R01_Pilot Jaw Muscle Phenotypes

Inclusion criteria

• Provide signed and dated informed consent form.
• Willing to comply with all study procedures and be available for the duration of study participation.
• Be 18 years or older.
• Have a minimum set of teeth present, be it natural, implant-supported or fixed prosthodontics: all anterior teeth (incisors, canines), at least one premolar, at least one molar (first or second molar; third molars not considered).
• TMD-Pain screener score equal to or greater than 3
• Myalgia (masticatory muscle pain) based on clinical exam following the DC/TMD protocol
• Concurrent arthralgia (TMJ pain) and/or headache attributed to TMD allowed
• Myofascial pain must meet the following criteria:

• Onset >3 months, occurring >15 days/month on average in the last three months from the screening session
• Minimum of 10 jaw pain episodes since onset, each episode lasting at least 30 minutes and no less than 2 hours within the day, OR unremitting

Exclusion criteria

• Traumatic facial injury or surgery on the face/jaw, arms or hands;
• Presence of pain related to dental and periodontal pathology;
• Currently undergoing active orthodontic treatment;
• Pregnant;
• Has any of the following medical conditions by self-report:

• Renal failure or dialysis,
• Heart disease (examples: uncontrolled arrythmia or hypertension, cardiomyopathy) or heart failure, Non-allergic bronchospasm (chronic obstructive pulmonary disease and emphysema),
• Diabetes (type I or II) that is not controlled with medication or diet,
• Hyperthyroidism,
• Uncontrolled seizures;
• Used any injection therapy (e.g., tender or trigger point injections, steroid injections), acupuncture, biofeedback, or TENS for the management of facial/jaw pain within 2 weeks prior to the screening assessment; If undergoing botulinum toxin injections in the head and neck area, must be 3 months since last set of injections and refrain from this treatment until study participation has ended
• History of major depression or other major psychiatric disorder requiring hospitalization within the last 6 months prior to the screening assessment;
• History of treatment for drug or alcohol abuse within the last 12 months;
• Current pain medication use (e.g., opioids, ibuprofen, acetaminophen) that cannot be stopped <24 hours prior to each study visit;
• Current use of medically prescribed muscle relaxants for the duration of study participation;
• Other conditions/diseases associated with altered pain perception: neurological or development disorders (dementia, autism spectrum disorder), neoplasm, multiple sclerosis, trigeminal neuralgia;
• Adults lacking capacity to provide informed consent for themselves;
• Unable to understand instructions for study procedures in English.
• Anything that would place the individual at increased risk or preclude the individual's full compliance with study procedures or completion of the study."