Profile assesses genetic and nongenetic factors that affect the serotonergic, adrenergic, and other neurotransmitter pathways that contribute to TMD pain. This technological revelation to pinpoint pain levels and identify neurotransmitter contributions to TMD represents a huge step forward in tackling TMJ-related discomfort, without going directly to potentially harmful painkillers or surgeries. 

With such an abundance of Americans suffering from the painful symptoms of TMD, dentists and oral surgeons are constantly on the lookout for better ways of diagnosing and treating patients, without the dangerous risks associated with pain management. Solutions such as Proove’s TMD Profile will undoubtedly revolutionize the dental industry in understanding this significant health issue through the analysis of DNA markers and nongenetic factors to recommend the most appropriate treatment.

By using such evidence-based and patent-protected healthcare decision tools, dentists and oral surgeons now have the capabilities to evaluate pain perception, assess opioid use disorder risk before treatment, and identify personalized treatment options to those suffering with this long-misdiagnosed condition.

Mr. Meshkin, founder and CEO of Proove Biosciences, is a 20-year veteran in the field of pharmaceuticals and molecular diagnostics, with a focus on precision medicine. Previously, he led new product planning and marketing for Prometheus Laboratories, managed e-business for the largest product at Johnson & Johnson, and was a team leader at Eli Lilly & Company’s venture fund. His work also has been lauded by the American Society of Interventional Pain Physicians, the American Academy of Neurology, the American Academy of Pediatrics, and the Medical Marketing Association. His most recent honors include finalist for the 2015 and 2016 Ernst & Young Entrepreneur of the Year Award in Orange County, Calif, 2016 Outstanding Emerging Technology CEO of 2016 from the Orange County Technology Alliance, as well as the 2016 Excellence in Entrepreneurship Award winner from the Orange County Business Journal. He can be reached at

Disclosure: Mr. Meshkin is an employee and shareholder of Proove Biosciences.

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