Title: The Unseen Cost of Jaw Pain: How TMJ Disorders Affect Patients and the Healthcare System

Introduction:
Temporomandibular joint (TMJ) disorders are a common condition that affects millions of Americans, causing pain and stiffness in the face and jaw. While minor symptoms may not require treatment, severe symptoms can lead to disabling pain that makes it challenging to eat, work, talk, or sleep. This article explores the challenges faced by patients with TMJ disorders, including the lack of insurance coverage and the high cost of treatment.

The Story of Jonna Tallant:
Jonna Tallant, a 51-year-old woman from Knoxville, Tennessee, has spent over three decades living with TMJ pain. She has tried various treatments, including mouthguards, six sets of braces, dental crowns, drugs, physical therapy, Botox, massage, acupuncture, chiropractic care, and surgery. Despite spending over $200,000 on treatment, Tallant has only experienced temporary relief and now needs another jaw surgery, which could cost as much as $75,000. Her insurance is unlikely to cover the costs of the surgery.

The High Cost of TMJ Treatment:
The costs of TMJ treatment can be exorbitant, with patients often required to pay out-of-pocket for their care. According to the National Academies of Science, Engineering, and Medicine, many medical insurers consider TMJ treatment too dental-focused for medical insurance, while dental insurers consider it too medical for dental insurance, leaving patients stuck in a "medical-dental divide." The academies’ study found that the insurance coverage available for TMJ disorders often excludes the safest forms of care and steers patients toward surgery, a riskier and irreversible option.

The Unfair Burden on Patients:
Terrie Cowley, a longtime TMJ patient and advocate, said that patients with TMJ disorders are often forced to refinance their homes and cash out retirement accounts to pay for their care. Cowley emphasized that the financial burden of TMJ treatment can be devastating, with many patients facing bankruptcy or serious financial hardship.

The Science of TMJ Disorders:
TMJ disorders are a complex condition, with scientific studies suggesting that women are affected by TMJ disorders two to nine times as often as men. Researchers believe that TMJ disorders are caused by a combination of factors, including muscle and jaw joint problems, teeth grinding and clenching, and poor sleep quality.

The Need for Reform:
Reform is needed to address the financial and clinical challenges faced by patients with TMJ disorders. The American Board of Orofacial Pain recommends a conservative approach to TMJ treatment, focusing on counseling, dietary changes, medication, physical therapy, and removable dental splints. Unfortunately, insurance coverage for this specialty care is often patchy, poor, or nonexistent, leaving patients with limited options.

FAQs:

Q: What are TMJ disorders?
A: TMJ disorders are a group of conditions that affect the temporomandibular joint, causing pain and stiffness in the face and jaw.

Q: How common are TMJ disorders?
A: TMJ disorders are estimated to affect over 33 million Americans, with women experiencing the condition two to nine times as often as men.

Q: What treatments are available for TMJ disorders?
A: Various treatments are available, including mouthguards, braces, dental crowns, drugs, physical therapy, Botox, massage, acupuncture, chiropractic care, and surgery.

Q: What are the costs of TMJ treatment?
A: The costs of TMJ treatment can be high, with patients often required to pay out-of-pocket for their care. Treatment costs can range from a few hundred dollars to tens of thousands of dollars.

Q: How can patients access more affordable TMJ treatment?
A: Patients can access more affordable TMJ treatment by seeking out orofacial pain specialists, who use a conservative approach that focuses on counseling, dietary changes, medication, physical therapy, and removable dental splints. However, insurance coverage for this specialty care is often limited.

Conclusion:
TMJ disorders are a common condition that affects millions of Americans, causing significant pain and disability. Unfortunately, the financial and clinical challenges faced by patients with TMJ disorders are complex and multifaceted. By addressing these challenges, we can work towards providing better treatment options and more affordable care for patients affected by TMJ disorders.

Author: fortune.com

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