Because of the high costs and traditionally poor outcomes among chronic TMJMD patients, the major goals of 3 National Institutes of Health (NIH)-funded projects were to identify predictors of when acute TMJMD incidents were likely to develop into chronic problems. Through these projects, we have:
isolated some significant biopsychosocial risk factors that successfully predicted the development of chronicity;
developed a statistical algorithm that can be used to identify “high risk” TMJMD patients who are prime candidates for early intervention in order to prevent chronicity (Epker, Gatchel, et al., 1999);
found evidence of biopsychosocial differences between the high-risk and low-risk groups (Wright, Gatchel, et al., 2004); and
documented support of the hypothesis that early intervention at the acute stage will prevent the development of chronic pain (Gatchel, Stowell, et al., 2006).
Moreover, there were significant cost-savings associated with early intervention (Stowell, Gatchel, et al., 2007). These results are quite promising because of their potential to decrease the high costs of chronic TMJMD. They have also demonstrated the construct validity of our high–low risk dichotomy. We are now conducting our fourth NIH-supported project in which we are “translating” this early assessment-intervention approach to actual community dental clinics. Indeed, these findings are in keeping with a seminal article on TMJMD treatment by Stohler and Zarb (1999), who made a plea for a “low-tech, high prudence therapeutic approach.”