This project proposes one study with the goal of assessing whether patient self-provided {{professionally supervised}} low cost interventions are as effective and well received in reducing symptoms and improving physical findings associated wit TMD as more traditional and costly professionally delivered therapies. This study will measure both short-term and long-term outcomes. A randomized clinical trial will evaluate differences in treatment outcome for subjects who receive a standard treatment protocol without a splint (N=76) as compared with the standard treatment plus a low cost occlusal splint (N=76) versus standard treatment plus a laboratory constructed and professionally fitted splint (N=76). Subject TMD diagnosis will be established using the RDC-TMD diagnostic criteria {{ and those with RDC-TMD AXIS I (muscle-based) disorders (myofacial pain) and Axis II Chronic Pain grades I and II (no pain related disability) will be included in the study population.}} Subjects will be evaluated at baseline, at the completion of an 8 week intervention and at 6 and 12 month follow-ups, using shared measures to assess clinical status, pain, and satisfaction with the treatment protocol. The long range goal of this study is to assess whether most patients with TMD can be managed effectively on both a short and long- term basis with primarily self-directed, low cost interventions that result in lower health care cost and utilization.
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